Atopic dermatitis

Atopic dermatitis is a chronic inflammatory skin disease that manifests with intense itching, dryness and redness, and can affect people of all ages, although it is more common in childhood. It is a complex pathology, with periods of outbreaks and remission, which can significantly impact the patient’s quality of life due to the discomfort it causes and its possible relationship with other allergic diseases, such as rhinitis or asthma.

Although it has no single cause, there are multiple factors that contribute to its development, from genetic predisposition to environmental elements that can trigger or aggravate symptoms.

Atopic dermatitis is a multifactorial condition influenced by different elements that affect the skin barrier and the immune system.

Síntomas

Symptoms of atopic dermatitis may vary according to age and severity of the disease, but the most frequent symptoms include:

Intense itching. It is the most characteristic symptom and can be uncontrollable, affecting the patient’s sleep and quality of life.
Dryness and redness. The skin is usually extremely dry, which favors the appearance of irritations and cracks.
Eczematous lesions. Inflamed, scaling or crusting patches of skin that may appear on the face, neck, elbows, knees and other bending areas.
Thickening of the skin (lichenification). In chronic cases, the skin may become thicker and rougher due to continuous scratching.
Overinfections. Lesions may become infected due to persistent scratching, which may require antibiotic treatment.

Among the main causes are:

Genetic factors. There is a hereditary predisposition to develop atopic dermatitis, especially in people with a family history of allergic diseases such as asthma, rhinitis or allergic conjunctivitis. In these cases, the skin presents alterations in its barrier function, which facilitates water loss and the entry of irritants that trigger inflammation.
Skin barrier dysfunction. The skin of patients with atopic dermatitis does not retain moisture well due to a deficiency in certain proteins, such as filaggrin. This leads to increased dryness and vulnerability to irritants, which promotes inflammation and flare-ups.
Hyperactive immune response. The immune system of people with atopic dermatitis tends to overreact to external stimuli, releasing inflammatory substances that aggravate irritation and itching. This dysregulated immune response can cause the skin to react intensely even to substances that would not normally cause problems.
Environmental factors. Elements such as cold, low humidity, pollution and exposure to chemicals in cleaning products or cosmetics can irritate the skin and trigger episodes of dermatitis. Also, contact with certain fabrics, such as wool or synthetics, can aggravate symptoms.
Allergens and irritants. Pollen, dust mites, certain foods and animal hair can act as triggers in people predisposed to atopic dermatitis. Although not all people with atopic dermatitis have diagnosed allergies, these elements may play a role in the onset and maintenance of symptoms.
Stress and emotional factors. Stress is not a direct cause of atopic dermatitis, but it can worsen outbreaks or prolong their duration. Situations of anxiety or emotional tension can influence the immune system and aggravate skin inflammation.
Altered skin microbiota. It has been observed that people with atopic dermatitis tend to have an increased presence of bacteria such as Staphylococcus aureus on the skin, which contributes to inflammation and superinfection of the lesions.

Due to the complexity of this disease, treatment usually combines different strategies to help control symptoms and reduce the frequency of outbreaks.

Tratamientos

Treatment of atopic dermatitis is based on improving skin barrier function, controlling inflammation and reducing itching. The most commonly used options include:

Intensive hydration. It is essential to apply emollient creams daily to keep the skin moisturized and reduce dryness. Products with ingredients such as ceramides, hyaluronic acid or urea help restore the skin barrier.
Topical corticosteroids. They are the treatment of choice in acute outbreaks, as they reduce inflammation and itching. They are used in creams or ointments with different potencies according to the severity of the symptoms.
Topical immunomodulators. Drugs such as tacrolimus or pimecrolimus are used as an alternative to corticosteroids in delicate areas, such as the face or eyelids, and in prolonged treatments.
Systemic therapies. In moderate or severe cases, oral treatments such as antihistamines to relieve itching or immunosuppressants to control inflammation may be necessary. In patients with severe atopic dermatitis, biologic drugs, which act more specifically on the immune system, may be used.
Infection control. If the lesions are superinfected, topical or oral antibiotics may be necessary.

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Cuidados y prevención

To minimize flare-ups and improve the quality of life of people with atopic dermatitis, it is essential to adopt proper care habits. Avoiding triggers is a key step in the management of this disease. Exposure to allergens, such as dust, pollen or animal hair, as well as contact with irritating fabrics or harsh chemicals, can aggravate symptoms. Identifying which specific factors affect each individual and reducing their presence in the environment can help prevent episodes of inflammation and itching.

Daily skin care is essential to maintain the skin barrier in optimal condition. Applying moisturizers several times a day, especially after bathing, helps to retain moisture and reinforce the skin’s protective function. It is advisable to use emollient products without fragrances or aggressive preservatives, formulated specifically for atopic skin.

Hygiene also plays an important role in preventing outbreaks. Showering with lukewarm rather than hot water is recommended, as high temperatures can dry out the skin and aggravate irritation. In addition, it is preferable to use mild, unscented cleansers rather than traditional soaps, which can strip the skin of its natural oils and weaken its protective barrier.

Stress is another factor that can influence the frequency and intensity of flare-ups. Although it is not a direct cause of atopic dermatitis, it can trigger or worsen symptoms. Incorporating relaxation techniques, meditation or physical activity into the daily routine can help reduce stress and contribute to better control of the disease.

If atopic dermatitis affects your quality of life and symptoms are persistent or severe, specialist guidance is essential. Accurate diagnosis and personalized treatment can make all the difference in controlling the disease. There are specialized solutions designed to reduce inflammation, relieve itching and improve skin health. Consult with our specialists and find the treatment that’s right for you.