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  Atopic eczema, irritant dermatitis and contact dermatitis


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 be used.

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, and fish.

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.