Atopic dermatitis is the most common chronic skin disease in infancy and childhood, accompanied by itching, redness and dryness. It is most common in the first year of life (60%).
Both genetic and environmental factors play a role in its formation. The outer layer of the skin is a barrier, and genetically, as a result of the disorder in the structure of this barrier, both the water retention function of the skin and the oil layer are disrupted, the moisturizing feature of the skin is disrupted, and the skin becomes dry. When the barrier function of the skin is disrupted, some allergens, microorganisms, and irritants easily pass through the skin, affecting the immune system and causing eczema.
In addition, in order for this protective barrier to be strong, microbiota, which are beneficial bacteria that should normally be present on our skin, must also be formed. As a result of early use of antibiotics, modern city life, and excessive hygienic life, the healthy microbiota that should normally be present on the skin cannot develop sufficiently. and the barrier function of the skin is impaired.
Itching and dryness on the skin are the main symptoms. Redness, flaking, watering, and crusting may occur.
In infancy, it is more common on the cheeks, forehead, behind the ears, and scalp. It is seen on the neck and on the outer surface of the arms or legs. It is not usually seen in the diaper area because it is moist. In school-age children, it is more common on the front of the elbow, the back of the knee and on the neck, and in adolescence, it is more common on the hands.
Itching is the most challenging finding for both the baby and the family. Because it causes sleep disorders in babies, it can also affect school performance and social life in children.
Atopic dermatitis, food allergy, allergic rhinitis or asthma. It may be the beginning of allergic diseases such as: This is called an atopic step. If it is thought to be triggered by an allergen or in moderate-severe cases that are resistant to treatment, a skin prick test or blood test can be performed to detect the allergen. 50% of children with severe eczema have food allergy. The majority of them have cow's milk or egg allergy. is detected.
While food allergy is more common in the period before the age of 1, aero allergens (house dust mites, animal dander, etc.) are more prominent in older children.
Atopic dermatitis progresses in attacks with exacerbation and recovery. .
The basis of treatment is the regulation and moisturizing of the damaged skin barrier.
First of all, Samak treatment skin care is moisturizing the skin. Even moisturizing alone can prevent flare-ups. The skin should be kept clean, if there is crusting, it should be removed. Frequent bathing can be done, but bathing time should be short. For body cleansing, soap-free cleansers should be used, and bath oils can be added to the rinse water. The water should be warm.
When the bath is finished, a moisturizer should be applied immediately within the first 3 minutes before drying completely. Moisturizing should be done regularly at least twice a day. Moisturizer should not contain preservatives and perfumes, should not be irritating or allergenic, should moisturize the skin well and repair the skin oil layer. The use of oils such as olive oil or coconut is not recommended.
With regular moisturizing. In mild eczema, other treatment steps may not be necessary.
The second step is to avoid triggers. These include avoiding soap, scented detergents and softeners, rinsing clothes twice after washing, using cotton clothes, avoiding wool, wearing loose-fitting clothes, preventing the environment from being hot or very humid, not sweating, avoiding cigarette smoke, and avoiding allergens if allergens are detected.
Since the skin barrier is disrupted, treatment is sometimes given to these patients if they develop an infection due to some bacteria or viruses on the skin.
In patients who have flare-ups and are resistant despite these applications, steroid-containing creams or creams with different effectiveness are used. is also included in the treatment. Such treatments must be given under the supervision of a physician. Systemically administered medications are also available in very severe cases.
Even if the skin findings improve, moisturizing should be continued regularly.
The effectiveness of probiotic use in the first year of life has not been shown very well, and although there are studies showing that it is beneficial in moderate-severe eczema in older children and adults. More studies are needed.
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