Atopic Dermatitis

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideEczema (Atopic Dermatitis) Causes, Symptoms, Treatment

Eczema (Atopic Dermatitis) Causes, Symptoms, Treatment

How can people prevent and avoid aggravating factors for atopic dermatitis?

Patients with atopic dermatitis should limit exposure to environmental and chemical factors known to cause exacerbations. These include dry skin, quick changes in temperature, the low humidity encountered during cold weather, and wool clothing.

What are skin irritants in patients with atopic dermatitis?

Irritants are substances that directly damage the skin, and when used in high enough concentrations for long enough, cause the skin to become inflamed. Soaps, detergents, and even water may produce inflammation. Some perfumes and cosmetics may irritate the skin. Chlorine and alcoholic solvents, dust, or sand may also aggravate the condition. Cigarette smoke may irritate the eyelids.

Common irritants

  • Wool or synthetic fibers
  • Soaps and detergents
  • Some perfumes and cosmetics
  • Substances such as chlorine, mineral oil, or solvents
  • Dust or sand
  • Dust mites
  • Cigarette smoke
  • Animal fur or dander
  • Flowers and pollen

Are food allergies important in atopic dermatitis?

Allergens are substances from foods, plants, or animals that provoke an overreaction of the immune system and cause inflammation (in this case, the skin). The importance of food allergy in atopic dermatitis is controversial. Although not all researchers agree, most experts think that breastfeeding the infant for at least four months may have a protective effect for the child. New lines of evidence even support exposing young children to normal environmental contaminants such as peanuts. Although such exposures may prevent the development of atopic dermatitis, there is no consensus on how to prevent the development of atopic diseases.

If a food allergy is suspected, it may be helpful to keep a careful diary of everything the patient eats, noting any reactions. Identifying the food allergen may be difficult and require supervision by an allergist if the patient is also being exposed to other allergens. One helpful way to explore the possibility of a food allergy is to eliminate the suspected food and then, if improvement is noticed, reintroduce it into the diet under carefully controlled conditions. A two-week trial is usually sufficient for each food. If the food being tested causes no symptoms after two weeks, a different food can be tested in like manner afterward. Likewise, if the elimination of a food does not result in improvement after two weeks, other foods may be eliminated in turn.

Changing the diet of a person who has atopic dermatitis may not always relieve symptoms. A change may be helpful, however, when a patient's medical history and specific symptoms strongly suggest a food allergy. It is up to the patient and his or her family and physician to judge whether the dietary restrictions outweigh the impact of the disease itself. Restricted diets often are emotionally and financially difficult for patients and their families to follow. Unless properly monitored, diets with many restrictions can also contribute to nutritional problems in children.

Medically Reviewed by a Doctor on 12/21/2016

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