Atopic dermatitis: explanations and advice from our experts

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As parents, it is important for you to understand what is happening with your child's skin. Our experts tell you everything you need to know to better manage this chronic disease.

DERMATOLOGIST

Dr Stepanka Capkova
Czech Republic

As Dr Capkova summarises, Atopic eczema is the most common chronic and inflammatory skin disorder in children in developed countries. It is a long-term or recurrent skin disease which affects mainly infants, children and youth.

DERMATOLOGIST

Dr Michaela Duchonova
PhD, Dermatologist, Slovak Republic

Dr Duchonova adds that the disease reduces quality of life over the long term, leaving an impact on the entire family.

Atopic eczema is the most common chronic and inflammatory skin disorder in children in developed countries

Hypersensitivity of the skin

Dr Capkova explains, “The skin and mucous membrane of a patient suffering from atopic eczema are genetically more sensitive to various substances that are naturally present in our environment. These substances enter our bodies through the skin, by breathing, or through our digestive tract. In an atopic patient, they come into contact with an immune system that is "out of tune", reacting in a hostile and strident manner. The biochemical processes in their skin as well as the nervous reflexive processes in their body occur in a slightly different manner. An atopic patient reacts differently to food, and their skin reacts to regular stimuli (which are or are not allergens) coming from the environment inside or outside of their body in an uncommon, strange and exceptional way.”

Atopic skin characteristics

Three symptoms that characterise atopic children's skin, as cited by Dr Duchonova, are dry skin, itching and inflamed sites (reddening, peeling, swelling, weeping skin and scabs…). As a result, skin poorly performs its barrier role, as shown below.

Dealing with atopic eczema

The real issue is that you have to manage your child's atopic dermatitis. As stated by Dr Duchonova, “What is most important is that parents cooperate with professionals, communicate and share their experience and everyday problems to keep atopic eczema under control.” Dr Capkova shares this point of view. “Treatment is not just based on drugs,” she clarifies, “but is composed of a set of measures.”

Treatment 'strategy': four key points according to Dr. Capkova

1. Regular moisturising with emollient creams and ointments is the basis for atopic eczema treatment.

2. 'Emergency brakes': Traditional topical corticosteroids are used to manage acute flare-ups of eczema symptoms.

3. Prevent further flare-ups by correct skin care, observing trigger factors and limiting exposure to them.

4. Influence the course of the disease over the long term through preventive care, a suitable diet and lifestyle, and systematic treatment.

No 'universal miracle cure'

Dr Capkova explains. “As atopic eczema is a disease based on genetic predisposition, current medicine cannot rid the eczema-prone patient of the disease completely. However, most symptoms ease or disappear on their own with age. There is no “universal miracle cure”. However, keeping the course of eczema “under control” is possible with well-informed parents and careful adherence to preventive and curative measures. This requires great patience, observing and eliminating individual triggers and worsening factors, as well as putting the atopic patient on a suitable diet. The results of proper skincare are visible only after several weeks or even months. Often several treatments and procedures have to be tried, but the parents, in proper cooperation with a paediatrician and a dermatologist, usually find the “right” cure for their child.”

The parents, in proper cooperation with a paediatrician and a dermatologist, usually find the “right” cure for their child.

Key points to remember

• Three symptoms: very dry skin, itching, local inflammation.

• The skin is hypersensitive to potential allergens.

• Moisturising is vitally important to strengthening the skin's barrier function.

• It's possible to control atopic eczema using appropriate preventive and curative measures.

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