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What do I do if my child has atopic dermatitis ?: Origin and detection factors of the disease in children | Experts | Mamas & Papas



Atopic dermatitis is a complex and heterogeneous disease that affects 5% of adults worldwide and approximately 15% of children, according to data from Annals of Nutrition & Metabolism. It is the most common chronic inflammatory skin disease. The pandemic has seen a serious rebound due to the use of hand gels, experts report. “Atopic dermatitis is one of the most common reasons for consultation. They account for approximately 25% ”, explains the doctor. Alba Sánchez Orta, dermatologist at the La Paz university hospital in Madrid. The expert maintains that it occurs quite commonly in children and in the case of adults it usually resolves before the age of 20. “In recent years it has advanced. The prevalence has increased to tripling with rates of more than 10% in Spain in terms of atopic traits ”, adds the expert.

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Sánchez assures that the exact reason that triggers it is unknown. It can be certified that in these patients there is a greater sensitivity of the skin and mucous membranes to environmental agents. And he explains that there is a greater predisposition to contract it in urban areas of developed countries, something linked to the “theory of hygiene”, and to the female sex, without clear significance. “As there is less exposure to allergens, it does not develop; They are also factors, fetal and perinatal, such as the type of feeding and breastfeeding ”, maintains the professional.

Various organisms such as Spanish Society of Allergology and Clinical Immunology (SEAIC) and the Spanish Academy of Dermatology and Venereology (AEDV) state that it is convenient for these people to maintain the conditions of temperature and humidity. Some studies consider adequate temperatures below 20 degrees and around 50% humidity.

Atopic dermatitis affects individuals with rhinitis or asthma. Currently there is more knowledge about drugs both probiotic and prebiotic can help in this regard. “In childhood there are chronic eczema-like lesions, dry, scaly plaques and lichenification on the front of the elbows, the back of the knees, neck and instep; in adults with alterations in the hands / face, eyelids and lips and prurigo-type lesions (raised papule with central erosion due to scratching caused by itching) ”, says the doctor.

According to Dr. Sánchez Orta there are several types of triggers for this disease:

  1. Irritants or drying of the skin as chemical agents.
  2. Emotional, as is the case with emotional stress.
  3. Environmental: patient becomes allergic to mites or supercolonized patient.
  4. Food: there are few that have been proven, but it is the case of cow’s milk protein and egg protein.
  5. Contact or inhaled allergens: dust, animal epithelium …

The dermatologist recommends that parents should treat the condition from the moment it manifests itself and that in case of serious outbreaks, the pediatrician should be consulted, who will indicate the most convenient procedure to follow. He also refers to good nutritional supplements, including probiotics from infancy to prevent the subsequent development of the disease. Diet is the main modulating factor. To improve the symptoms of atopic dermatitis, the expert recommends eating a favorable diet of omega 3 fatty acids, vitamin C, B5, sulfur …

Beyond the physical footprints

For Sánchez Orta, it should be taken into account that if children have a personal predisposition, outbreaks can be triggered and they can be derived from stress, during exams or when sleep is not optimal. “This is the case of the pandemic, when they missed school. The child saw the suffering and somatized it ”, says the expert. The doctor points out that parents have a hard time facing the increasing economic cost of drug treatment and the obligation of preferential care for the child with this disease, many times with respect to other issues, even other children who do not have health problems. And, of course, the concern of the whole family also increases.

“Both in children and adults emollients or topical corticosteroids are indicated for the treatment of atopic dermatitis. It is also important to avoid certain foods such as coffee, alcohol, sugar, and saturated fat. Therefore, when in doubt with any food, it is advisable to check the labels of the products and consult with those in charge when eating out of the house ”, he adds. Olalla López, pharmacist.

It is revealing after a survey carried out by the laboratory PiLeJe (50% men and 50% women in Spain, of them 50% of the sample between 18-45 years and the other 50% between 46-70 years) to verify how atopic dermatitis conditions the quality of life of those who suffer from it , that 52% of the people who suffer it in Spain, feel dissatisfaction with their own image. 64% of those surveyed say that the condition of their skin directly affects their mood. 46% have canceled or modified plans they had planned due to the condition of their skin. On the other hand, 62% of the people who suffer from this disease affirm in the survey that at certain times they have changed their way of dressing depending on the condition of their skin. It can also be noted that 44% of people say that the pandemic has increased the number or intensity of episodes of atopic dermatitis that they regularly suffer.

Atopic dermatitis in children and adolescents not only in terms of physical appearance, but also in other areas. “It affects the quality of life. In young children, who are restless as a general rule, it is more difficult to avoid scratching the affected areas, “he says. Lucia Victoria Mota Torresano, health psychologist. For this reason the professional dictates that the family has to be more vigilant to help the minor not touch the affected area, a situation, according to her, which can generate frustration in the family, since, due to age, the child do not understand what is happening and the strategies used do not have the expected effect on the family environment. On the other hand, the psychologist highlights that older children can put strategies into practice and be more aware.

The itching of someone with atopic dermatitis increases in frequency at night. For the professional, the lack of rest can make children more irritable and tired, hindering their school and social performance. There is also complexity in the composition of social relationships, since they may have a tendency to isolation, shame or fear of insult or ridicule, stigmatization or rejection. “Due to their own mood, the child or adolescent may stop doing things that they like because they don’t feel like it or because of how that makes them feel. You can avoid expressing your emotions to others. You have to be attentive to this and give it space to feel comfortable and express yourself “, maintains the expert.

“The best thing for the family is to help children to identify the sensation they feel when they need to scratch from an early age. They can tell parents and help them draw attention to the things they would do if they didn’t scratch. When they are older it would not be necessary, since they themselves, when they identify it, could focus their attention on what they are doing ”, argues Mota Torresano.

If the family has any doubts, the specialist in health psychology recommends a professional job to offer them tools in situations in which they do not know what to do to help the child, without adding more stressors that increase itching.

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