An acute flare-up of atopic dermatitis is a particularly challenging time for you as parents and for your child. The skin becomes red, inflamed, and itches intensely – and in many cases, the flare-up is very unpleasant for your child. In such moments, quick help is required. With the right treatment, the flare-up can be alleviated quickly, and the itching stopped. In this article, you will learn everything you can do to help your child quickly and ease the flare-up.

What happens during an atopic dermatitis flare-up?

An atopic dermatitis flare-up occurs when the skin is suddenly irritated and inflamed by substances that are usually harmless, such as pet hair or pollen. The itching and burning can be particularly distressing for your child. 

The triggers for flare-ups can be diverse. And every child is different. That's why it's important for you to try to find out what triggers an acute flare-up in your child. This way, you have the chance to better avoid future flare-ups.

What can triggers for atopic dermatitis flare-ups be?

Allergens: Pet hair or skin flakes (e.g., from cats or dogs) or environmental influences (e.g., pollen, dust mites) can trigger allergic reactions.

Stress: Emotional stress or psychological burdens can exacerbate symptoms or trigger a flare-up.

Weather conditions: Extreme temperatures, particularly cold and dry air, can dry out the skin and intensify symptoms.

Skin irritations: Irritants such as harsh soaps, perfumes, or certain fabrics (e.g., wool) can irritate the skin and exacerbate inflammation.

Infections: Viral or bacterial infections (e.g., with Staphylococcus aureus) can worsen the condition of the skin and lead to a flare-up.

What helps during an acute flare-up of atopic dermatitis?

As soon as a flare-up begins, it's important to act quickly to alleviate inflammation and stop itching. Your dermatologist will usually prescribe anti-inflammatory creams or ointments. Sometimes, shampoos for the scalp are also used.

The two main groups of medications that help during an acute flare-up are corticosteroid creams and corticosteroid alternatives such as calcineurin inhibitors.

Corticosteroids – A proven treatment option for inflammation
Corticosteroid creams are a very effective method to quickly relieve inflammation and effectively stop tormenting itching. They specifically target the inflammatory reactions in the skin, providing noticeable relief often after a short time. There are corticosteroid creams of various strengths that can be individually adjusted to the severity of the flare-up – your dermatologist will choose the appropriate strength for your child. Parents often feel concerned when they hear that their child needs a corticosteroid cream – but this concern is unfounded today. Modern corticosteroid preparations are very safe when used correctly and are specifically developed for the gentle treatment of sensitive skin.

The corticosteroid alternatives: Calcineurin inhibitors
Calcineurin inhibitors are a good alternative to corticosteroids, especially for sensitive areas of skin such as the face or genital area. They also have anti-inflammatory effects like corticosteroids – but are steroid-free. Calcineurin inhibitors are well-tolerated and suitable for long-term use. Another advantage: they can not only be used during an acute flare-up but also for prevention (proactively) to reduce inflammation and keep the skin stable and free of symptoms in the long term.

Parent checklist: What to do during an atopic dermatitis flare-up?

Here is a brief checklist to help you treat the flare-up quickly:

1. Apply treatment as prescribed
   Apply the prescribed cream or ointment thinly to the affected areas according to the doctor's instructions – not too thick and only for as long as necessary.

2. Don't forget basic therapy
   Continue to use your emollient base cream daily to strengthen the skin barrier and care for and soothe the skin between flare-ups.

3. Alleviate itching
   Try to prevent your child from scratching! Help them distract themselves, for example, with games, cuddling, or a soothing cream. Cotton gloves can also help keep itching at bay at night.

4. Avoid irritants
   Use fragrance-free care products and ensure your child wears soft, breathable clothing that doesn't further irritate the skin.

   
   

Conclusion – With the right treatment, manage the flare-up quickly

An acute flare-up of atopic dermatitis can be very burdensome for your child and for you. But with the right treatment, you can quickly alleviate the flare-up. Whether with a corticosteroid cream or a corticosteroid alternative: Your dermatologist is the best person to consult to find the appropriate therapy for your child.

Sources

1. AWMF (2024). S3 Guidelines on Atopic Dermatitis. 

2. mein-allergie-portal.com (2022). Treat or prevent atopic dermatitis flare-ups?