Atopic dermatitis: where does it come from, what causes inflammation? Causes, symptoms, care.
Atopic dermatitis (AD for short) is a hereditary inflammatory disease, the symptoms of which affect both children and adults. It is also known as atopic eczema or eczema. The first symptoms of atopic dermatitis in children can be noticed during the first 5 years of life, and the disease can appear even in infants.
We can say that AZS is already a disease of civilization — The incidence of atopic dermatitis is highest in developed countries and is constantly growing. In this article, you'll learn about the origins of atopic dermatitis, can its causes be identified? What are the key symptoms? What really works for atopic dermatitis? Are wet dressings and petroleum jelly good skin care methods during a flare-up?
Where does atopic dermatitis come from: causes of the disease
Atopic Dermatitis is primarily "enemy of childhood", touching 10–20% of young patients, and this disease in most cases (60–90%) ceases before reaching the age of majorityDespite this, AD is still present in the adult population, affecting 2,1–4,9% of people [1]. Interestingly, in about a quarter of adult patients struggling with AD, symptoms appear as a completely new health problem (i.e. the patient did not suffer from this condition in childhood, and the first symptoms appeared only later in life).
Where does atopic dermatitis come from, what causes it? What factors determine the occurrence of this chronic disease?
Causes of atopic dermatitis
Instead of one simple causes of atopic dermatitis, we usually deal with complex interactions between several factors that together create "vicious circle of inflammation"Imagine your child's skin is a defensive wall. In atopic dermatitis, this wall is breached, and defense mechanisms become overly aggressive. Where does AZS come from, what causes it??
Experts point to four main causes — groups of disorders that overlap each other:
🔹 Epidermal barrier defect (i.e. the mentioned "leaky skin wall"): This is a key element and the main cause Skin problems. In patients with atopic dermatitis, the epidermal barrier is defective. This means the epidermis is unable to adequately protect the body from external factors or maintain proper hydration. When this "lipid barrier" is damaged, water loss and irritants and allergens can easily penetrate.
🔹 Genetic disorders: Susceptibility to atopic dermatitis is often inherited. An inherited genetic predisposition affects the structure and function of the skin.
🔹 Immunological disorders (overly aggressive alarm system): In patients with atopic dermatitis, the immune system is abnormally active, especially the Th2 system. This leads to excessive production of proinflammatory cytokines (such as IL-4 and IL-13), which fuel troublesome symptoms: inflammation and itching.
🔹 Microbiological disorders: This refers to disturbances in the skin's bacterial flora, or microbiome. Patients with atopic dermatitis are particularly susceptible to colonization (acquisition) or infection with a pathogen, most commonly Staphylococcus aureus.
Other causes? The development and course of atopic dermatitis are influenced by numerous factors. environmental and individual factorswhich cause exacerbation of inflammation and disease symptoms.
You already know where atopic dermatitis comes from and that the etiology of this disease is often complex. However, it's worth knowing that the disease proceeds with periods of exacerbation and remission (symptom relief) for several years and in most cases it disappears when the child reaches puberty.
What causes atopic dermatitis symptoms? Can food or inhalant allergies exacerbate atopic dermatitis?
The answer is clear: Yes, both food and inhalant allergies are the most common factors exacerbating atopic dermatitis. (AZS), which is crucial in conducting therapy and eliminating bothersome symptoms.
Expert advises
AD is often compared to the "atopic march" because it is the first step in the development of other allergic diseases, such as allergic rhinitis or bronchial asthma. In this complex process, the patient's immune system becomes hypersensitive – and this reaction manifests itself on the skin.
Causes of atopic dermatitis: food allergens and their relationship to the disease
Food allergens have the greatest impact on the skin of young children and infants. However, when we consider where does atopic dermatitis come from? and exacerbation of inflammation, we must be aware that the patient's age is of great importance in the context of allergens:
🔹 Infants and toddlers (up to 5 years of age):
Approximately 20–40% of the youngest patients with atopic dermatitis are diagnosed with a coexisting food allergy [1,2]. Clinical studies show that in approximately 50% of them, exacerbation of skin lesions occurs after consumption of allergenic foods. Most often, these are cow's milk proteins and chicken egg whites (so-called classic food allergens), as well as fish, peanuts, soy and wheat [1].
🔹 Older children, adolescents and adults:
In this age group, reactions to classic food allergens are less common. Exacerbations are often the result "allergic cross-reaction", caused by simultaneous allergy to plant pollen allergens (inhaled) and specific foods.
If the relationship between food hypersensitivity and atopic dermatitis is clinically confirmed, a temporary elimination diet is recommended, preferably in consultation with a doctor and an experienced dietitian.
What Causes Atopic Dermatitis? Inhalant Allergy: Adults' Main Enemy
How much do little children react? mainly for food, but in older children and adults it is airborne allergens are considered the most common cause of exacerbation of atopic dermatitis symptoms. The skin of people with atopic dermatitis, who are prone to allergic reactions (IgE-dependent), is very sensitive to airborne factors. From what? Exactly what inhalant factors exacerbate skin inflammation?
These allergens include:
- House dust mites
- Plant pollen
- Animal hair
- Molds
- Cockroaches and human skin
Once you know causes exacerbation of inflammation in atopic dermatitis, you may now be wondering what to do next, how to help your child?
Expert advises
Avoiding contact with specific allergens is essential in the treatment of atopic dermatitis. In patients whose skin is not adequately treated with topical treatments and whose allergy to inhalant allergens is confirmed by testing, the doctor may recommend allergen-specific immunotherapy (SIT). The best-documented clinical effects of SIT are achieved in patients allergic to house dust mites and pollen.
In summary: AD is a relapsing disease. To effectively control symptoms, it is necessary close cooperation with the doctor i avoiding identified exacerbating factors, which in individual patients may be both oral and inhaled.
AD: symptoms in infants and older children
The main symptoms of AZS are severe and persistent itching and dryness and roughness of the skin devoid of a hydrolipid coat.
Expert advises
In infants from 3 months of age and children up to 3 years of age, symptoms in the form of erythematous lesions, known as atopic eczema, most often appear on the cheeks, scalp, trunk, and extremities (primarily on the extensor side). Interestingly, atopic dermatitis in infants usually does not affect the skin under the diaper. In older children, skin lesions usually affect the inside of the elbows and knees, the neck, wrists, ankles, and around the mouth and eyes.
Constant itching of the skin forces the child to scratch, which leads to worsening of inflammation and bacterial infectionsmainly caused by Staphylococcus aureus bacteria (Staphylococcus aureus), resulting in skin changes in the form of scabs and oozing lesions.
You already know where atopic dermatitis comes from and what symptoms it causes, but due to the difficulties in diagnosing and differentiating skin diseases in children, we encourage you to read our article about symptoms of seborrheic dermatitis.
Atopic skin care: what about atopic dermatitis? Are petroleum jelly and wet dressings a good idea?
Proper care of atopic skin is not an addition to therapy, but pillar of treatment, essential in the everyday life of a sick patient. Let's look at two fundamental methods of supporting the skin in the course of atopic dermatitis.
What about atopic dermatitis? Emollients as the foundation of care.
Emollients are the basis of care for every patient with atopic dermatitisAlthough classic petrolatum, as one of the greasiest ingredients, is not the only solution, it perfectly illustrates the purpose of emollients – lubrication and sealing.
Why are emollients crucial + what can replace classic Vaseline?
🔹 Reconstruction of the lipid barrier (passive and active action):
Emollients, especially active ones (containing physiological fats such as ceramides, cholesterol and free fatty acids), are intended to reconstruct the lipid coat skin. In atopic skin care child's classic Vaseline (synthetic emollient), can be replaced with skin-friendly, natural and active emollients - in our other article you can read more about it emollients.
🔹 Reduction of itching and inflammation:
Moisturizing dry skin significantly reduces itching and supports the relief of inflammation. They also restore proper hydration of the epidermis.
🔹 Steroid-sparing effect (Steroid Sparring Effects):
Regular and systematic application of emollients (recommended 3-4 times a day) helps keep the skin in better condition, reduces the need and frequency of use of topical glucocorticosteroids (TCS).
Let us remember that a lasting improvement in the function of the epidermal barrier is achieved only after 2–4 weeks of systematic use emollients. In this article you will find more information about this, what about AZS works best – cosmetics for the care of skin with atopic dermatitis.
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Pharmacologist, Chief expert in the field of opinions on cosmetics, medical devices, washing and rinsing agents and biocides, Institute of Mother and Child
Atopic skin care: Whether and when to use wet dressings (Wet-Wrap Treatment) make sense?
Wet dressings (WWT) this intensive, short-term rescue therapy, used in crisis situations, not in everyday life atopic skin careHow they work wet dressings and when are they used?
- For whom:
This method is recommended especially for children aged 6 months to 10 years with severe atopic dermatitis (when the SCORAD index exceeds 50).
- Procedure:
The therapy involves the use of two layers: wet dressing soaked in emollient (or TCS in case of severe exacerbation) and on top of a dry layer. This method is carried out for 3–14 days under strict medical supervision.
- Key Benefits:
Wet dressings they evoke spectacularly good therapeutic effect (observed after a week). They work cooling, anti-inflammatory and antipruritic. Additionally, they create mechanical barrier protecting the child from unconscious scratching.
Expert advises
Caution should be exercised because the use of TCS under occlusion (wet dressing) increases the absorption of the drug, which in the case of long-term therapy may be associated with an increased risk of side effects, e.g. adrenal suppression.
To sum up, the topic,,Co for atopic dermatitis”: emollients are daily reinforcement for the skin barrier, while wet dressings are "emergency first aid kit" for severe and treatment-resistant exacerbations of AZS symptoms.
Bibliography:
- Nowicki RJ, Trzeciak M., Rudnicka L. et al., Biological drugs in the treatment of atopic dermatitis – recommendations of the Polish Dermatological Society, the Polish Allergology Society, the Polish Pediatric Society and the Polish Society of Family Medicine, "Alergologia Polska - Polish Journal of Allergology", 2020, volume 7, pp. 171-179
- Nowicki R., Trzeciak M., Wilkowska A. et al., Atopic dermatitis – current therapeutic guidelines. Expert opinion from the Dermatology Section of the Polish Society of Allergology and the Allergology Section of the Polish Society of Dermatology., "Progress in Dermatology and Allergology" (Postep Derm Alergol), 2015, XXXII (4)
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