Why atopic dermatitis occurs is not well understood, though it has been
the subject of active research for quite some time. There is no one single
cause. An educated guess, with the aid of research, shows that it could
be the result of a complicated interaction between factors in the environment
and elsewhere, the body’s immune system, and inherited genetic traits.
The immune system plays a critical role, making people very vulnerable
to irritants and allergens. Atopic dermatitis patients have a family history
of eczema and allergic conditions like hay fever and asthma, and an allergic
skin inflammation response.
Atopic dermatitis affects the whole body. It manifests on the skin when
various triggers upset the body.
Factors triggering atopic dermatitis
Factors which cause and aggravate it include; dry skin, irritants, infections,
allergens, emotional factors, and climate.
Dry skin: The skin of people with atopic dermatitis loses its moisture
holding capacity and becomes dry. A dry skin is a poor barrier to germs.
The condition becomes difficult to control when certain factors make the
skin still drier. These include winters (cold, dry air), frequent washing
with very hot water, soaps and antiseptics, low humidity, and high temperatures.
Regular use of emollients may help in reducing the dryness.
Irritants: Certain substances and materials irritate the skin of atopic
dermatitis patients and help stoke the condition. These are soaps, harsh
detergents, wool, cosmetics and dust among others. All efforts must be
made to avoid these things.
Infections: People with atopic dermatitis are easily affected by infections
because of their dry, cracked skin. Moreover, in some cases, their immune
system is too weak to fight these infections. Bacterial, viral and fungal
infections are important triggers for atopic dermatitis aggravation.
Bacterial infection is caused by staphylococci and streptococci bacteria,
which are also found on normal skin, where the oil on skin prevents any
mischief by them. However, the dry skin of an atopic dermatitis patient
is a fertile ground for them to thrive. The infection may worsen and become
resistant to normal medications. In such cases, antibiotics may have to
Viral infections, which cause colds and herpes, also aggravate atopic
dermatitis by spreading it all over the body. It can lead to a severe
form of atopic dermatitis called eczema herpeticum.
Allergens: Allergens are also well-known triggers of atopic dermatitis
and its aggravation. The kinds of allergens that cause this condition
are food and environmental allergens.
Approximately a third of eczema cases of children are due to food allergies.
They are most commonly to eggs, cow’s milk, soy, wheat, peanuts,
Food allergens aggravate atopic dermatitis more in young children than
in older children or adults. Between 20% and 40% of young children, have
food allergies that can worsen their condition. The problem of food allergies
can be tackled by introducing new foods. Sometimes new foods can aggravate
atopic dermatitis symptoms, but it may not be a true allergy. It is the
response the skin gives while adjusting to the new food. The symptoms
usually disappear within a month when the adjustment is made.
Environmental allergens; Aeroallergens, which are conveyed by air, are
the common cause of atopic dermatitis in many children. Some common aeroallergens
are animal danders, dust mites, molds and pollens. However, the atopic
dermatitis caused by these allergens is of the milder variety where the
first signs in children are a running nose, sneezing and swollen eyes.
The condition improves after removal of the allergen. Many of these allergens,
especially pollens, are difficult to remove since they are everywhere.
Emotional factors: Emotional factors like stress are well known to cause,
maintain and aggravate atopic dermatitis in adults and children alike.
Stress can be caused by illness, or change of home, office and school.
Family conflicts or deaths in the family can be strong triggers for emotional
upsets. Atopic dermatitis itself can produce stress, stoking the condition.
In women, hormones may trigger the onset of atopic dermatitis. The condition
may worsen during menstruation and during early stages of pregnancy.
Emotional stress in children can affect their overall development. Consulting
a psychiatrist or a therapist could be useful if the stress is seen
to aggravate the condition.
Climate: Certain climates are triggers for atopic dermatitis. Winter
is one such climate because the low humidity helps in drying up the skin.
Cold, damp climates can make the condition resistant to treatment. The
condition usually improves in summer due to exposure to ultra-violet light.
However, sweating due to excessive heat or physical exertion, in any clime,
may trigger the condition.
Keeping an even temperature, dehumidifiers, air-conditioning and cool
baths during summers are other ways to contain this condition.