Atopic Dermatitis is a very common disease that affects a large percentage of the world population. It is a special type of allergic hypersensitivity and is caused due to hereditary genes and environmental factors. It is also commonly termed as “Eczema”. It is a chronic inflammatory skin condition characterized by dry plaque that is red and severely itchy. The symptoms can be mild where the skin looks dry and scaly or they can be more severe where the skin becomes red, raised and raw with oozing, crusting and scaling. Although there is no cure for this skin condition it can be managed by being consistent and diligent with your daily skincare routine. It can occur anywhere on the body and is usually found on the back of the arms, knees. There are many types of eczema. Atopic eczema refers to the hereditary tendency toward eczema, asthma and allergies. People with eczema may also suffer from one of the other atopic diseases. All dermatitis are eczema and all eczema are dermatitis.
The theory of eczema management is to get moisture back into the skin and to create a barrier to protect the skin which eventually improves the patient skin- barrier function. Redness and rashes of atopic dermatitis are visible on the top layer of the skin but the main cause can be lying underneath the skin. Atopic Dermatitis is more than a skin condition. It is a disease caused by the overactive immune system that leads to inflammation in the body. It is an internal inflammation that causes the symptoms. It is also called ‘Itch the rashes’ for a reason. While scratching may offer short term relief, in the long run, you are actually making atopic dermatitis and itching worse. This is called Itch-scratch cycle. Our skin has three layers. In healthy skin, the outer layer called epidermis keeps foreign substance such as bacteria, virus and allergens away from getting into the skin. When you have Atopic Dermatitis the outer layer of skin is weaker and more susceptible to inflammation caused by the immune cell in the body. The damage done by scratching also contributes to the breakdown of skin cells making it easier for foreign substances to get in. Even if one of these foreign substances break through the skin barrier, the immune system gets affected. These immune cells travel to the lymph nodes which are in the second layer of skin called dermis. Once in the lymph nodes, those immune cells activate your body defenders called T-helper cells. The immune cells release a substance that cause the familiar redness and rash on the skin surfaces although these substances normally go away after a short time. If you have an Atopic Dermatitis, the cell does not switch off, instead they continue to react even when your skin looks clear. Even when you have no visible rash the underlying inflammation is still active beneath your skin. The itching leads to scratching which further weakens the skin cell in the epidermis allowing more foreign particles to get in and increases your risk of infection and the itch-scratch cycle continues.
The exact cause of atopic dermatitis is unknown. However, research has shown that there are genetic, immunological and environmental factors that can play a role. It can come and go and can come more around the body. This is the chronic nature of the disease. The outer layer is the skin barrier. Our skin is the barrier to the outside world. It is somewhat waterproof and keeps our internal organ and system safe from the elements and from bacteria that try to invade our body. Healthy skin is like bricks and mortar. The skin oils which are like mortar hold together the skin cells whereas the cells which are like the bricks create nice stronger barriers. Atopic Dermatitis patients, however, have an unpaired barrier that means that their skin barrier is broken allowing natural moisture out and allowing irritant and allergens in. This causes the skin to become dry and cracked and when this happens it is known as a flare-up.
The Key to maintaining healthy skin is to take care of the skin every day. You need to control and maintain the skin barrier. You cannot cure eczema but it takes daily diligence and continued effort that can control it to a good extent. Bathing and moisturising are keys to the health of eczema skin. Frequent bathing even 2 or 3 times daily followed by a moisturizer should be your first defence in managing eczema and their flares. Bathing allows moisture to enter the skin and coat the skin with a moisturizer helps to seal that moisture in the skin.