What is it about ?
Atopic eczema is a chronic skin condition that causes a rash that is itchy. It can appear at any age, but often starts in childhood.
The characteristic sites affected by atopic eczema are:
- the skin folds,
- the face,
- the neck,
- the eyelids.
The cause is not yet fully understood. In L’atopy, there is often a hereditary predisposition to allergies. The affection is therefore common in the direct family. Atopy most often manifests itself in the form of eczema,asthma and / or hay fever.
In addition, certain environmental factors can aggravate atopic eczema, for example:
- perspiration,
- friction,
- work in a humid environment,
- long hot showers repeatedly, with the use of large amounts of soap, …
- the use of certain ointments, hygiene products and cosmetics.
What is its frequency?
Eczema is one of the most common skin conditions. It is twice as common in children as in adults. It is estimated that between 20% and 30% of adults have ever had the condition.
How to recognize it?
The main symptom is a chronic rash, accompanied by itching. This rash can take different forms:
- red patches on dry skin,
- raised circular lesions,
- sometimes wet,
- sometimes slightly scaly (peeling).
The skin may appear a little thickened. The itching intense pain often leads to scratching lesions, which can also be infected with bacteria. As a result, the lesions begin to fester and a yellowish crust forms.
Atopic eczema usually progresses in flares. Skin irritation can trigger a flare-up, such as when using foaming soaps, wearing rough clothes, heavy heat and sweating, stress, smoky environment, etc.
Sometimes these are allergic reactions (for example to dust, pets, certain food, etc.) that trigger (in part) the symptoms.
How is the diagnosis made?
The diagnosis is based entirely on the clinical picture, i.e. on the occurrence, evolution and appearance of lesions. Often the doctor also performs allergy tests on a blood sample or by means of skin allergy tests (prick tests).
To detect a food allergy, an elimination diet is indicated. You must then follow a very strict diet, then you reintroduce new foods one by one. If eczema occurs, it is most likely an allergy to the last food reintroduced.
What can you do ?
- The skin of people with atopic eczema is particularly sensitive. You must therefore protect your skin as much as possible, on the one hand by avoiding irritation, and on the other hand by applying protection.
- Avoid all products that contain detergent, such as bath foam, shampoo, foaming soaps, cleaning products, and dishwashing liquids. You can replace them with less irritating products, such as bath oil. This tip can also be useful when the water contains a lot of lime.
- Preferably wear gloves for your household tasks (cleaning, dishes, cutting fruits and vegetables, etc.) or professional.
- Rinse well after swimming in chlorinated water and then apply moisturizer.
- Wear loose clothing, preferably cotton, and avoid coarse fabrics and wool. Synthetic textiles are generally safe, but they sometimes increase perspiration.
- Heat can make eczema worse. The sun itself is good for eczema, but sweating has a negative effect. New lesions can develop in areas that sweat (armpits, skin folds, etc.). It is therefore recommended to concentrate heavy physical efforts during the cooler hours of the day. Keep the environment cool as much as possible. The best temperature for bath water is between 32 ° and 34 °.
- Avoid cigarette smoke and smoky environments.
- Ideally protect your skin by applying a moisturizer, twice a day to healthy skin. Preferably choose hypoallergenic creams, without perfume, dyes or preservatives. This kind of product is over the counter. Most pharmacies can also prepare moisturizers for you, which certainly do not contain any of the products to avoid. Usually, these creams are based on cetomacrogol or urea.
What can your doctor do?
Atopic eczema cannot be cured. The treatment targets 2 pillars: the basic preventive treatment, which we mentioned above, and the management of relapses. These flare-ups can be very bothersome because of the itching and aesthetic inconvenience.
Most lesions respond well to cortisone creams. Depending on the severity of the eczema, the doctor will decide whether it is better to use a low potency preparation (for example, a hydrocortisone cream) or a high potency preparation (for example, a betamethasone cream. ). As soon as the lesions begin to disappear, we switch to a maintenance cream that does not contain medication.
In severe cases, a short course of cortisone tablets may be considered according to a regimen with gradual reduction. Chronic cases, marked by frequent flare-ups, may benefit from drugs that affect the immune system. This type of treatment is prescribed by a doctor specializing in the skin (dermatologist).
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