Atopic Dermatitis

Atopic dermatitis or commonly called as atopic eczema is a condition where the skin of the child turns red and itchy. It is commonly seen in infants and young children but in some it can persist even up to teenage and later years of life.

What are the common symptoms and signs of atopic dermatitis?

The most common feature of atopic dermatitis is a dry itchy skin. Because of constant itching the skin can get thickened, cracked and scaly. The skin can get red to brownish-gray patches or small, raised bumpy areas which leak fluid and get crusted (image 1). The common areas to be involved are the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of elbows/knees, and in infants, the face and scalp as shown in the image 2.

What are eczema flares?

Children with atopic dermatitis can have times when the skin turns red, hot, burning, crusted or “weepy” and more itchy. These phases are called as flares. They are similar to asthma attacks in children. The areas in the body which are more prone to flares are the hands, feets, back of elbows/knees and neck.

Are food allergies the cause of atopic eczema?

In some children atopic dermatitis and food allergies are related. In children with severe infantile eczema and poor response allergy to milk and egg should be considered.

How can I keep the skin of my child healthy?

The two basic principles are avoiding skin irritants and keeping skin well hydrated.

Avoid things that irritate your baby’s skin, such as: strong soaps, perfumes, woolen clothing directly on skin, sudden changes of temperature and excessive sweating (image 3)

Make your baby bathe in luke warm water with a very mild soap or a non-soap cleanser as described in image 4. After bath, gently pat skin dry (avoid rubbing the skin) to keep it moist or slightly wet. Apply moisturizer right away on the wet skin to retain the moisture. This is called as ‘Soak and Seal Technique’ as shown in image 5.

What should I do when the skin flares up?

During times of flares the child would need a steroid cream to be applied in addition to the moisturizer. Remember that their are many types of steroids available ranging from very mildly potent to super potent. Milder steroids are used for face which moderate are preferred for the rest of the body. This needs to be decided by your doctor.

What are the complications of Atopic Dermatitis in children?

The most common complication of atopic eczema is a bacterial skin infection. Children with atopic eczema have a cracked and broken skin. This increase the risk of the skin getting infected with bacteria. With superadded bacterial infections the skin becomes more red, hot, swollen, sore and develops oozing of pus. Early treatment with topic or oral antibiotic is required in such situations. Bleach baths can be quite helpful in children getting frequent skin infections (image 6)

The other common complications are viral skin infections such as herpes viral infections. Apart form these various other complications are seen such as sleeping problem because of excessive itching, poor self confidence, psycological issues and bullying in school.

Do you have an Eczema Action Plan?

This is a written one-page document which provides key information on how to treat your child as the eczema changes. It provides information on the daily bathing advice and moisturizer to be used, what to do when their is a flare and when to consult your doctor. Every child with atopic eczema should have an eczema action plan!