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

What are aeroallergens?

Some allergens are called aeroallergens because they are present in the air. They may also play a role in atopic dermatitis. Common aeroallergens are dust mites, pollens, molds, and dander from animal hair or skin. These aeroallergens, particularly the house dust mite, may worsen the symptoms of atopic dermatitis in some people. Although some researchers think that aeroallergens are an important contributing factor to atopic dermatitis, others believe that they are insignificant.

No reliable test is available that determines whether a specific aeroallergen is an exacerbating factor in any given individual. If the doctor suspects that an aeroallergen is contributing to a patient's symptoms, the doctor may recommend ways to reduce exposure to the offending agents. For example, the presence of the house dust mite can be limited by encasing mattresses and pillows in special dust-proof covers, frequently washing bedding in hot water, and removing carpeting. However, there is no way to completely rid the environment of aeroallergens.

What are home remedies for atopic dermatitis?

Treatment involves a partnership between the doctor and the patient and family members. The doctor will suggest a treatment plan based on the patient's age, symptoms, and general health. The patient and family members play a large role in the success of the treatment plan by carefully following the doctor's instructions. Some of the primary components of treatment programs are described below. Most patients can be successfully managed with proper skin care and lifestyle changes and do not require the more intensive treatments discussed.

Skin care: A simple and basic regimen is key. Staying with one recommended soap and one moisturizer is very important. Using multiple soaps, lotions, fragrances, and mixes of products may cause further issues and skin sensitivity.

Healing the skin and keeping it healthy are of primary importance both in preventing further damage and enhancing the patient's quality of life. Developing and following a daily skin-care routine is critical to preventing recurrent episodes of symptoms. The key factor is proper bathing and the application of an emollient to the wet skin without towel drying. Generally, an effective emollient is a reasonably stiff ointment or cream (one that does not move out of an opened inverted jar). People with atopic dermatitis should avoid hot baths and showers. A lukewarm bath with a capful of chlorine bleach (Clorox) helps to cleanse and disinfect the skin. The doctor may recommend limited use of a mild bar soap or non-soap cleanser because soaps can be drying to the skin. Oatmeal baths are often helpful. Red, irritated areas can be treated with 1% hydrocortisone cream (two to three times a day), which can be obtained at most pharmacies and does not require a physician's prescription.

Once the bathing is finished, apply an emollient immediately without towel drying. This restores the skin's moisture and inhibits the evaporation of water, increasing the rate of healing, and establishing a barrier against further drying and irritation. Lotions generally are discouraged because they have a high water or alcohol content and evaporate quickly. Creams and ointments work better at healing the skin. Tar preparations can be very helpful in healing very dry, lichenified areas. Whatever preparation is chosen, it should be as free of fragrances and chemicals as possible.

Another key to protecting and restoring the skin is taking steps to avoid repeated skin infections. Although it may not be possible to avoid infections altogether, the effects of an infection may be minimized if they are identified and treated early. Patients and their families should learn to recognize the signs of skin infections, including tiny pustules (pus-filled bumps) on the arms and legs, appearance of oozing areas, or crusty yellow blisters. If symptoms of a skin infection develop, the doctor should be consulted to begin treatment as soon as possible.

Treating atopic dermatitis in infants and children

  • Give lukewarm baths.
  • Apply an emollient immediately following the bath.
  • Keep a child's fingernails filed short.
  • Select soft cotton fabrics when choosing clothing.
  • Consider using antihistamines to reduce scratching at night.
  • Keep the child cool; consider a humidifier.
  • Learn to recognize skin infections and seek treatment promptly.
  • Attempt to distract the child with activities to keep him or her from scratching.
Medically Reviewed by a Doctor on 12/21/2016

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