What is atopic dermatitis and how to treat it

Atopic dermatitis, also known as atopic eczema, is a chronic inflammatory skin disease that causes redness, itching and dryness. Although it is most common in children, it can also affect adults, frequently occurring in areas such as the hands and chest.

What is atopic dermatitis

Atopic dermatitis is a skin condition that manifests with periodic outbreaks of inflammation, causing intense itching and skin lesions. In adults, atopic skin can appear on various areas of the body, with the hands and chest being commonly affected areas. This condition is not contagious and is often related to other atopic diseases such as asthma or allergic rhinitis.

Symptoms

Symptoms of atopic dermatitis vary from person to person and may include:

• Intense itching: This is the most common symptom and can be severe, leading to constant scratching.

• Dry, flaky skin: The skin tends to be very dry, which can lead to flaking.

• Redness and inflammation: Areas of the skin become red and inflamed during outbreaks.

• Lesions: Oozing or crusting blisters may appear, especially if the skin is scratched.

• Thickening of the skin: Over time, the skin may become thicker and thicker.

In adults, commonly affected areas include.

• Hands: Atopic dermatitis on the hands is common due to constant exposure to irritants and frequent washing.

• Chest: Lesions on the chest can be particularly bothersome due to rubbing against clothing.

Causes

The exact cause of atopic dermatitis is not fully understood, but it is thought to be the result of a combination of factors.

• Genetic: A familial predisposition to atopic disease increases the risk of developing atopic dermatitis.

• Immunological: An overactive immune system may overreact to irritants or allergens, causing inflammation in the skin.

• Environmental: Factors such as cold weather, low humidity and exposure to irritants (soaps, detergents, chemicals) can trigger or worsen symptoms.

• Skin barrier disruptions: A defective barrier function in the skin allows moisture loss and entry of allergens and bacteria, contributing to inflammation.

Diagnosis

Diagnosis of atopic dermatitis is based primarily on.

• Medical history: the physician will collect information on symptoms, their duration, triggering factors and family history of atopic disease.

• Physical examination: The appearance and distribution of skin lesions will be evaluated.

• Complementary tests: In some cases, allergy tests may be performed to identify possible triggers or skin biopsies to rule out other diseases.

Treatment

Management of atopic dermatitis is aimed at controlling symptoms and preventing further flare-ups. Treatment options include.

• Moisturizing: Applying emollients and moisturizers several times a day helps restore the skin barrier and prevent dryness.

• Topical corticosteroids: Used to reduce inflammation and relieve itching during outbreaks.

• Topical immunomodulators: Medications such as calcineurin inhibitors may be prescribed to control inflammation in sensitive areas.

• Antihistamines: They may help reduce itching, especially if it interferes with sleep.

• Phototherapy: Controlled exposure to ultraviolet light may be beneficial in moderate to severe cases.

• Systemic therapies: In severe cases, oral or injectable treatments such as immunosuppressants or biologic agents may be considered.

It is essential to identify and avoid individual-specific triggers, such as certain foods, allergens or irritants.

When to go to the doctor

It is recommended to consult a dermatology or allergology specialist if.

• Symptoms significantly interfere with daily activities or sleep.

• Skin lesions show signs of infection, such as intense redness, pain, heat or oozing.

• Usual treatments are ineffective or outbreaks are frequent and severe.

• New affected areas appear, such as atopic dermatitis on the hands or chest, which had not previously been problematic.

Proper diagnosis and treatment are essential to control atopic dermatitis and improve the quality of life of those who suffer from it.

Reviewed by Dr. Santiago Guillé