People suffering from atopic dermatitis have skin that can be labeled as “defective”. Some proteins in its outermost layer do not function properly and this makes the epidermal barrier more vulnerable. In addition, the mechanisms of skin inflammation are not fully adjusted. Thus, the combination of these two factors causes outbreaks of dermatitis in the form of eczema (red, scaly, itchy skin) to appear. In this link you can read more about the causes of atopic dermatitis.
There are some basic measures in the daily life of people with dermatitis that we are going to review below:
Moisturizer is your best ally
Skin with atopic dermatitis has an altered lipid mantle, which causes it to lose water through its surface more easily than non-atopic skin. Emollient creams help replenish the naturally defective mantle, making it easier to retain water and decreasing the likelihood of inflammation in the area.
However, if you have dermatitis, you’ll know that moisturizer on red, flaky areas stings a lot. So how to proceed? Let’s move on to the next point.
Treatment: the sooner the better
If the skin is scaly, red and/or itchy, it is likely that it is not healthy skin, but already has some degree of inflammation, i.e. it is a dermatitis outbreak.
At this point, the moisturizing cream is not able to reverse the inflammation that is occurring, and as the skin surface is altered, contact with the components of the cream generates discomfort.
The interesting thing at this point is to reduce inflammation and for this nothing better than drugs such as corticosteroids or calcineurin inhibitors. The sooner you apply them, the shorter the duration of the outbreak, the less annoying you will be and the easier it will be to tackle the problem.
Shower or bath: no fixed rules
On many occasions I have heard people advise showers versus baths, as well as decreasing the frequency of baths. The reality is that at present there is still no clear scientific evidence about what is best, and there is no reason to advise against one or the other.
In general, we can do whatever makes us feel most comfortable in terms of hygiene. The important thing is to always apply moisturizer after showering or bathing as (this has been proven) this is the best time to do so. Applying the emollient after most of the water has been removed from the skin surface but while it is still damp allows for greater retention of moisture and greater effectiveness of the moisturizer we are using.
Fragranced cosmetics: the fewer the better
People with atopic dermatitis have an increased risk of becoming sensitized to certain molecules, i.e. becoming allergic to them. We are not talking about allergies that cause asthma or urticaria, but allergic contact dermatitis. People with contact allergy develop eczema (outbreaks of dermatitis) similar to atopic dermatitis after contact with a particular substance (metal, colorants, dyes, preservatives ….).
Perfumes are present in a lot of cosmetics. Knowing that, if you have dermatitis, the risk of developing some sensitization is higher, it is generally advisable to use low perfumed products in order to avoid this complication.
If you do not improve, talk to your dermatologist
You may have followed these guidelines with all the rigor in the world. You may have applied moisturizer daily and treated your outbreaks with discipline right after their appearance and yet you see that you are not improving, that your skin itches and the treatment does not help.
In this case, talk to your dermatologist. Chances are you are not doing it wrong. There are simply cases of atopic dermatitis that cannot be managed with creams alone. Fortunately, there are other treatment options that your dermatologist can explain to you. The goal is to avoid discomfort and itching so that they have the minimum impact on your quality of life and that you feel well, which is what is really important.
Do you have atopic dermatitis and how do you manage it?
