Under the recommendation of dermatologist, Dr. Paulo Morais, live well with your skin.
Have you ever heard of Atopic Dermatitis or Eczema?
If you're still not sure what we're talking about, know that Atopic Dermatitis has even been on the cover of VOGUE magazine! The initiative in the fashion magazine sought to highlight and challenge stigmas and prejudices related to this skin condition, which in addition to affecting appearance, this chronic inflammatory disease, carries the wrong stigma of being contagious and reflecting a supposed lack of care.
Atopic Dermatitis is a complex narrative, where genetics, environmental factors and the propensity to allergies intertwine, influencing not only the skin, but also everyday life. So this is not just an article about red spots and itching, but about the importance of daily care, early prevention and proper treatments to improve the health of your skin.
Atopic eczema: a skin mystery
The skin is our greatest shield against the world, the largest organ of the human being. But what happens when the skin revolts? Imagine an incessant itching that mainly affects the little ones, but also the adults. This is atopic eczema.
Our skin needs the right amount of "natural moisturisers". Normal skin produces an oily film to protect itself, while atopic skin does not. This function is known as the "skin barrier" or "barrier function" of the skin. But if this is compromised, the dryness of the skin can lead to allergies and irritable states, creating red spots and itching (eczema).
Eczema affects 15 to 20% of children under the age of 7, with rates increasing every year. It may disappear around the age of 5, but for some, it is a persistent visitor well into adolescence and adulthood. Genetics and allergy propensity come into play, affecting 10 to 20 percent of the population.
Eczema doesn't just stay on the skin, it interferes with quality of life. How? It affects school, sleep, self-esteem, causing frustration and anxiety.
How do I know if I have Atopic Dermatitis? Symptoms and Characteristics
Here are the most common symptoms for you to identify:
- Extreme dryness of the skin
- Itching and redness
- Inflammation of the skin
- Scales or scabs
- Pain
- Fissures and desquamation of the dermis
- Changes in skin color
- Appearance of blisters or vesicles
- Irritation and redness around the eyes
- Increased sensitivity to irritating products or elements.
If you experience any of these symptoms, you may be suffering from atopic skin. However, if you have any doubts, we recommend consulting a dermatologist to resolve them and indicate the appropriate treatment.
Prevention from Childhood and Innovative Strategies
Itching, better known as itching, becomes an irritating cycle. It is, therefore, necessary care and strategies to substantially reduce the likelihood of eczema, such as using emollients in the first weeks of life or to break this cycle quickly and effectively, such as resorting to soothing thermal water frequently.
The numbers highlight the need for awareness, but finding a doctor who understands this condition well is a challenge. In this context, we reinforce our confidence in this fight and count on Dermatologist Dr. Paulo Morais to explore the universe of atopic dermatitis, better known as atopic eczema, and discover strategies to keep our skin happy and healthy.
- Why do some people have eczema from a young age? What is the most appropriate treatment in these cases?
Although it can manifest at any age, atopic eczema usually appears in childhood, starting in the first year of life in 60% of children and in the first 5 years of life in approximately 90% of cases. The development of the disease in young children results from the interaction between genetic predisposition, epidermal barrier defects, immune dysfunction, alteration of the skin microbiome, and environmental triggers.
The general principles of the treatment of atopic eczema in this age group, which should be transversal to any age, include the improvement of the skin barrier, elimination of triggering factors, active education and participation of patients and families, and treatment of inflammatory lesions.
Moisturizers should be applied daily to improve skin barrier function, increase hydration, reduce xerosis, itching, and inflammation, and decrease the need for anti-inflammatory agents. They should contain few ingredients, well-tolerated preservatives and be free of fragrances and sensitizers.
The bath should be short and in warm water, and bath oils, syndets or soaps with physiological pH, mild and hypoallergenic should be used. To control the exacerbations of the disease, low or medium potency dermocorticoids or topical calcineurin inhibitors may be necessary. In severe forms, topical therapy should be combined with systemic medications.
- What is the relationship between bacteria on the skin and eczema?
One of the characteristics of atopic eczema is cutaneous dysbiosis, with loss of bacterial diversity, with an increase in some bacteria on inflamed skin and a reduction in the density of others. A typical feature is increased colonization by Staphylococcus aureus, which is found on injured skin in more than 90% of patients. The amount of S. aureus increases in the composition of the skin microbiome during flare-ups, and the severity of eczema lesions is associated with the density of colonization by this bacterium on the skin. S. aureus plays an important role in the pathogenesis of the disease, producing different types of toxins (superantigens) capable of inducing and maintaining a chronic inflammatory reaction. Therefore, measures to reduce colonization by this bacterium are essential, decrease the severity of the disease and correlate with clinical improvement.
- Is there a difference between the treatment of eczema in babies, children and adults?
Treatment of the patient with atopic eczema should be individualised and therefore should take into account variables such as the patient's age, ability to adhere, patient preferences, extent of the disease, location and type of lesions, the presence (or not) of superinfection, comorbidities and response to previous treatments. Taking into account the safety and route of administration of the drugs and the characteristic variability in the morphology and distribution of lesions in different age groups, it is clear that the treatments performed on a baby are different from those performed on an adult.
- In addition to topical treatments, what are the main recommendations that can relieve the discomfort caused by atopic dermatitis?
In addition to topical medications, which are useful in crises, basic and discomfort-relieving measures are essential, including:
a) daily application of moisturizer immediately after bathing (at least twice a day), and products with additional soothing/soothing action may be used;
b) use of loose, light, unlabeled, cotton or fiber mixed with soft cotton clothing, and it is not recommended to use rough, synthetic or wool fabrics directly on the skin;
c) Avoidance of cosmetics containing alcohol, fragrances or astringents and bath products that are aggressive, drying or make too much foam;
d) use of a humidifier at home to maintain air humidity and maintain a moderate temperature;
e) avoidance of extreme temperatures, rapid temperature changes, hypersweating and exposure to environmental pollution, tobacco smoke, dust, sand and chlorine;
f) reduction of emotional stress and anxiety.
- Are there any new treatments for eczema that not only relieve symptoms, but also help prevent recurrences?
New topical substances, oral or injectable treatments for atopic eczema are currently available or being studied, which allow the patient to be free of symptoms and recurrences in a more effective and lasting way. Topical phosphodiesterase-4 inhibitors and topical Janus kinase (JAK) inhibitors, as well as promising new systemic treatments such as injectable immunobiologicals and oral JAK inhibitors, are emerging therapies.
We have accumulated experience with tacrolimus ointment which, after treatment of eczema exacerbation (reactive treatment), can be used twice a week prophylactically to prevent recurrence (proactive treatment).
On the other hand, the disciplined and daily application of moisturizer throughout the integument is an essential strategy in the prevention of eczema flare-ups. In addition, a new generation of products called "bioactive moisturizers", which incorporate substances with the ability to improve the skin barrier, rebalance the skin microbiome and relieve inflammation, itching and xerosis, can be an asset in warding off the aggravations of the disease.
- In addition to affecting the skin, eczema can also influence the emotional state. How should parents deal with children and adolescents to ensure their well-being?
If we consider the complexity of atopic eczema, its chronicity, symptoms and therapy, its association with behavioral, emotional, self-esteem and sleep changes in affected children becomes noticeable, as well as with a negative impact on the quality of life of patients and their families.
In families with children with eczema, the ability to cope is a determining factor in the non-development of significant family disruption, requiring the parents' ability to: a) understand the suffering, discomfort or physical and emotional discomfort that the disease may cause; b) develop supportive and affectionate relationships with their children; c) offer emotional support and encourage open communication about feelings; d) deal confidently with children's behavioral problems; e) encourage the hydration and hygiene care routine; f) ensure adequate clothing, food and an environment free from disease triggers; g) provide access to support groups, psychotherapy, behavioral therapy techniques, and/or relaxation techniques. These measures contribute to the successful management of the disease in the long term and to maximising the well-being of affected children and adolescents.
Certified Solutions, Professional Guidance, Commitment to Health
While there is no cure for atopic skin, there are dermatitis treatments that help manage symptoms and prevent flare-ups. By offering clinically tested products, SweetCare offers certified solutions and access to personalized care, under the professional guidance of pharmacists, that go beyond aesthetics, meeting the specific dermatological needs of each one. Also read here for auxiliary articles in the management of atopic eczema.
Discover the La Roche-Posay products indicated for skin with atopic dermatitis at SweetCare. LIPIKAR is Europe's number 1 range of hygiene and body care products for sensitive, very dry and atopic eczema-prone skin.