Atopic Dermatitis (AD) is a common type of eczema that affects more than 9.6 million children and about 16.5 million adults in the United States. It’s a chronic condition that is identified by the development of dry, scaly, red patches of skin on the face, arms or legs. These affected areas are extremely itchy,” explains Angie Seelal, R-PAC specializing in dermatology with Advanced Dermatology PC, “and can interfere with sleep and trigger scratching that can bring additional skin problems: worsened inflammation and the risk of infection.”
“ The good news is that there are interventions to help manage this disruptive skin condition,” noted Seelal.
Atopic dermatitis is not contagious, despite its appearance. For complex scientific reasons, people with AD have an overactive immune system that triggers inflammation that leaves the skin dry and prone to itching and rashes. Research has focused on the skin protein ‘filaggrin,’ which helps maintain a protective skin barrier,” explains Seelal. “A mutation in the gene that codes for filaggrin may be implicated in AD.”
Unfortunately, there is no cure for AD. “However, we have effective treatments that can help patients control symptoms. And early treatment can ward off long-term damage from AD such as lichenification – the skin thickening that can result from chronic scratching,” explains Seelal. Here are some tips for coping with AD:
- Moisturize, moisturize, moisturize: “Dry skin is the enemy,” observes Seelal. With AD, a super-effective moisturizer is needed. Ointments with higher oil content provide the most protection. People should avoid any additives that may be irritants. Ask your dermatologist for suggestions or check the National Eczema Association’s website for a list of evaluated products. Do a trial run on a small spot on your skin to check for sensitivity. Your moisturizer should be handy at every household sink for post-washing and packaged to go for re-application when out and about,” Adds Seelal.
- Bathe smart: “An effective bath or shower routine helps us maximize moisturizing,” says Seelal. “Use lukewarm water instead of hot, use a gentle cleanser for sensitive skin, and stay away from scrubbing and soap.
- Follow the three-minute rule: “After washing,” explains Seelal, “we’re primed to moisturize, but we need to do this in a timely way: an oil-rich moisturizer should be applied within three minutes after washing to seal in moisture. If you have topical medications, those should be applied first, followed by the moisturizer.”
- Topical treatments? Understand the options: “Moisturizing is required, states Seelal, but often it’s not enough.”Corticosteroids, topical calcineurin inhibitors (TCIs), and PDE4 inhibitors are topical treatments with different mechanisms for tamping down the body’s immune response to decrease inflammation. Patients should talk with their doctor to get a clear understanding of how each medicine works and its side effects. Steroidal treatment, for example, is often limited, while TCIs may be long term.”
- Light therapy requires a commitment: “Phototherapy – most often in the form of UVB rays – can help up to 70 percent of patients who haven’t improved with topical treatment,” notes Seelal. “But it involves frequent ongoing treatments.”
- Learn about targeted ‘biologic’ treatment: In 2017,” the FDA approved Dupixent® as the first ‘biologic’ drug for AD: It works on a genetic level to block proteins that trigger skin inflammation. Patients receive every-other-week injections.“Your dermatologist can help customize a plan so that AD doesn’t devastate your life,” concludes Seelal.