Atopic eczema is a condition that affects many people all over the world. One of the more prevalent types of eczema, is also known as atopic dermatitis (AD), and it can be extremely challenging to treat.
Atopic eczema is a chronic inflammatory skin condition that can flare up at any time. Part of this is due to an overactive immune system that affects the skin's barrier.
A recent population-based study in the United States has shown that the impact of moderate-to-severe atopic eczema on the overall health of adult patients is comparable to serious chronic disorders such as heart disease.
All throughout the body, moderate-to-severe atopic eczema can cause inflamed skin and excruciating itching. The knees, elbows, face, neck, feet, hands, and wrists are frequently impacted areas. The condition is quite varied and can range in severity from moderate to severe, necessitating gradual care techniques.
Dr. Dwayne Koot, a pharmacologist and Sanofi Medical Advisor, says that the burden of itching on patients is complicated and connected to other symptoms such as pain, sleep problems, and mental distress.
“Given that atopic eczema runs in families and some people are genetically susceptible to it, it's crucial to realise that these genetic predispositions could cause the immune system to go into hyperdrive and become overactive, which could lead to skin barrier defect,” he told IOL Lifestyle.
There are many emotional and mental aspects to atopic eczema that should not be overlooked, including environmental triggers and stress (which can be a psychological trigger).
In terms of other triggers, using soaps and detergents is generally not good for people with atopic eczema because, “when you use harsh soaps or detergents it washes away the protective barrier and breaks down the skin barrier that is trying to replace itself once again,“ said Koot.
It's crucial to remember that every patient with atopic eczema is unique. The severity of the disease varies; in fact, the majority of patients have mild cases; a small patch of dry skin here and there can be easily remedied with a little moisturiser, and patients have an excellent quality of life.
“On the other end of the spectrum, however, there may be 20% of patients who are not mild; instead, they may be moderate or even severe. If these patients' diseases are managed, the psychosocial pressures they endure will be greatly reduced, which will improve their quality of life. If these patients' diseases are not managed, they bear a multifaceted burden,” Koot added.
He goes on to say that the extreme itch and physical pain are misunderstood and underestimated as a burden of atopic eczema. Many patients describe the itch as all-consuming and worse than pain. This itch is often accompanied by pain caused by scabbing and open wounds from uncontrollable scratching inevitably leading to skin infections.
“There is a high level of depression and frustration for patients with atopic eczema compared to other skin diseases such as the cost of visiting doctors and specialists, purchasing expensive prescription, wet wraps, and topical therapies is something that is often overlooked.”
In addition, patients may lose income if their health prevents them from working. A lack of productivity and poor focus are consequences of additional sleep disruptions.
Dr Koot said there was a common misconception that food was often a major trigger.
“While it may be true that certain foods cause flare-ups in some individuals, no healthcare provider should advocate for food elimination diets without first consulting a professional. Food is frequently not the trigger; atopic eczema may inadvertently cause food allergies than the other way around.”
How does one manage atopic eczema?
The simple solution is to go from soap to aqueous cream, o treat skin delicately, and to avoid rubbing it dry with a towel after bathing.
The principle of treatment is simply applying moisturiser frequently; if necessary, ten times per day. The mainstay of treatment is moisturiser, followed by atopic creams and ointments, if these don't work, a dermatologist referral, and finally systemic treatment is necessary. Patients should not accept a lower quality of life because many of them have been dealing with atopic eczema since they were children, and it has long been believed that atopic eczema is a disease that only affects children.
Another method to explore with a healthcare practitioner is the use of topical creams and ointments with the proper potency as maintenance therapy to prevent flares. Where topical therapies are ineffective, it is usually advised to move on to a trial of phototherapy or systemic medication, Dr.Koot said.
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