atopic dermatitis


What is atopic dermatitis (AD)?

            Atopic dermatitis, which is sometimes called atopic eczema or hereditary eczema, is a very common, itchy, sensitive skin condition that runs in certain families.

            AD may flare up at times of stress or during the change of seasons, or it may just appear for no obvious reason. The problem frequently goes away by itself, but it may return in adolescence or adulthood and possibly turn out to be a lifelong problem.

Who gets it?

            You, your child, or other family members may have one or more of the following symptoms in addition to the skin rash: dry, sensitive skin; allergies to medications, pollen, dust, house dust mites, ragweed, dogs, or cats; or other problems such as persistent runny nose, sinusitis, sneezing attacks, or chronic itchy or irritated eyes. Any one of these symptoms helps to suggest that atopic dermatitis is the hereditary cause of the chronic skin rash.

            Although most cases begin in childhood (often in infancy), atopic dermatitis may start at any age and has an unpredictable course.

How is AD treated?

Topical steroids

            The main treatment for atopic dermatitis is topical steroids. They are safe if used as directed and should be applied only for short periods of time, if possible, and only for active disease (i.e., itching and redness).

They are applied once or twice daily and should be used with caution, on areas such as the eyelids, underarms, and genitals.

 Topical steroids should be stopped when the skin is healed, and they should not be used to prevent future rashes.


Non-cortisone topical treatments


 Immunomodulators such as tacrolimus ointment and pimecrolimus cream, which contain no steroids, are sometimes prescribed in certain circumstances.


Other treatment measures


          Oral antihistamines such as hydroxyzine or diphenhydramine and chlorpheniramine probably won’t reduce          itching, but they can be helpful if they bring about drowsiness or sleep.

Thoroughly mixing ___tsp. or _____cup of household bleach (“bleach baths”) in bath water will help reduce the incidence of bacterial infections. (That’s what is used to chlorinate swimming pools.)

Infrequently, oral steroids or antibiotics may be necessary.


Is there a cure?


No, but it can be kept under control, and sometimes it clears up by itself for long periods of time and sometimes permanently!


How is AD prevented?


 Avoid or lessen exposure to possible trigger factors such as dry skin, irritants, harsh soaps, overheating, sweating, and allergens.

Apply moisturizers, particularly in the dry winter months, immediately after bathing, to “trap” water in the skin. Suggested products include__________or__________.

                 Use barrier creams such as _____________________, which may work better than simple moisturizers in             preventing atopic dermatitis.