Atopic dermatitis (AD) is one type of eczema, a group of allergic-inflammatory skin conditions. Most children will develop the condition within their first year. Around 80% of children will outgrow their eczema in adolescence or adulthood. However, a large number of people may experience symptoms into adulthood.
Takeaways:
- – Atopic dermatitis is the most common form of eczema. It is an uncomfortable, inflammatory skin condition that is common in babies and children and is characterized by a dry and compromised skin barrier.
- – Foods, personal care product dyes and perfumes, clothing material, extreme temperatures, and environmental allergens are potential triggers.
- – A genetic mutation in filaggrin, the protein that determines skin barrier function and moisture, is present in about 50% of those with severe AD.
- – AD requires the consistent application of possibly a variety of treatments to manage the condition. Examples include moisturizing, food, perfume, and dye avoidance, wearing loose, cotton clothing, and using a combination of over-the-counter and prescription medications and topical ointments.
The severity of eczema or atopic dermitis is multi-factorial. It appears that it is heavily influenced, however, by three factors: genetics/family histories, urbanization, which changes the balance of microorganisms within the environment, as well as environmental triggers, such food proteins.
What is atopic Dermatitis?
Eczema is a family of allergic-inflammatory itchy, rash skin conditions, of which atopic dermatitis is the most common. Atopic dermatitis affects one in ten children, and is caused by the skin’s reduced ability to retain water. AD is often characterized by redness, itching and dry patches.
AD and eczema are difficult skin conditions to treat. Eczema can be the beginning of a process called the atopic marche.
This progression is defined:
- Eczema;
- Allergies to food
- Allergic rhinitis, also known as hay fever
- Asthma.
What foods can trigger atopic dermatitis and eczema or make it worse?
The risk of AD and eczema is increased when oral exposure to food allergy proteins does not occur first, or does not occur in conjunction with skin exposure. The main food triggers are eggs, dairy products, soy, grains, nuts, shellfish and seafood. Children with atopic skin dermatitis who do not have IgE-mediated allergies to food can still be affected by exposure to these foods. Extreme temperatures, environmental allergens, and body care products/chemicals/scents are also associated triggers. Any of these triggers may contribute to periods of worsened symptoms, known as flare-ups.
About 50% of people with severe AD have mutations in the filaggrin gene, the primary protein that is involved in skin barrier and moisture. When the skin barrier is compromised antigens (molecules or foreign particles) from food or environment can more easily penetrate the barrier. This triggers an immune response.
Atopic Dermatitis: Tips for improvement
AD is often treated repeatedly and consistently to achieve improvement. AD is characterized by dry skin, a compromised barrier to the skin that allows antigens into the skin. Tips for managing AD include removing triggers, improving your skin barrier, and reducing histamine and inflammation. Recommendations may vary depending on the severity of the condition, genetics and risk factors.
After 4-6 weeks of an elimination diet, remove common food triggers like egg, dairy products, soya, wheat and nuts. This will allow you to track your progress. Working with your healthcare provider, learn how to gradually and methodically reintroduce food to determine individual triggers and tolerance.
After a shower or bath, apply moisturizer on all skin areas within 3 to 5 minutes to lock in moisture.
Do not use antibacterial soaps or harsh soaps to wash your hands. These can cause skin irritation.
Moisturize the skin twice daily.
A humidifier in the bedroom will increase the moisture content of the air.
Applying Wet Wraps on severe patches
Use only personal care and household items approved by the National Eczema Association , or, at least, avoid dyes and perfumes in personal care products.
Use OTC creams or prescription ointments only as directed by your doctor.
Other treatments may be recommended by some practitioners, such as cryotherapy and phototherapy.
Avoid wearing synthetic materials or clothing with heavy textures.
Antihistamines can reduce allergic reactions.
It is important to avoid IgE-mediated allergy for as long as possible or until your physician recommends that you do otherwise.
Atopic dermatitis, a skin condition that is common among children and adults, can be uncomfortable. There are many factors that influence the severity and frequency of symptoms. However, some foods such as dairy products, eggs, wheat soy, nuts, and wheat can be known triggers. Improve AD requires a multi-faceted approach that includes removing triggers, such as certain foods, improving skin barrier and moisture and reducing inflammation.
Resources
- Cleveland Clinic. Atopic Dermatitis.
- Immunity, inflammation, and disease. Hygiene practices: Are they protective factors for eczema symptoms?
- National Eczema Foundation. What is Eczema?
- National Eczema Society. Children and Eczema.
