Atopic Eczema: How Common Is It and How Can It Be Treated?

Atopic dermatitis

Atopic Eczema: How Common Is It and How Can It Be Treated?

Living with atopic eczema or dermatitis can be hard because of its increasing prevalence across the world. Although it can settle as you get older, atopic eczema is still challenging to treat. This article looks at the prevalence of atopic eczema, its treatment options, and some home remedies for improving its symptoms.

What Is Atopic Eczema?

Atopic eczema is a complex pruritic skin condition that results in skin dryness, itchiness, and rash. Atopic eczema is also known as atopic dermatitisThis chronic condition starts in early infancy but can also affect adults (1).

Atopic eczema mainly occurs on the arms, neck, face, behind the knees, and inside the elbows. If you have a family history of food allergy, hay fever, asthma, or any other allergic disease, you are at substantial risk of having atopic eczema.

What Causes It?

No scientific research has fully sorted out the primary cause of atopic eczema. When exposed to irritants, the immune system becomes overactive and disordered, leading to inflammation. The skin becomes itchy and dry as a result of inflammation-causing damage to the skin barrier. Dry skin becomes susceptible to rashes and cracks in atopic eczema (2).

One primary cause of atopic eczema is genetics. You are more prevalent to having atopic eczema if any of your parent has any allergic disorder, asthma, or any form of eczema.

According to a research study, atopic eczema is caused by a mutation in a gene that is responsible for creating filaggrin. This protein maintains a protective, healthy barrier of the skin. Insufficient filaggrin loses its ability to build a healthy barrier, due to which skin's natural moisture is lost, and bacteria & viruses can enter into the skin. This is the reason why people with atopic eczema are more prone to infections and dry skin (3).

How Common Is Atopic Eczema?

Being one of the most common types of eczema, atopic eczema is affecting a significant population worldwide. As atopic eczema is more common in children, it affects 15-20% of children across the globe. About 1-3% of adults are also susceptible to having atopic eczema. It means that there is a 2-3 fold increase in the incidence rate of atopic eczema worldwide (4,5).

In the United States, about 10.1% (31.6 million) of people have some form of eczema (6). Atopic eczema impacts 7.3% of adults in the United States, among which about 40-50% of people have moderate to severe disease symptoms (7).

In the United States, more than 9.6 million children develop atopic eczema every year. Also, atopic eczema accounts for 10-20% of referrals of males and females to dermatologists (8).

Symptoms Of Atopic Eczema:

Atopic eczema starts showing its symptoms before a child is five years old. The symptoms of atopic eczema in infants include dry and scaly skin on the face characterized by red patches. These red patches can spread to the neck, arms, and legs.

Other symptoms include:

Red rashes on knees and elbow creases.
Flaky skin
Small bumps on the skin
Cracked skin that sometimes starts bleeding.
Intense itching

What’s New In Science?

Atopic eczema is difficult to treat, and this itchy condition leaves many people frustrated. A lot of research studies are conducted to develop different ways of treating atopic eczema. One research study involving blind clinical trials found that atopic eczema may be treated by a universal bacterial strain derived from healthy human skin (9).

Another research by NIAID is in progress to identify how the contribution of the immune system triggers the development of atopic eczema. The study is also focusing on the genetic determinants of atopic eczema so that an effective treatment may be developed to improve lives with severe atopic eczema (10).

Treatment Options For Atopic Eczema:

As there's no cure for atopic eczema, its symptoms can be improved by different treatment options. The following are the main treatments:

1. Emollients (moisturizers): Atopic eczema causes extreme dryness of the skin. Moisturizers are the first treatment option for relieving itchiness and dryness of the skin. The best time to apply a moisturizer is to apply it immediately after bathing. Lotions, creams, and ointments are three types of moisturizers that can be very helpful in hydrating the skin.

2. Topical Steroids: Topical steroids come as ointments and creams to prevent inflammation during flare-ups. Low potency topical steroids are helpful as a short-term treatment option. You should apply topical steroids to your skin twice a day. However, they are not a good option as a long-term treatment option.

3. Antihistamines: Atopic eczema can also be treated by the oral supplementation of antihistamines. However, there’s no validation on the efficacy of antihistamines. But the itch-scratch cycle can highly be managed by antihistamines like Benadryl (diphenhydramine) (11).

4. Oral Medications: One of the most studied treatment options for atopic eczema include oral medications like cyclosporine or interferon, oral corticosteroids, and antibiotics in case of bacterial infection.

5. Phototherapy: Phototherapy has been proved to be effective in 70% of people undergoing it. During phototherapy, patients are treated with ultraviolet B light (NB-UVB) to overcome the damaging effects of ultraviolet A radiation coming from the sun (12).

Home Remedies For Treating Atopic Eczema:

If you want to ease the symptoms of atopic eczema, you can try the following home remedies:

1. Don’t Scratch The Affected Area: Whenever your skin feels itchy, do not scratch it because scratching the skin causes inflammation and bleeding. Rather than scratching it, gently press the skin. For infants with atopic eczema, trim their nails so that they do not scratch the skin.

2. Take A Warm Bath: Bathing is important for hydrating and retaining moisture in your skin. Avoid taking long hot showers because they can dry out your skin.

3. Use A Humidifier: The itching and flaking of the skin can be worsened by dry indoor air. Use a humidifier to lock moisture in the air inside your home.

4. Apply Bandages: You can avoid scratching by protecting the affected area of the skin by applying bandages.

5. Soap And Moisturizer: Using a good moisturizer and mild soap will protect your skin from drying out. Shower with soap and smooth the skin with a lightweight moisturizer at least one time a day.

Written by Amanda Samuelsson

References:

1. Atopic Dermatitis: Practice Essentials, Background, Pathophysiology. 2021 Jul 29 [cited 2021 Aug 10]; Available from: https://emedicine.medscape.com/article/1049085-overview

2. De Benedetto A, Agnihothri R, McGirt LY, Bankova LG, Beck LA. Atopic Dermatitis: A Disease Caused by Innate Immune Defects? J Invest Dermatol. 2009 Jan 1;129(1):14–30.

3. Weidinger S, O’Sullivan M, Illig T, Baurecht H, Depner M, Rodriguez E, et al. Filaggrin mutations, atopic eczema, hay fever, and asthma in children. J Allergy Clin Immunol. 2008 May 1;121(5):1203-1209.e1.

4. Atopic Dermatitis: Global Epidemiology and Risk Factors - FullText - Annals of Nutrition and Metabolism 2015, Vol. 66, Suppl. 1 - Karger Publishers [Internet]. [cited 2021 Aug 11]. Available from: https://www.karger.com/Article/FullText/370220

5. Overview of Atopic Dermatitis [Internet]. AJMC. [cited 2021 Aug 11]. Available from: https://www.ajmc.com/view/overview-of-atopic-dermatitis-article

6. Eczema Prevalence, Quality of Life and Economic Impact [Internet]. National Eczema Association. [cited 2021 Aug 11]. Available from: https://nationaleczema.org/research/eczema-facts/

7. Atopic Dermatitis in America | AAFA.org [Internet]. [cited 2021 Aug 11]. Available from: https://www.aafa.org/atopic-dermatitis-in-america/

8. What is atopic dermatitis and how can I tell if I have it? [Internet]. National Eczema Association. [cited 2021 Aug 11]. Available from: https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/

9. Universal strain of bacteria derived from healthy human skin can treat eczema [Internet]. News-Medical.net. 2021 [cited 2021 Aug 11]. Available from: https://www.news-medical.net/news/20210223/Universal-strain-of-bacteria-derived-from-healthy-human-skin-can-treat-eczema.aspx

10. Eczema (Atopic Dermatitis) Studies | NIH: National Institute of Allergy and Infectious Diseases [Internet]. [cited 2021 Aug 11]. Available from: https://www.niaid.nih.gov/clinical-trials/eczema-atopic-dermatitis-studies