What is eczema or atopic dermatitis?
Eczema or atopic dermatitis is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long-lasting (chronic) and tends to flare periodically. Often, atopic dermatitis disappears as a child grows older, though some children will have atopic dermatitis flares into adulthood.
According to the National Eczema Association, people with atopic dermatitis are more likely to develop other diseases. Often called “comorbid conditions,” the most common of these include asthma ,hay fever, other forms of eczema such as seborrheic or contact dermatitis, staph infections, and depression.
The study also showed that both children and adults with atopic dermatitis were at an increased risk for developing attention deficit hyperactivity disorder (ADHD). This risk was further increased among people with AD who also had certain other conditions, such as asthma or insomnia.
What are the types of eczema?
All types of eczema cause itching and redness, but atopic dermatitis is the most severe and chronic type of eczema. Other types of eczema include:
- Hand eczema
- Contact dermatitis, which occurs only when the skin makes contact with certain substances
- Dyshidrotic eczema, a blistering form of eczema that’s found on the fingers, palms, and soles of the feet
Doctors and researchers are working to better understand how eczema works and why it affects so many people. There’s currently no known cure for this common disease.
What causes eczema?
Eczema is caused by poorly functioning skin barrier properties. This may be due to a mutation in the gene called filaggrin. Normally, every cell in the skin has two copies of the filaggrin gene. However, people who are susceptible to eczema only have one copy of this gene.
Once the skin barrier is disrupted, skin is unable to retain moisture, and becomes dry and scaly. Environmental allergens such as pollen or animal dander, irritants and bacteria can also enter the skin and activate the immune system. This causes inflammation that makes the skin red and itchy.
What triggers eczema?
Some things make eczema more likely to appear. These include:
- Contact with irritants such as smoke, dust, chemicals, even water
- Allergens, such as plant pollen, animal dander, and dust mite proteins
- Heat, which can aggravate the itch and make affected people more likely to scratch
- Allergic reaction to particular foods, although this is rare. Food allergy typically causes redness and swelling around the lips within minutes of eating the offending food.
What are the symptoms?
Atopic dermatitis is chronic, meaning it does not usually go away in a few days or weeks. It might get better or worse but the symptoms typically return. The physical effects of eczema can include:
- Skin dryness
- Red and scaly areas on the front of the elbows and the back of the knees
- Watery fluid weeping from affected skin
- Itchiness
- Lesions (sore patches) that may become infected by bacteria or viruses
How is eczema or atopic dermatitis diagnosed?
Identifying atopic dermatitis (eczema) doesn’t need a lab test. A physician will likely make a diagnosis by examining your skin and reviewing your medical and family history. You doctor may use skin prick testing to determine if you have environmental allergies contributing to poorly controlled symptoms. Lab tests or biopsy are sometimes used to rule out other skin diseases or identify other conditions that may cause similar symptoms.
When you suspect a certain food is causing your child’ s rash, tell the doctor and ask about identifying potential food allergies.
What are the complications of atopic dermatitis?
People with atopic dermatitis or eczema have compromised skin defense that sometimes leads to secondary infections. The psychological effect of a chronic skin condition may further affect your quality of life.
- Bacterial and fungal skin infections. Cracked and broken skin exposes your skin to bacteria and fungi. The risk is higher if you scratch your eczema or treatments when used incorrectly.
- Viral skin infections. Reduced skin defenses also increase the risk of viral infection. One example is the herpes simplex virus, which normally causes cold sores. This can develop into a condition called eczema herpeticum.
- Psychological effects. A survey from National Eczema Association showed that more than 30% of people with atopic dermatitis were also diagnosed with depression and/or anxiety. One explanation for why people with inflammatory skin diseases like eczema are more susceptible to mental health issues may be impaired body – brain communication during an inflammatory response.
Learning your triggers and taking good care of your skin, will reduce the frequency and severity of atopic dermatitis flare-ups. You and your allergist can work together to find a combination that works for you. Please call Dr. Amy Schiffman, allergist in Boca Raton, Florida at (561) 409-2800, to discuss your skin and allergy needs.