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Savannah Allergy Associates

Allergist - Guard Against Atopic Dermatitis Flare-ups

Atopic dermatitis or eczema is a long-term allergy-related skin disease with symptoms such as dry, itchy skin, and rashes on the face, inside the elbows, behind the knees, and on the hands and feet.  Scratching the skin can cause redness, swelling, cracking, and moist weeping followed by crusting and scaling.  The disease is intermittent and can recur after periods of remission.

Although atopic dermatitis is the most common form of eczema, the disease takes many forms including:

• Allergic contact eczema that is caused when the skin reacts to something the immune system recognizes as foreign like poison ivy.
• Contact eczema that results from contact with an irritant such as laundry detergent or cleaners.
• Dyshidrotic eczema that is indicated by blistering and irritation on palms of the hands and soles of the feet.
• Neurodermatitis-scaly patches on the head, lower legs, wrists or forearms resulting from a localized itch or insect bite
• Nummular eczema-coin-shaped spots of irritation that can be crusty and itchy.
• Seborrheic eczema-yellowish, oily, scaly patchs on the scalp, face, or other parts of the body.
• Stasis dermatitis-usually caused by poor circulation and localized on the lower legs.

Atopic dermatitis can occur in people of all ages, but tends to strike children and infants most often.  People who live in cities or in dry climates are also susceptible to it.  Current opinions suggest that the disease is caused by both genetic and environmental factors, and people who develop atopic dermatitis are also likely to experience allergies and asthma.

Diagnosing atopic dermatitis can be tricky as each individual has a unique medical history, and there are no simple tests.  Allergy testing, patch testing, and avoidance or elimination practices may help isolate the cause, however.  Some common causes include
• Irritants such as soaps, fragrances, and cleaners
• Cigarette smoke
• Foods such as soy, wheate, milk, fish, peanuts, and eggs
• Dust, mold, and pollen
• Clothing fibers

Stress, anger, and frustration can make the condition worse as can temperature, climate and secondary skin infections.  Other things that can cause dermatitis to flare include poor moisturizing after baths, low humidity in winter, dry climates year-round, excessively long or hot baths and showers, and bacterial infections.

Treatment plans for atopic dermatitis are individually tailored to each patient and should be carefully followed.  Patients should be alert to which products and measure work best for them.  In addition to topical skin creams, a physician may also prescribe oral medications, light therapy, and lifestyle changes.

Adapted from Coping with Allergies and Asthma, Winter 2006 Edition.

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