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Atopic Eczema (Infantile Eczema, Atopic Dermatitis)

The atopic eczema information advice that you find here is written for the benefit of non-medical laypersons by an atopic eczema specialist who is part of a team of 100 practising UK consultants and GPs. The content is in keeping with UK guidelines and based on current best practice for the management and treatment of atopic eczema.

Atopic Eczema (Infantile Eczema, Atopic Dermatitis): Definition

The terms eczema and dermatitis are often used interchangeably. The word eczema comes from the Greek word meaning to “boil over”. There are many different types of eczema but this information mainly relates to the common type known as childhood atopic eczema. The word atopic means that there is an inherited predisposition to the development of eczema and/or asthma and and/or hay fever.

Atopic Eczema (Infantile Eczema, Atopic Dermatitis): Incidence/Age/Sex

Atopic eczema and asthma are becoming more common in the U.K. and 15% of young children suffer from atopic eczema. It occurs more commonly in urban areas than in rural areas and in small families compared to large families. It appears to also occur more commonly in wealthier families, particularly in social class I. Males and females are equally affected.

Atopic Eczema (Infantile Eczema, Atopic Dermatitis): Causes and Prevention

The occurrence of atopic eczema appears mainly to be related to an individuals genetic make-up. In other words a person inherits a tendency to develop these conditions. Other factors, such as stress, dry environments, contact with irritants on the skin and infection such as colds may aggravate atopic eczema.

The current evidence suggests that breast feeding does not prevent the onset of atopic individuals. Some investigators have suggested that pregnant mothers should avoid dairy products when pregnant which may then reduce the chances of atopic eczema in offspring. This however is not proven at the present time and avoidance of dairy products in pregnancy may be nutritionally damaging for the baby.

Historically sufferers of atopic eczema have been thought to be extra sensitive to certain substances, usually invisible proteins, called allergens in the environment. These include common allergens such as house dust mite (more accurately the droppings of the house dust mite), grass, tree and weed pollen, proteins on cat and dog fur, feathers and occasionally foods such as egg, milk and nuts. Those with atopic eczema tend to have a hypersensitivity of their immune system and produce high levels of an antibody called IgE antibody to these particular allergens. Considerable debate still remains as to the relevance of these antibodies. Over the years exclusions and desensitization have been attempted with limited proven benefit. Most individuals will grow out of their atopic eczema (see outcome). Once individuals have grown out of their atopic eczema high levels of antibodies still persist and therefore some dermatologists regard the presence of antibodies to be part of the individuals genetic make-up rather than the true cause of the problem.

Atopic Eczema (Infantile Eczema, Atopic Dermatitis): Signs & Symptoms

Atopic eczema most commonly starts at the age of 2 or 3 months and typically in the first 18 months of life. Initially redness may occur on the cheeks, with the subsequent onset of red, dry, scaly, itchy skin. This tends to affect the areas behind the knees and fronts of the elbows. It can extend to involve any body site but in children rarely involves the napkin area. Itching and scratching is one of the most distressing features to be witnessed by parents. This often results in sleep disturbance which can place a considerable burden on family harmony.

Atopic Eczema (Infantile Eczema, Atopic Dermatitis): Complications of the Disorder

The skin of an atopic eczema sufferer is particularly vulnerable to infections. This includes bacterial infections (impetigo) and viral infections (warts, molluscum conta

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Atopic eczema (infantile eczema, atopic dermatitis): Treatment, symptoms, advice and help

About atopic eczema (infantile eczema, atopic dermatitis)

Atopic eczema is a common allergic condition of the skin characterised by intermittent flare ups of skin inflammation in response to some triggering agents. It is termed as infantile eczema when seen in children of less than one year of age.

Atopic eczema (infantile eczema, atopic dermatitis): Incidence, age and sex

Atopic eczema is a common skin affliction occurring in infants and small children. Its onset usually occurs before the age of five years and it is quite uncommon for an adult to be suddenly affected with this skin disorder without any history in childhood. The incidence of atopic eczema has been on the rise in recent times.

Signs and symptoms of atopic eczema (infantile eczema, atopic dermatitis): Diagnosis

Atopic eczema presents with rashes and redness of skin which may cause itching. Sometimes, an individual may experience itching before the initiation of the rash. Constant scratching can lead to thickening of the skin. In occasional instances, cracking of the skin with oozing may be seen especially in infants. The face and head are the most common sites affected in younger children and infants. Adolescents may experience these skin symptoms mainly on the wrist, elbow or back of knee.

Atopic eczema typically occurs in periodic episodes of remissions and relapses. It is not an infectious disease and cannot be transmitted from person to person. The initial appearance of this condition is seen in childhood and its progress may vary with age. In most instances, flare-ups of skin inflammation reduce as a child grows up and may disappear altogether by adulthood. It may be associated with other allergic conditions like allergic rhinitis or bronchial asthma.

Some measures like keeping skin well-moisturized, avoiding the above mentioned and other triggering agents, wearing loose, cotton clothing may help in preventing frequent eruptions of the disease.

Causes and prevention of atopic eczema (infantile eczema, atopic dermatitis)

The exact cause of atopic eczema is not clear. Genetic factors may play a role in causing atopic eczema. It can be inherited from parents with atopic eczema or other allergic diseases. Persistently dry skin may increase the chances of flare ups of atopic eczema in susceptible individuals. Some triggering agents which may lead to exacerbations are emotional stress and extreme conditions of weather especially heat. Allergens like house dust, pollens, fragrant cosmetics or food products like eggs and fish may also cause flare ups of this skin disorder.

Atopic eczema (Infantile eczema, Atopic dermatitis): Complications

The skin may become dark and thick (lichenification) due to excessive scratching over skin rashes. This change of skin colour and texture may be irreversible. Occasionally these allergic skin rashes may be superimposed with bacterial infections.

Atopic eczema (Infantile eczema, Atopic dermatitis): Treatment

The consulting skin specialist may prescribe topical medications like steroid ointment or cream which usually diminish the inflammatory skin symptoms. Sometimes anti-allergic medications like anti-histamines may also be effective. Oral steroid drugs are reserved for severe skin affliction which does not improve with topical treatment. Secondary bacterial infection may require antibiotic drugs for effective elimination of the disease. Apart from the treatment, self care or preventive measures also contributes in reducing the relapses of atopic eczema.