Atopic dermatitis, how to treat it (even in children)

S.ai how is atopic dermatitis recognized and treated? This disease also affects children, but now a new drug is coming

‘What red spots, what happened to you? You have very dry skin, do not use cream? ». Here are the questions that patients often hear Atopic dermatitis. Yes, for the most obvious symptoms of the disease are precisely these: the spots and the skin that almost appear to flake. In addition to the most annoying disorder: an often unstoppable itching.

Do children only suffer from atopic dermatitis?

It is not only children who suffer from it, but increasingly also adults: in Italy today 35,500 people over the age of 18 are affected by Atopic dermatitis, one in 4 in severe form. With a negative impact on quality of life and, especially in summer, a feeling of shame or embarrassment for these marks on the skin. “There are still many clichés to dispel,” said Silvia Ferrucci, head of the allergological dermatological service, IRCCS Cà Granda Foundation, Maggiore Policlinico Hospital in Milan. “For example, many people resign and think that there is nothing to do. Instead, it is not like that. There are therapies, but it is also necessary to rely on a dermatological center to learn new life habits, which are fundamental to treating the disease well “.

Why is lifestyle important for patients with atopic dermatitis?

“We must defend the skin barrier, as in those who suffer from it Atopic dermatitis it is not well structured: it is for this reason that the skin tends to be dehydrated and hypersensitive. And then it is essential to keep the risk of contact allergy away. That means first and foremost choose ad hoc products with your dermatologist. For daily hygiene, we focus on those that contain few surfactants: they are oil-based and clean without producing foam. Likewise, one should pay attention to body products, which must have a moisturizing and emollient formulation with lipids such as ceramides, but without perfumes, additives and medicinal plants that can cause contact allergies. And even if it’s hot, do not overdo it with showers, because they are not good for you. One a day is enough, with warm water lasting no more than five minutes, and the body must first be dried by dabbing the skin with a soft towel in natural fabric, then the moisturizer must be applied ».

Is it true that the symptoms of atopic dermatitis improve in the summer?

“This is often the case, especially in mild forms Atopic dermatitis. But not always. In the heat, sweat increases, which can weaken the already fragile skin barrier and cause inflammation in the skin. In addition, high temperatures even at night alter sleep, agitate and trigger a vicious circle of worsening symptoms, starting with itching. Here too, to help yourself, you need to make the right choices, starting with clothing. The clothes must be in cotton or linen, but be careful of the fabric, which must not be rough. Another important point, and it applies all year round: no protruding seams or labels that can increase the irritation. In addition, the apartment must be kept cool, perhaps with the help of a dehumidifier, because let us keep in mind that even moisture can aggravate disturbances ».

Have yes or no for atopic dermatitis?

“If the atopic dermatitis is in a period of remission, there is no problem. Obviously, it is necessary to talk to your dermatologist about it, also based on the therapy you are following: for example, monoclonal antibodies do not cause reactions to the sun, but this does not apply to all medicines. Together with the specialist, sunscreen should also be chosen, with a high protection factor and without ingredients that can cause skin allergies. Swimming in the sea or in the pool is not forbidden, but it is important to immediately take a short shower with fresh water. And no anxiety if there is sand on the body, the important thing is not to remove it by rubbing the skin with a towel. Better to let it lie until you dive into the water again ».

Food, is there any ban at the table for atopic dermatitis?

“There are precautions to be taken to ward off atopic dermatitis. Sometimes you do not think about it, but those with atopic dermatitis may suffer more easily than allergies and for this reason it is good to be careful. In your diet, for exampleAs far as possible, avoid all foods that contain histamine, the substance that can trigger itching and thus aggravate the symptoms. This category includes crustaceans, fermented cheeses and chocolate, to name the most common ».

How is atopic dermatitis treated in children?

“IT ALL STARTED WITH RED SPOTS ON THE FACE AND ARMS” says Anna, Elio’s mother, who is now 7 years old. “As we got older, the situation got worse. He added the asthma, the vesicles, which have also stretched to the legs, with an itching so strong that it does not sleep at night. And the disease did not go away with any cure. ” Anna’s story is the story of many mothers who lose their composure because their little ones suffer Atopic dermatitis. “This chronic inflammation of the skin, characterized by intense itching, and which usually occurs before the age of 5, can develop into a severe form,” explains Dr. Elena Galli, Head of the Allergology Unit at San Pietro-Fatebenefratelli Hospital in Rome and Head of the Commission on Atopic Dermatitis in SIAIP (Italian Society of Pediatric Allergy and Immunology). “It so happens that the lesions extend to different parts of the body and that they can no longer be kept under control with local pharmacological therapies and with specific emollients and cleansers. In addition, allergic rhinitis and asthma can be associated with dermatitis.”

The new treatment for atopic dermatitis in children

FOR THESE FORMS, SOLUTION IS NOW ARRIVING. Dupilumab, a monoclonal antibody already used for severe forms of atopic dermatitis in adults and adolescents, is also approved for the 6-11 age group. “The drug works by inhibiting interleukins 4 and 13, which are the main causes of inflammation at the base of both dermatitis and asthma, and since it is not an immunosuppressive agent, it is well tolerated,” assures Dr. Galli. “The therapy consists of subcutaneous injections that even the mother can do and does not require periodic laboratory tests”. The results are very fast and as it happened for Elio, the improvements have not only affected the skin but also the asthma. So Anna and her family found sleep and serenity.

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