Atopic Dermatitis

Atopic dermatitis is a chronic (long-lasting) disease that affects the skin. It is not contagious; it cannot be passed from one person to another. The word “dermatitis” means inflammation of the skin. “Atopic” refers to a group of diseases in which there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever. In atopic dermatitis, the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking, “weeping” clear fluid, and finally, crusting and scaling. In most cases, there are periods of time when the disease is worse (called exacerbations or flares) followed by periods when the skin improves or clears up entirely (called remissions). As some children with atopic dermatitis grow older, their skin disease improves or disappears altogether, although their skin often remains dry and easily irritated. In others, atopic dermatitis continues to be a significant problem in adulthood.

Atopic dermatitis is often referred to as “eczema,” which is a general term for the several types of inflammation of the skin. Atopic dermatitis is the most common of the many types of eczema. Several have very similar symptoms. 

 

Cause

Despite the fact that atopic dermatitis is very common, no one knows exactly what causes it. Researchers believe that people with atopic dermatitis are genetically more prone to having immune reactions, and that coming into contact with an irritant "triggers" their extra-sensitive skin to react.

The "triggers" could be things that are applied to the skin (e.g. the perfumes or preservatives in some skin creams), things that the skin comes into contact with (e.g. chlorine, pet dander, pollen) or things that are eaten (e.g. nuts, shellfish).

Atopic dermatitis is often made worse by the "vicious cycle" that develops when inflamed skin is scratched, making it even more inflamed and itchy, and causing more scratching.

Studies conducted in identical twins suggest that genetics play a major role in the development of atopic dermatitis. In one study, the identical co-twins of the person with atopic dermatitis (i.e. the siblings who shared 100% of the same genes) were seven times more likely to develop atopic dermatitis relative to the general population.
Recent research has led to the discovery that eczema may be linked to immune system problems. When individuals suffer with immune system problems it basically means that their own immune system is attacking itself.

That said, environmental factors also play an important role in the development of atopic dermatitis; just because a person has atopic dermatitis does not mean that their children certainly will.
Researchers there think that a second skin barrier structure, consisting of cell-to-cell connections known as tight junctions, is also faulty in eczema patients and likely plays a role in the development of the disease.

Treatment

The doctor has two main goals in treating atopic dermatitis: healing the skin and preventing flares. These may be assisted by developing skin care routines and avoiding substances that lead to skin irritation and trigger the immune system and the itch-scratch cycle. It is important for the patient and family members to note any changes in the skin’s condition in response to treatment, and to be persistent in identifying the treatment that seems to work best.

 

Treatment for atopic dermatitis includes topical steroid creams, antihistamines, and immunotherapy, eating healthy, eliminating irritants, and topical non-steroid solutions. Atopic dermatitis creams help with itching, inflammation, and the dryness associated with the rash.

Antibiotics to treat skin infections may be applied directly to the skin in an ointment, but are usually more effective when taken by mouth.

Moisturizing frequently helps with the itching and dryness associated with atopic dermatitis. The best time to apply a moisturizer is right after bath time when the skin is still wet.

Controlling Atopic Dermatitis:

·        Prevent scratching or rubbing whenever possible.

·        Protect skin from excessive moisture, irritants, and rough clothing.

·        Maintain a cool, stable temperature and consistent humidity levels.

·        Limit exposure to dust, cigarette smoke, pollens, and animal dander.

·        Recognize and limit emotional stress.

Cradle Cap

Some babies, in the very first few months of life, may experience a general scaliness and redness around the scalp area. The scales may be oily and yellow in color. It may also appear as red or slightly pinkish crusted patches. This condition is known as "cradle cap" and is pretty common in brand new babies.

If the redness and scaliness also occurs on the baby's face, behind the ears, on the forehead or eyebrows and/or in the diaper area, the condition is labeled as seborrheic dermatitis. For most babies, cradle cap will heal by itself within a few months without any special treatments. Most experts believe that cradle cap does not cause any itching or discomfort to a baby.

Cradle cap is very common in babies younger than eight months. It is likely to appear during baby's first three months, and it can linger for weeks or months. The reason for this is that in babies the condition typically remits after 6-8 months, but in adults the problem is almost always chronic and will just tend to relapse and remit while it worsens over time. Older babies and toddlers can also get cradle cap. Although the condition can look unsightly. If the scaliness and redness spread to the face, neck or armpits, or even the diaper area, doctors call cradle cap "seborrheic dermatitis".

Cause

Cradle cap is the result of overactive glands in baby’s scalp – they secrete too much oily discharged, which accumulates into patchy areas and then flake off once it’s dried.

It’s caused by hormones that are passed from mother to baby during childbirth. Once the hormones level out, baby’s cradle cap will disappear.

Treatment

Most standard anti-fungal shampoos, topical steroids, and topical treatments such as selenium sulfide and pyrithione zinc typically only provide temporary relief because they are not addressing the root cause of the problem.

The scalp can be washed regularly with a mild baby shampoo - that is one with the least amount of potential irritants. Brushing with a soft brush can help to remove the scales.
Some people suggest the use of small amounts of baby oil which if rubbed on to the affected areas may help to soften the scales which can then be removed more easily with a fine toothed comb. This treatment needs to be done very gently otherwise it can worsen the condition and bring about temporary hair loss.

Applying Vaseline liberally overnight is another popular treatment. The softened scales either fall off during the night or can be brushed off in the morning.
Another suggestion is applying a paste made from sodium bicarbonate (baking powder) which is left on for 10 minutes.