Atopic Eczema (Dermatitis)

Atopic Eczema (Dermatitis)Eczema is a common allergic disease that often affect the face, elbows and knees, among other body parts depending on the age of the patient. This red, scaly, itchy rash is usually seen in young infants, but can occur later in life especially in atopic individuals. The diagnosis of atopic dermatitis is based on three factors: 1) itchy, 2) "eczematous" or bubbly rash in an 3) atopic individual.

Q: What are some common triggers of eczema?
A: Common triggers include heat, sweating, and contact with irritants such as wool, pets or soaps. In older individuals, emotional stress can cause a flare-up. For some patients, usually children, food can also trigger eczema. Secondary infections also can cause a flare-up in children. These patients usually have very dry skin and "allergic shiners",an extra crease, called a Dennie's line, across their lower eyelids.

Q: How common is eczema?
A: Its estimated that eczema affect 10-15% of all children and about 2% of adults. Among children with eczema, less than 15% of patients will maintain their disease after puberty.

Atopic Eczema (Dermatitis)Q: How can eczema be treated?
A: Preventing the eczema itch is the primary goal of treatment. The patient must stop scratching and rubbing the rash. Lubricating the dry skin with cream or ointment, especially during dry seasons, is essential. Patients should remove all "irritants" that aggravate the condition from their environments. If a food is identified as the culprit, it must be eliminated from the diet.

Topical corticosteroid cream medications are most effective in treating the rash once all preventative measures are taken. Rarely, antihistamines or oral corticosteroids are also prescribed, and if a secondary infection has been introduced by scratching, antibiotics are required.

Q: If my child have eczema, is there a risk for him to develop other diseases in the future?
A: Although we know now that there are many types of eczema; in children, eczema can be part of a bigger picture called atopy. About 50% of these children later develop allergic rhinitis and/ or asthma.

Q: If i have eczema, is there a risk for my children to have it?
A: Yes. We know now that genetics play a major role in eczema and other atopic diseases. About 50% of patients with atopic dermatitis have a family history of atopy (i.e.: one or both parents have either one or more of the following disease: allergic rhinitis, asthma, eczema, food allergy, urticaria, anaphylaxis, ... or others).

Q: Can eczema be prevented from occurring to my newborn child?
A: Many studies aimed at decreasing or delaying the occurrence of allergies in children with family history of allergies. Below are some advices to help reducing the risk of your child developing allergic rhinitis, food allergy, atopic eczema &/ or asthma:

  1. Maternal smoking, active or passive, during pregnancy is associated with increased wheezing during infancy. Exposing children to secondhand smoke in the home has also been shown to increase the development of asthma and other chronic respiratory illnesses. Therefore, it is extremely important that infants not be exposed to tobacco smoke before or after they are born.
  2. Breast feeding for the recommended time period of at least 6 months strengthens children's immune systems, This practice has been shown to reduce percentage of allergic diseases in later life.
  3. Other specific recommendations for newborns who are at very high risk include:
    • Consumption of Probiotics by mothers during last trimester of pregnancy and breast-feeding.
    • Solid foods should not be introduced to high-risk infants until 6 months of age.
    • Consumption of dairy products should be delayed until 1 year, eggs until 2 years, and peanuts, nuts, and fish until 3 years of age.
    • Diets rich in antioxidants and omega-3 fatty acids should be encouraged during the second half of pregnancy.
    • Reducing contact with major environmental allergens is shown to reduce development of environmental allergies including asthma. This is especially for House dust mites. However, recent medical data have suspected such relationship.

(For the proper measures on house dust mite control, Please see the section on controlling indoor allergens)