Why does atopic dermatitis appear?
In children with atopy, the skin produces less proteins and fats that retain moisture. Because of this, the top layer becomes loose, evaporates water and allows germs, dust particles and detergent residues to enter. The immune system responds to this with inflammation, and the inflamed skin itches even more - a vicious circle of “itching - scratching - new inflammation” arises. The disease is triggered by a combination of heredity and environment, so it cannot be cured by diet alone.
- Hereditary feature of the skin barrier
- Dry air, heat, overheating and sweating
- Soap, bubble bath, hard water
- Wool, synthetics, rough seams on clothes
- House dust, animal hair, mold
- Teething, infections, family stress
What does a rash look like on a baby?
In the first months of life, the rashes are usually symmetrical and located on the cheeks and forehead, while the skin around the mouth and nose remains clear. Later, the outer surfaces of the arms and legs join, and after a year the rash moves to the elbow and popliteal folds. The skin looks red, covered with small blisters, becomes wet and dries out in crusts, and remains dry and rough between exacerbations. The child rubs his face on the pillow, worries when changing clothes and wakes up at night.
- Redness and peeling on the cheeks and forehead
- Weeping and crusting during exacerbation
- Dry, rough skin between flare-ups
- Itching, restless sleep, scratching
- The area around the mouth is usually free
Nutrition and other provocateurs
Food allergies occur only in some children with atopic dermatitis, so broad diets “just in case” are harmful: they impoverish the diet and do not improve the skin. A product is considered guilty only when the reaction is reproduced: after its use, complaints arise over and over again, and when eliminated, they go away. A nursing mother does not need complete restrictions either. Much more often, exacerbation is associated with household reasons - overheating, dry air in winter and frequent washing with soap.
- Check a suspicious product with your doctor, rather than rule it all out at once.
- Keep the room cool and humid
- Bath daily in warm water without soap, 5–10 minutes
- Do not use bubble baths or hard washcloths.
- Wash baby clothes with a fragrance-free detergent and rinse well
- Keep your nails short to reduce damage from scratching.
Diagnostics
The diagnosis is made by a doctor based on the appearance and location of the rash, the nature of the itching, age of onset and family history; There is no specific test to confirm atopic dermatitis. The examination is needed for something else: to exclude similar diseases and to find concomitant allergies if complaints indicate it. A general blood test and determination of total IgE complete the picture, and allergy panels and skin tests are prescribed selectively, because a positive result in itself does not mean intolerance to the product.
- Examination of the skin and assessment of severity
- General clinical blood test
- General IgE and specific IgE according to indications
- Children's food allergy panel for suspected allergies
- Skin scraping if scabies or fungus is suspected
- Food diary for recurring reactions
Skin care and treatment
The main daily measure is emollients: emollient creams are applied generously and several times a day, always immediately after bathing on damp skin. They restore the barrier and significantly reduce the frequency of exacerbations. For inflammation, the doctor adds local anti-inflammatory drugs for a short course; when used correctly, they are safe, and refusing them out of fear leads to prolonged itching and scratching. Antihistamines do not help everyone, and systemic treatment is prescribed only for severe cases. The doctor always selects the regimen.
- Emollients daily, even when the skin looks clean
- Local anti-inflammatory drugs as prescribed by a doctor
- Mild detergents without alkali and fragrances
- Cotton clothes, cool humid air in the room
- Treatment of associated infection as prescribed by a pediatrician
- Refusal of untested folk remedies and herbal baths when getting wet