Atopic Dermatitis: Treatments, Triggers, and Nutrition Tips

Congratulations, a baby is born. There's nothing quite like a new baby—the chubby cheeks, sweet sounds, and soft, delicate skin.

Not for everyone. Between 10-20 percent of infants worldwide suffer from a condition known as "atopic dermatitis," commonly referred to as "skin asthma" or "atopic eczema."

(Not) Nice to Meet: What is Atopic Dermatitis?

Atopic dermatitis is an inflammatory skin condition. It can occur at any age but is most common in children—90% of atopic dermatitis cases are detected by age 5, with 65% appearing within the child's first year.

Atopic dermatitis mainly features a reddish rash appearing on the skin. In infancy, it typically appears on the face, scalp, elbows, and knees. During childhood, it is mainly found on the neck, elbow and knee folds, and generally within the body's folds.

The causes of atopic dermatitis are unclear, though it is believed to be an autoimmune phenomenon, meaning abnormal immune system activity combined with some disruption in the skin's integrity, affecting its ability to protect the body. The rash sometimes experiences flare-ups, leading to inflammatory wounds, primarily due to itching—because the rash is very itchy.

Atopic dermatitis is not a dangerous disease and is not contagious, but it can impact the quality of life due to persistent itching, wounds, and inflammations that could worsen. Extreme cases might see the rash appearing all over the body, which poses a risk of fluid loss and impaired body temperature regulation—though these are relatively rare extremes.

As mentioned, atopic dermatitis is most common in childhood. In half the cases, the disease will subside after a few years, but in the other half, the skin issues persist into adulthood.

(Photo illustration: shutterstock)

Diagnosis: How Do I Know I Have Atopic Dermatitis?

The diagnosis of atopic dermatitis is relatively simple, despite there being no single test to distinctly indicate it. A specialist in dermatology can easily diagnose the condition by interviewing the patient—or their parents—and examining the rash. Diagnosis is made when the rash spreads in regions typical of atopic dermatitis, with lesions appearing with characteristics of the condition, and there is significant itching.

Additionally, atopic dermatitis usually appears with other allergic diseases. So when such diseases are present, it strengthens the diagnosis of atopic dermatitis. A family history of various allergic diseases, atopic conditions, asthma, etc., may also strengthen the diagnosis since there are visible genetic factors influencing it.

Moreover, in certain cases, adults can also develop atopic dermatitis. In these cases, a dermatologist will diagnose the condition through additional symptoms, such as dry skin covered with scales, open skin wounds, or yellowish, pus-filled crusts. In adults, atopic dermatitis sometimes also manifests as cracks behind the ears, which aids in precise diagnosis.

I Have Atopic Dermatitis. What's Next?

The treatment for atopic dermatitis is divided into two main types: prevention and actual treatment. Prevention involves eliminating factors that worsen the disease. It is recommended to dress the baby or child in 100% cotton garments, in light clothing that does not cling to the skin. Tight or synthetic clothing may worsen the rash and itching. It's also advisable to keep cleaning agents, perfumes, and other products that could irritate the skin away from the child.

There are various factors that adversely affect the development of lesions, and it is advised to stay away from them as much as possible. Perfumed soaps may exacerbate the formation of the rash and lesions, as can laundry detergents, shampoos, and different cleaning agents. It is best to avoid contact with these substances as much as possible—opt for unscented soaps, and use gloves when dealing with cleaning agents (for adults, of course). Hot and dry weather can worsen the symptoms, as can sweat. Therefore, as mentioned, it's essential to ensure wearing light and breathable clothing and taking frequent baths.

(Photo illustration: shutterstock)

Bacterial or viral infections in the body could worsen the state of atopic dermatitis. Therefore, it's essential to quickly treat such infections if they occur. Psychological stress also negatively impacts the disease, so it's important to try to remain calm, possibly seeking mental or emotional support as needed. If atopic dermatitis occurs alongside other allergies, it's critical to be aware that consuming allergenic products could also exacerbate the development of lesions.

Moreover, the prevention of lesion development and the soothing of existing rash and itching can be achieved by consistently moisturizing the skin with a dedicated fragrance-free moisturizer. Current studies show that regular moisturizing of an infant's skin may prevent the development of atopic skin inflammations and other allergic disorders. It's also recommended to bathe the baby or child daily with lukewarm water containing bath oil. After bathing, gently pat them dry without rubbing the skin.

When there's an actual outbreak of atopic dermatitis, with worsening rash and lesions, they require actual treatment. Treatment involves several medication types: In the case of itching, various medications can help soothe the skin; if there are inflammatory lesions with a potential bacterial infection, appropriate antibiotic ointments can be used, and in severe cases—oral antibiotic treatment may be necessary. Regular outbreaks of lesions can be managed with steroid-containing medications and ointments. These ointments calm the itching and prevent inflammation development. However, prolonged use of such medications can lead to significant side effects, so they should be used only under the precise guidance of a dermatologist. There are also certain types of ointments that do not contain steroids, which may assist in treating lesions in sensitive areas, like body folds or eyelids, and can be used for an extended period.

In severe cases of atopic dermatitis, and when regular treatment is insufficient, phototherapy—light therapy—is an option. Additionally, sometimes treatment includes medications that suppress the immune system or biological treatments intended to disrupt the biological mechanism of inflammation development.

The treatment is similar at any age—in infants, children, and adults.

Nutrition: What Should I Eat if I Have Atopic Dermatitis?

Studies show that a poor diet adversely affects disease development, as does obesity. Therefore, it's particularly important for children and adults suffering from atopic dermatitis to maintain a balanced and healthy diet. As mentioned earlier, atopic dermatitis often appears alongside other allergic diseases or various food allergies, so it's essential to monitor these accompanying symptoms and avoid foods that cause allergies.

It's recommended to base the diet on whole grains instead of white flour, avoid sugar as much as possible, especially white sugar, and increase the intake of vegetables and fruits, and dietary fibers. It's also recommended to incorporate probiotics into the diet, through foods like yogurt or dietary supplements. In fact, taking probiotics during pregnancy and breastfeeding may prevent the development of atopic dermatitis in a baby.

(Photo: shutterstock)

There are various types of complementary medicine treatments that can help in cases of atopic dermatitis. Homeopathy may be effective for treating atopic dermatitis when specifically tailored to the patient. Another common alternative therapy is homotoxicology, a method using natural remedies that help the body eliminate toxins from the digestive system and skin.

As mentioned, stress significantly impacts the disease's state, so it's important to address such situations if they occur by receiving appropriate mental support, reducing stress as much as possible, engaging in calming physical activity, and more.

Finally, one subject that should receive attention, especially in children, is the social aspect. The lesions associated with atopic dermatitis can be prominent and unpleasant, something that might discourage other children. Children and educational staff might also fear that these lesions are contagious. It is crucial to support the child socially and educate the educational staff at kindergarten or school about the disease and its symptoms. If possible, it is also helpful to talk to the children in class or kindergarten, explaining the disease and its symptoms, and emphasizing that it is not contagious. This approach can ease the child's social burden and help them overcome any embarrassment they may have.