Atopic eczema is a common disease in industrialized countries and can affect up to 20% of children and 3% of adults. It is striking that the disease appears in 60% of children before the age of one and is diagnosed four to six times more frequently compared to the incidence 50 years ago.
The main symptom in those affected is severe itching, which is primarily triggered by a disturbed barrier function of the skin. In most cases, eczema patients present with sensitive, dry skin accompanied by redness. Susceptibility to external stimuli, such as scratching, leads to further irritation, resulting in a vicious cycle of irritation and itching. Since the symptoms occur particularly at night, other accompanying symptoms such as irritability or poor concentration can be indirect sequelae of atopic dermatitis in addition to a sleep deficit. Provocation factors (triggers of atopic dermatitis) can be, for example, external mechanical irritations of the skin (clothes, allergens) or internal, such as sweating, physical stress, poor diet or alcohol.
Allergies can also negatively affect the overall picture of atopic eczema. Airborne allergens (aeroallergens), animal dander, pollen, or food allergens (milk, egg whites, wheat, etc.) are considered other trigger factors (triggers).
The cause of atopic eczema is not fully understood. It is assumed to be multifactorial (multiple causes).
Symptoms can vary in severity among affected individuals. In principle, it can be assumed that the skin barrier (disturbed skin flora consisting of various good bacteria) can no longer withstand external attacks by bacteria (e.g. Staphylococcus aureus) or yeasts (e.g. Malasezzia) and progressive colonization leads to further deterioration of the skin condition.
Atopic dermatitis occurs in episodes and can vary in duration and intensity. In an acute phase, inflammatory symptoms predominate, such as redness, oozing with crust formation, which can lead to a so-called secondary infection (grafted infection) with bacteria or fungi. Infants in the first 3 months of life may develop atopic eczema with a cradle cap on the head or redness (erythema) on the cheeks with no vesicles (papulovesicles). Scratching may result in weeping and crusty areas of the body (face and sides of arms, knees) that may become bacterially inflamed if left untreated. The predilection sites (skin areas showing symptoms) vary from the infant stage (first 3 months) through puberty to adulthood.
Diagnosis is mainly clinical (appearance) and by family history (occurrence in the family). In most cases, the affected show certain so-called atopistigmata, such as a dry skin (sebostasis), thinner lateral eyebrow area (Hertoghe's sign), a double lied fold and a paradoxical vascular reaction (white stripes when scratching the skin - in healthy red stripes).
The treatment of atopic eczema can be as varied as its appearance. Due to a disturbed skin barrier, basic care with ointments and lotions is recommended, the composition of which is adapted to the skin condition. Externally, specific active substances (urea, evening primrose oil, zinc, dexapanthenol), infection-inhibiting (antibiotics in the case of skin colonization) or anti-inflammatory ointments (glucocorticoids) or also immune-suppressive active substances (tacrolism) are in the foreground. In the case of far advanced symptoms and especially in children, antihistamines are used to reduce itching. In particularly severe manifestations, clucocorticoids and immunosuppressive agents from transplant medicine (cyclosporin A) continue to be used.
Other measures such as light therapy, climatic treatment, high-dose vitamin administration (vitamins E and D) and self-management (reduction of stress factors, alcohol awareness, allergen management) are effective options in the treatment of atopic eczema.
Another measure is the additional support by simple and oral intake of probiotics. See our product Protexema.
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