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Atopic Dermatitis

Atopic Dermatitis

What is atopic dermatitis?

Atopic dermatitis, also called eczema, is an allergic skin disorder that usually appears in babies or very young children, and may last until the child reaches adolescence or adulthood. Eczema causes the skin to itch, scale, and flake.

Parents with eczema are more likely to have children with eczema. Different triggers can make eczema worse, including stress, other allergies, and sweating. Of children who have eczema, 65 percent will show signs of eczema in the first year of life and 90 percent will show signs of eczema within the first 5 years.

Exzema occurs in approximately 10 percent to 20 percent of all infants. Of these children, nearly one half will improve as they grow and develop between the ages of five and 15 years. Other children may have some form of eczema throughout their lifetime.

What are the symptoms of eczema?

The location on the body that is affected by eczema tends to change with age. In infants and young children, the dry skin is usually located on the face, outside of the elbows, and on the knees. In older children and adults, eczema tends to be on the hands and feet, the front of the arms, and on the back of the knees. The following are the most common symptoms of eczema. However, each child may experience symptoms differently. Symptoms may include:

dry, scaly skin
small bumps that open when scratched
redness and swelling of the skin
a thickening and hardening of the skin (with chronic eczema)

Excessive rubbing and scratching can tear the skin and cause an infection. Some children only have a few episodes of flare-ups, while other children will have atopic dermatitis throughout adulthood.

The symptoms of eczema may resemble other skin conditions. Always consult your child's physician for a diagnosis.

How is eczema diagnosed?

Atopic dermatitis is very common. The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates that about 10 percent of infants and children have atopic dermatitis. Diagnosis is usually based on a physical examination and complete medical history. Diagnosis may also include the following:

family history (Children born to a mother who has allergic conditions are more prone to eczema.)
personal history of allergies or asthma
blood tests
skin tests

Treatment for eczema:

Specific treatment for eczema will be determined by your child's physician based on:

your child's age, overall health, and medical history
extent of the reaction
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the reaction
your opinion or preference

There is no cure for eczema. The main goal of treatment is to remove any irritants and decrease the amount of dryness and irritation.

Management of eczema symptoms:

The following are suggestions for the management of eczema:

Avoid contact with irritants, as determined by your child's physician.
Bathe your child more frequently, use moisturizers, and practice good skin care techniques.
Do not use harsh soaps. Ask your child's physician for a brand he/she would recommend that will not cause the skin to become further irritated.
Make sure your child's fingernails are short, as scratching may cause an infection.
Use lubricating lotions at least once a day. Ask your child's physician for a brand he/she would recommend that will not cause the skin to become further irritated.
Dress your child in light clothes - sweating can make eczema worse.

Your child's physician may also prescribe medications in severe cases. The following medications are most commonly used to treat eczema:

antihistamines - these medications help to decrease the amount of itching. Some examples are diphenhydramine (Benadryl.) or hydroxyzine (Atarax.). These medications may cause drowsiness. Some new antihistamines are also available that do not cause drowsiness. Consult your child's physician for more information.
steroid creams - these topical medications help to decrease the inflammation in the skin, thus, decreasing the itching and swelling. This helps with itching and swelling. Some examples are hydrocortisone ointments, mometasone (Elocon.), or triamcinolone (Kenalog.).
antibiotics


		Programs that treat this condition:

		Allergy Program
		Atopic Dermatitis Center
		Dermatology Program


					Children's Hospital Boston is the primary pediatric teaching hospital of Harvard Medical School

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