Atopic dermatitis is the most common form of eczema treated by allergists. Often when we ask the parents of children what they know about atopic dermatitis, they respond that it is “just really bad dry skin.” The reality is much more complex.
This disease is a chronic inflammatory skin disorder that is genetically transmitted in families and may affect up to 20 percent of children. It manifests as itchy, red, blistered, thickened skin that occurs often in areas of the body that are able to flex, like in back of the knee or inside of elbows.
The diagnosis is made by your allergist clinically, meaning only by history and physical exam. Atopic dermatitis primarily occurs due to barrier dysfunction (impairment in the skin’s ability to prevent penetration of external antigens), leading to excess water loss through the skin. Other factors may include decreased production of ceramides (waxy fatty substances naturally produced by your skin) and abnormal responses to bacteria that colonize the skin of a patient.
Successful treatment of atopic dermatitis is based on three principles:
- Hydration: As water loss through the skin is a major characteristic of this disease, moisturizing with a thick over-the-counter ointment is very important to healing old eczema patches on the skin and possibly preventing new ones.
- Topical Therapies: Prescription topical therapies have variable potencies, different methods of treating eczema symptoms, and limited availability for some patients. Coordinating with your allergist on the right medication for you can bring relief more quickly.
- Trigger Avoidance: Your allergist will use skin testing to identify food or environmental allergens that, if avoided, can improve the severity of your eczema symptoms.
However, now is an exciting time in atopic dermatitis research! New discoveries are being made about the nature of this disease every day. In just the past few years, the FDA approved two new therapies for the treatment of chronic atopic dermatitis, and more are on the way.