6 Sept 2024
What is atopic dermatitis?
Atopic eczema is the most common chronic skin disease in children and often manifests in infancy with severe itching and inflamed skin. This blog post provides an overview of symptoms, causes, and treatment options for this condition and offers valuable tips for alleviating discomfort.
The Main Points at a Glance
Definition: Atopic dermatitis (atopic eczema, asthma eczema) is the most common chronic skin disease in children. Most affected individuals show symptoms from infancy.
Symptoms: Typical for neurodermatitis are severe itching and inflammatory, dry, and sometimes oozing or crusting skin changes. In infants, these primarily occur on the face and the extensor sides of the limbs. In childhood, they shift to the cubital fossae and popliteal fossae.
Cause: A combination of genetic, environmental, and immunological factors is considered the trigger for neurodermatitis. Approximately 70% of those affected suffer from an allergy-induced form.
Diagnosis: Medical history, physical examination, allergy test, blood test.
Therapy: Avoidance of triggering factors and basic therapy measures to build up the skin barrier. Additionally, urea-containing creams and washes should be used. Depending on the severity, corticosteroid preparations are prescribed.
Prevention: Tight clothing, silk, wool, and synthetic fibers should be avoided. The skin should always be moisturised with fatty ointments and creams.
Complications: Scratching can introduce germs into the skin and cause infections.
Prognosis: Unfortunately, neurodermatitis is not curable, but in most cases, it can be well managed or may resolve on its own.
Symptoms: What Symptoms Do Children with Neurodermatitis Have?
Characteristic of neurodermatitis is a severe itching. It is also marked by extremely dry, scaly, and leathery inflammatory skin changes, referred to as eczema. Sometimes, these even ooze and are covered with crusts. The itching is particularly strong at night and causes many children to have difficulties falling and staying asleep. Additionally, children tend to scratch intensely, further irritating the skin and leading to infections. The severity of symptoms varies from child to child. Moreover, the appearance of the condition changes with age.
Infancy: In over two-thirds of cases, itching and skin changes occur during infancy. In this age group, the face (especially the cheeks and scalp), the extensor surfaces of the limbs, and the trunk are primarily affected. Often, multiple areas are affected simultaneously. Usually, pronounced cradle cap on the scalp is an early sign of developing neurodermatitis.
Childhood: During childhood, especially the elbow creases and the back of the knees are affected. However, skin changes can also be found on the face, neck, and nape. Moreover, children with neurodermatitis often have “shiny nails” that occur as a reaction to scratching due to severe itching.
Puberty: During puberty, there is often an improvement in symptoms.
Did you know that our specialists at the ItchyMonsters are specialised in neurodermatitis in childhood?
Diagnosis: How Do Dermatologists Diagnose Neurodermatitis in Children?
The diagnosis of neurodermatitis is also made in children by dermatologists, specialists in skin diseases. They take a medical history (anamnesis) and examine the skin. Generally, the diagnosis of neurodermatitis can already be established as a visual diagnosis. If an existing allergy is suspected as the trigger, an allergy test is conducted. Additionally, a blood test can help distinguish between the allergic and non-allergic forms of atopic eczema. This test looks for antibodies (IgE antibodies) against specific allergens.
Cause: Why Do Children Develop Neurodermatitis?
Atopic dermatitis occurs more frequently in families, which suggests that genetic predisposition plays a significant role in its development. These genetic factors, combined with environmental and immunological factors lead to a malfunction of the skin barrier and the body’s immune system. Generally, a distinction is made between allergic and non-allergic neurodermatitis. 60-70% of those affected suffer from the allergic form, which can be triggered by substances such as pollen, pet dander, dust mites, and fragrances. In children, some foods, particularly cow's milk, eggs, soy, wheat, fish, hazelnuts, and peanuts, are included. Emotional stress, extreme climates, and hormonal fluctuations can also trigger flare-ups of neurodermatitis.
In about 40-60% of cases, there is a connection with other atopic diseases such as asthma and hay fever. Atopy refers to the hereditary tendency to develop hypersensitivity reactions.
Therapy: What Helps with Neurodermatitis in Children?
When treating atopic dermatitis, it is particularly important to avoid triggering factors and to build up the skin barrier with basic therapy measures. Gentle cleansing using urea-containing cleansing lotions and also urea-containing emollient care is important. If necessary, corticosteroid creams for local application may be prescribed. These relieve inflammation and reduce itching. It is important to follow medical instructions to avoid side effects. In case of an acute eczema flare, calcineurin inhibitors can be applied to the affected areas. Antihistamines may also be prescribed for itching.
