Atopic dermatitis : Concerned Pediatric Diseases

     Allergies are conditions in which the body reacts abnormally to foreign substances. When they occur, they manifest as various specific disorders. Atopic dermatitis can develop at any age, not only due to genetic and environmental factors, which are closely interrelated, but also due to what may be termed the “body’s readiness”—a subtle factor that lies in between. This is especially true in children, whose immune systems and vital organs are not yet fully developed and therefore less capable of withstanding external influences. How, then, can we care for our children and loved ones?

2 Main Factors of Atopic Dermatitis

Atopic dermatitis (eczema) results from two main categories of factors:

1.  Internal factors

     These include abnormalities in the skin’s structure. In such cases, the skin has microscopic openings that lead to excessive moisture loss, making it difficult for the skin to retain hydration. These openings also allow environmental allergens to penetrate. Additionally, immune system dysfunction and a family history of allergies may contribute to the condition.

2.  External factors

     These are environmental triggers, such as allergic reactions to certain foods, hot weather or sweating that causes itching, skin infections, contact with irritants or allergens, and emotional stress—all of which can exacerbate symptoms.

Symptoms of Atopic Dermatitis

The condition is chronic, with symptoms that come and go, usually accompanied by itching. Genetic predisposition serves as the foundation, while environmental factors trigger flare-ups.

• In young children, symptoms often appear as dry, scaly red rashes around the cheeks, lips, ears, and outer folds of the limbs—areas frequently affected by friction during movement. Over time, small blisters may also develop.
• In older children and adults, symptoms typically occur in the inner creases of the elbows and knees, as well as the neck, hands, feet, and torso. In some cases, the condition persists into adulthood.

Although symptoms may improve with age—and many individuals may outgrow the condition some experience late-onset or persistent eczema, with approximately 5% of cases continuing into adulthood.

Management and Care of Atopic Dermatitis

These care guidelines apply to older children, adults, and parents or caregivers of young children with the condition. Starting from bathing routines, physicians recommend the following:

• Avoid using hot water or prolonged bathing, as these can dry out the skin. Instead, bathe with room-temperature water for no more than 5–10 minutes at a time.
• Do not scrub the skin with exfoliating powders or bead scrubs.
• Avoid spa treatments and steam baths (such as saunas), as these may irritate the skin.
• Use mildly acidic soaps with a pH of 5.0–5.5. Alkaline soaps can irritate the skin and promote bacterial growth.
• Avoid antibacterial soaps and herbal soaps.
• Apply moisturizer immediately after bathing, when the skin is still damp, to lock in moisture. This strengthens the skin’s barrier and helps prevent allergens and pathogens from penetrating.
• Choose creams that are fragrance-free and preservative-free.

The use of coconut oil is not recommended, as it may increase moisture evaporation through the skin. Moisturizers should be applied daily, at least twice a day. If rashes or itching occur, it is important to resist scratching and to keep fingernails trimmed short.

Medication Guidance from Pediatricians

     The use of steroids, antihistamines, anti-itch medications, anti-inflammatory drugs, and immunosuppressants is considered symptomatic treatment and should be administered under medical supervision. In cases of food allergies, the offending foods should be avoided, and a medical consultation is recommended for proper diagnosis.

Last updated:

05/01/2023