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Atopic dermatitis is a chronic, relapsing disease characterized by dry skin, rashes, and itching. It occurs in both adults and children and can occur at any age.
The name of the disease has historically changed and was previously known as constitutional eczema, atopic eczema, neurodermatitis, and Besnier's prurigo. However, recently, the term atopic dermatitis has become established in the medical community.
Atopic dermatitis is hereditary and is most often associated with a genetic defect in the synthesis of the protein filaggrin. Atopic dermatitis is significantly more common in children in families where one or especially both parents suffer from allergic diseases, such as allergic rhinitis and bronchial asthma.
With atopic dermatitis, the skin's barrier function is primarily affected. Damage to the epidermal barrier (hydrolipid mantle) can be triggered by various factors, both genetic and environmental, leading to changes in the composition of epidermal lipids and a deficiency of proteins responsible for cell-cell communication, resulting in a noticeable decrease in skin hydration. Irritants such as dust, pollen, hygiene products, pathogens, and house dust mites can penetrate vulnerable areas of the skin and cause a flare-up of atopic dermatitis or worsen its course. Due to the violation of the epidermal barrier and changes in the pH of the skin, various proteins and bacterial toxins penetrate deep into the dermis, pathogenic microflora is activated, the so-called microbiome changes, which, in turn, also negatively affects the course of the disease.
One of the most common complications of atopic dermatitis is the addition of a secondary infection - streptococci, staphylococci, yeast-like and mold fungi.
Causes of exacerbation of atopic dermatitis
Triggers (triggers) of an external and internal nature play a special role in the exacerbation of an existing disease. External triggers include: - Unfavorable environmental conditions (not necessarily the presence of pollutants, but even just high humidity, sudden temperature changes, wearing synthetic clothing, pollen and food allergens). - Dietary errors, especially excessive consumption of fast carbohydrates and gluten-containing products (even if gluten intolerance has been ruled out in the laboratory). Internal environmental triggers are most often pathologies of the gastrointestinal tract (pancreatitis, gastritis and cholecystitis), endocrine system, past infectious diseases, and nervous and mental stress. Also, one of the risk factors for the development of atopic dermatitis is the unreasonable and often uncontrolled use of drugs, which is associated with the availability of a huge number of over-the-counter pharmacological agents on the Russian market.
Symptoms of Atopic Dermatitis
The main symptoms of atopic dermatitis are rashes and itching. The rash appears and can last for a long time on the flexor surfaces of the arms and legs, the back of the hands, the upper chest, and around the eyes. With a long course of the disease, thickening and darkening of the skin (lichenification) occurs at the sites of these rashes, cracks appear, sometimes not healing for a long time without additional treatment.
Outside of an exacerbation of atopic dermatitis, the skin is always dry, flaky in the area of the flexor surfaces of the arms and legs; shiny flesh-colored papules are often present; cracks and a median fissure of the lower lip appear; cracks in the lower edge of the attachment of the auricle. Itching can often be so severe that scratching occurs, which results in wounds and ulcers, which in turn can become infected with microorganisms and worsen the situation.
Outside of an exacerbation of atopic dermatitis, the skin is always dry, flaky in the area of the flexor surfaces of the arms and legs; shiny flesh-colored papules are often present; cracks and a median fissure of the lower lip appear; cracks in the lower edge of the attachment of the auricle. Itching can often be so severe that scratching occurs, which results in wounds and ulcers, which in turn can become infected with microorganisms and worsen the situation.
Diagnosis of atopic dermatitis
Diagnosis of the disease is based on allergy tests and a general blood test. Allergy testing is an integral part of diagnosing atopic dermatitis and is performed using skin testing (skin allergen tests) and determination of specific IgE antibody levels. Increased permeability of the skin barrier makes the skin vulnerable to allergens, toxins, and irritants, which trigger an abnormal immune response. This typically involves T-helper cells type 2 (Th2)—cells that enhance the adaptive immune response. They lead to the production of interleukins (IL-4, IL-5, IL-13), which activate B lymphocytes, which produce immunoglobulin E (IgE), which triggers the allergic reaction. As a result, the number of eosinophils in the peripheral blood increases, which protect the body from allergens. An additional criterion is association with respiratory allergy - this is allergic rhinitis and bronchial asthma.
How to distinguish atopic dermatitis from other, at first glance, similar skin diseases
For example, patients very often confuse atopic dermatitis with seborrheic dermatitis. With the latter, rashes are located on the scalp, seborrheic areas of the face, the skin is most often oily (in contrast to atopic dermatitis), there is an abundant amount of crusts and scales.
With allergic dermatitis, redness of the skin of the trunk, upper and lower extremities looks like spots or small red or purple papules.
Psoriasis appears as limited plaques, raised above the surface of healthy skin, on the trunk, which are located on the extensor surfaces of the arms and legs. The plaques are covered with silvery waxy scales, and when scraped, they manifest specific skin symptoms (psoriatic triad).
In case of fungal infection, laboratory diagnostics and detection of fungal mycelium from the rash play a key role. But this is not always possible, since a long-term rash can become infected with microorganisms.
Unlike seasonal skin changes, manifested by peeling and dryness, with atopic dermatitis, red spots with peeling, nodules (papules) appear, sometimes weeping areas and eczema may occur.
With allergic dermatitis, redness of the skin of the trunk, upper and lower extremities looks like spots or small red or purple papules.
Psoriasis appears as limited plaques, raised above the surface of healthy skin, on the trunk, which are located on the extensor surfaces of the arms and legs. The plaques are covered with silvery waxy scales, and when scraped, they manifest specific skin symptoms (psoriatic triad).
In case of fungal infection, laboratory diagnostics and detection of fungal mycelium from the rash play a key role. But this is not always possible, since a long-term rash can become infected with microorganisms.
Unlike seasonal skin changes, manifested by peeling and dryness, with atopic dermatitis, red spots with peeling, nodules (papules) appear, sometimes weeping areas and eczema may occur.
Skin care rules for atopic dermatitis
Let's talk about the basic rules of skin care for atopic dermatitis. First of all, what can harm atopic skin? This is the frequent use of soap, shower gels, scrubs and washcloths, brushes. Excessive sunbathing negatively impacts the progression of atopic dermatitis, as photodamage caused by ultraviolet radiation deprives the skin of the ability to synthesize molecules that make up the hydrolipid mantle. Using daily hygiene products containing fragrances, preservatives, and essential oils increases allergic reactions and causes exacerbations due to their antigenic effects. Wraps containing numerous organic substances, honey, herbs, essential oils, and fragrances can also have a negative impact. A diet high in fast carbohydrates, baked goods, seasonings, and marinades also has a negative impact. So, how should one treat atopic skin? There are three main principles: first, gentle cleansing; second, moisturizing and softening; and third, preventing irritation and itching. Therefore, it is strictly forbidden to use scrubs and washcloths, which completely destroy such a vulnerable epidermal barrier.
Patients with atopic dermatitis can safely visit a cosmetologist and undergo treatments. During periods without flare-ups, laser and phototherapy, as well as various hair removal procedures, can be performed. Skin with atopic dermatitis requires hydration, including injections—it is best to choose products based on hyaluronic acid. Chemical peels are preferable, superficial ones based on glycolic or lactic acids, and the peeling time during the procedure should be kept to a minimum. Regular daily use of emollients and moisturizers prolongs the interval between relapses and reduces the intensity of acute phases. The most effective treatment is the use of so-called emollients in an optimal dosage of 250 g per week.
Considering the basic principles of caring for atopic skin, the Cerafavit LIBREDERM line of products can be recommended for use both during an exacerbation and for maintaining remission.
Patients with atopic dermatitis can safely visit a cosmetologist and undergo treatments. During periods without flare-ups, laser and phototherapy, as well as various hair removal procedures, can be performed. Skin with atopic dermatitis requires hydration, including injections—it is best to choose products based on hyaluronic acid. Chemical peels are preferable, superficial ones based on glycolic or lactic acids, and the peeling time during the procedure should be kept to a minimum. Regular daily use of emollients and moisturizers prolongs the interval between relapses and reduces the intensity of acute phases. The most effective treatment is the use of so-called emollients in an optimal dosage of 250 g per week.
Considering the basic principles of caring for atopic skin, the Cerafavit LIBREDERM line of products can be recommended for use both during an exacerbation and for maintaining remission.
Let's look at facial skin care as an example. Gently cleanse your face of daily impurities and makeup. It is best to avoid products based on surfactants, as they can cause additional irritation to atopic skin. After cleansing, gently apply a few drops of Cerafavit soothing toner-softener with a cotton pad or your fingers. Allow it to absorb to restore the skin's pH, moisturize, and prepare it for the application of your skincare products.
Body care: For daily skin care for children and adults, you can use the Cerafavit lipid-restoring cream-gel. The ceramides and prebiotics in the gel regulate and maintain the balance of the skin's normal microbiome, helping to restore its protective function. After a bath or a lukewarm shower, dry your skin with a soft cotton towel using blotting movements and apply lotion or cream.
In the Cerafavit collection, you can always chooselotion,balmorcreamto soften and moisturize your skin, depending on your preferences in texture and skin type. Lotions and balms are suitable for atopic dry and very dry skin, and cream is suitable for sensitive and dry skin. The active complex of all the above-mentioned Cerafavit emollients is equally effective in restoring and maintaining the skin's hydrolipidic barrier. When caring for atopic skin, the composition of the product is very important: preference should be given to emollients with fewer ingredients, without fragrances, without known allergens and preferably containing physiological lipids - ceramides, as well as prebiotics.
In the Cerafavit collection, you can always chooselotion,balmorcreamto soften and moisturize your skin, depending on your preferences in texture and skin type. Lotions and balms are suitable for atopic dry and very dry skin, and cream is suitable for sensitive and dry skin. The active complex of all the above-mentioned Cerafavit emollients is equally effective in restoring and maintaining the skin's hydrolipidic barrier. When caring for atopic skin, the composition of the product is very important: preference should be given to emollients with fewer ingredients, without fragrances, without known allergens and preferably containing physiological lipids - ceramides, as well as prebiotics.