Atopic Dermatitis is a skin disease that affects between 2-5% of adults and as many as 10-20% of children globally. It is a chronic, long-term condition characterised by dry, flaky, irritable skin and occasional flare-ups with more distressing symptoms. While there’s no known cure, regular and consistent skin care can protect skin.

What is Atopic Dermatitis?

Atopic Dermatitis – also known as Atopic Eczema – is a chronic skin disease that affects the skin on the face and body of babies, children and adults.

Incidences are on the increase, particularly in the Western world, with a two- to three-fold increase in reported cases than there were 30 years ago. There is no conclusive cause known for Atopic Dermatitis but there is evidence of links with both asthma and hay fever.

The disease mainly affects children – 10-20% of children globally are affected – while 2-5% of adults have the condition.

In adults the rash tends to affect the neck and décolleté, the inside of elbows, back of knees, hands and feet, as well as the face and scalp. Symptoms and affected areas are slightly different when it comes to children and babies.

People with Atopic Dermatitis often experience additional problems – such as lack of sleep, stress, discrimination and a lack of self-confidence. As well as maintaining a good skin care routine, there are certain lifestyle changes that can alleviate the symptoms – such as wearing cotton clothing, keeping temperatures low to avoid sweating and avoiding trigger foods.

Graphic illustration of skin. — 1. Impaired skin barrier function facilitates the invasion of microorganism 2. Activation of immune cells, inflammation 3. Itch

Woman´s back with infected skin. — Affected areas vary from person to person. Typical symptoms are dry, flaky and irritable skin.

Potential causes and triggers of Atopic Dermatitis

Dermatologists have yet to discover a definitive cause for Atopic Dermatitis, nor a cure. However, there is evidence of a number of factors that make some people more at risk than others. These include:

Genetics. There is a proven link between Atopic Dermatitis, asthma and hay fever. If one or both parents suffer from one of these conditions, there is a chance that their child will develop Atopic Dermatitis. The risk increases proportionally so if both parents have all three conditions, the chance of the child inheriting the disease goes up.
Climate/location. Cold climates put people more at risk of Atopic Dermatitis, as do polluted cities. There is evidence that Jamaican children brought up in London are twice as likely to develop Atopic Dermatitis as their peers in Jamaica.
Gender. Females are slightly more prone to Atopic Dermatitis than males.
Mother’s age. Children born to mothers late into their childbearing years are at a higher risk than those born to younger mothers.

Mother and child cuddling. — Atopic Dermatitis can be genetically inherited. Parents suffering from it or asthma or hay fever may hand it down to their child.

Middle-aged woman´s face. — Women, in general, are more prone to Atopic Dermatitis and even their age of giving birth can be crucial.

Atopic skin lacks natural moisturizing factors (NMF´s), such as amino acids, and has impaired barrier lipid formation. This makes the skin barrier weak and underlying layers prone to infection caused by nails scratching through the skin surface.

The symptoms of Atopic Dermatitis are also the triggers. Because skin is dry and itchy, sufferers scratch. By scratching, they disturb the skin barrier function. This leaves underlying layers exposed and vulnerable to infection from the environment. The bacteria causes irritation and so the itching continues. This is known as the Atopic Skin Cycle.

Further contributing factors

Other influences that can aggravate existing symptoms, although different people have different triggers, include:

food allergies – eg. milk, cheese, nuts, shellfish
alcohol allergies
allergies to house mites, pollen and/or dust
abrasive or non-breathable fabrics – eg. wool and nylon
nickel – a common metal found in jewelry and watches.
formaldehyde
certain washing detergents – often labeled ‘biological’
stress
sleep deprivation
sweat
cigarette smoke

Read more about factors that influence skin.

Woman wearing a cotton pullover. — Cotton in clothing, amongst others, is recommended- it´s soft and comfortable. Wearing cotton gloves for the night, for example, prevents scratching during sleep.

Controlling the symptoms of Atopic Dermatitis on the body

There is no known cure for Atopic Dermatitis but there are a number of ways that sufferers can help to care for their atopic skin and perhaps even prolong the periods between flare-ups.
The most important is keeping skin constantly moisturized with emollients.

Emollients

Emollients (also known as moisturizers) must be applied daily, regardless of symptoms. These lotions, face creams, shower oils and bath additives keep skin supple and moist, and therefore less susceptible to itching and damage. Regular use of emollients helps to reduce itching.

Ingredients often found in formulas of emollients include:

Ceramide 3 replenishes the skin’s natural protective barrier and Colloidal Oatmeal helps relieve the itching due to eczema.
Licochalcone A (an extract of the licorice root reduces redness due to dryness.

Dermatological treatments

Flare-ups require more intensive care with acute creams being added to the daily moisturizing routine. These topical creams often contain hydrocortisone.

Corticosteroids (such as hydrocortisone) are known to be effective and fast-acting in alleviating itching and reducing inflammation. However, it does have some drawbacks. For example, prolonged use can thin skin.

For that reason it’s not sustainable in the long term, nor is it ideal for use on babies and children.

Woman applying cream on her left leg. — Topical acute creams are often needed when flare-ups appear. As those creams may contain hydrocortisone, the long-term usage is not recommended.

Daily personal care for Atopic Dermatitis on the body

Although triggers vary from person to person, there are quite a few lifestyle changes that sufferers have found to be effective:

Keeping room temperatures and humidity low to avoid sweating.
Wearing clothes that are soft next to the skin. Cotton is comfortable and can be layered in the winter. Scratchy textures, such as wool, and non-breathable fabrics like nylon are best avoided.
Keeping skin care products in the fridge as cool creams help alleviate itchiness.
Writing a diary, noting any triggers that cause flare-ups.
Taking holidays in cool to moderate climates – not too hot or too cold.
Washing new clothes before wearing them to remove irritating dyes and fabric finishers.
Wearing cotton gloves at night to prevent scratching during sleep.
Wet wrap’ therapy can help reduce itch and lessen the desire to scratch (speak to your dermatologist for more information).
Taking showers rather than baths, but never too hot (<32°) and not too often or too long.
Limiting bath times to no longer than 5-10 minutes.
Always using bath oils (or shower oils) as these have a lipid refreshing, caring effect.
Avoiding any harsh sponges or massage brushes in the bath or shower.
Doing mediation and yoga to relieve stress.

Woman in a relaxed pose with cocked leg. — Cotton in clothing, amongst others, is recommended - it´s soft and comfortable. Wearing cotton gloves for the night, for example, prevents scratching during sleep.

Woman after shower, wrapped in a towel, towel turban on her head. — Showers are better than baths, as long as they are not too expanded and not hotter than 32°.