Eczema is an inflammatory skin disease that accompanies itching and rash. Other names include atopic eczema, atopic dermatitis, constitutional eczema or prurigo besnier.
Atopic dermatitis is a darn disease that gives many puzzles to medicine. Unfortunately, despite extensive research, atopic dermatitis has so far not been curable. In addition, there is no therapy that would be equally effective for each patient. What helps a patient very well, the other can not strike. Therefore, it may be useful to try a variety of treatment options. For all neurodermatitis, however, the following applies: Avoid shock-inducing factors, treat inflammation as quickly as possible and maintain the skin well.
About 15 to 20 percent of all children and 1 to 3 percent of adults in industrialized countries live with this condition. In Germany, more than two million people suffer from atopic dermatitis alone. And the incidence is increasing. Why this is so, is still debatable. Improved living conditions with extensive hygiene as well as the increasing frequency of allergies are discussed.
In contrast to psoriasis (psoriasis), which is often seen on the extensor side, atopic eczema typically occurs on the flexor side (especially at the elbow and back of the knee) as well as in the neck and facial area. In the affected areas, the skin is extremely dry, red and inflamed. She sometimes itches very much. This is a serious problem especially for children. Understandably, you will find it particularly difficult to avoid scratching when the itching starts to get worse. Unfortunately, scratching aggravates eczema because it causes new skin irritation. This creates a self-reinforcing cycle of ever-new skin irritation, itching and scratching. This cycle has to be broken therapeutically.
Nodules and pustules due to atopic dermatitis
Skin thickening and coarsening (so-called lichenification), nodules and pustules are characteristic symptoms of atopic dermatitis. In addition, the skin is often sensitive and prone to external stimuli, such as sweat, detergents, clothing or food. Sometimes the skin itself reacts to hard water with redness and eczema. Most of the complaints occur in spurts.
External signs of atopic eczema
There are special features that often indicate atopic dermatitis. These include, among others:
- dry skin and lips (sebostasis)
- laterally thinned eyebrows (Hertoghe sign)
- double lower eyelid fold (Dennie Morgan fold)
- frequent conjunctivitis
- reinforced drawing of the hand lines
- frequent skin eczema or skin infections
- Decolorization of the skin after mechanical stimuli (so-called white dermographism).
Eczema symptoms by age
Depending on the age, the symptoms of atopic dermatitis may differ.
Cradle scab in babies: Baby dermatitis is also referred to as infant eczema. It occurs from birth until the second year of life. The skin of the infant / toddler is reddened and shivers. In particular, the scalp and cheeks are affected. The diseased areas can be dark red and wet. Later, the wet spots dry out and a scab forms. It is also called milk scab, because this scab looks like dried milk. Often this milk scab forms itself back on its own. However, with age, other parts of the body, such as the diaper area, may also be affected.
Eczema in children and adolescents: From the age of 3 to 18 years, the typical appearance of atopic dermatitis (see symptoms) occurs, affecting the elbows and popliteal fossa. The itching is especially stressful for children. Especially at night he disturbs the peaceful and restful sleep. This often results in sleep disorders in childhood. During the day, lack of concentration and constant tiredness are the result. In addition, there are often family tensions and mental stress. These in turn worsen the skin symptoms of atopic dermatitis. Not infrequently, such an intensifying cycle arises.
As in infancy, atopic eczema can also subside in this phase and disappear by itself. Unfortunately, however, the opposite is possible and the affected areas continue to spread and also affect the face, neck, wrists, ankles and backs of the hands.
Atopic dermatitis in adults: If the disease does not disappear spontaneously in childhood, one can assume a life-long neurodermatitis. Rarely does atopic eczema first appear in adulthood. Then most of the hands, ears, neck and face are affected by itchy skin symptoms.
The exact causes of atopic dermatitis are not yet known.According to modern knowledge, it is probably a combination of genetic predisposition, immunological change and external influences (so-called trigger factors). According to recent research, an enzyme produced by house dust mites (phospholipase) could also promote neurodermatitis. The enzyme alters phospholipids of human skin. These altered lipids mobilize certain immune cells (T cells) of the body's defense system, which in turn promote inflammatory reactions of the skin.
Recently, scientists have discovered certain genes that play a role in the development of atopic dermatitis. Due to the genetic defects, the normal barrier function is impaired. Certain proteins (proteins) are missing, so that the skin can form its horny layer only insufficiently and therefore dries out easily.
Dry skin in turn is more susceptible to irritation of any kind, such as the infestation of pathogens and allergens. Scratching aggravates the situation in addition, inflammation is the result. The immune system now reacts permanently with the formation of antibodies, even against per se harmless antigens such as pollen, the feces of dust mites or animal hair.
The hereditary disposition and the reaction of the immune system alone do not necessarily lead to atopic dermatitis. Only when several factors interact, the atopic eczema breaks out. These factors include external factors such as:
- Skin-drying factors (especially frequent bathing or showering)
- skin-irritating substances (such as wool clothing, preservatives in cosmetics and cleaning agents)
- increased allergen load
- Skin colonization of germs (bacteria, viruses and fungi)
- Climate factors and environmental influences (such as extreme cold or heat, exhaust gases or tobacco smoke)
- mental stress and stress.
Atopic dermatitis not psychologically conditioned
A disturbed parent-child relationship or even supposed "eczema personalities" as the cause of the disease are now considered outdated. The experts agree that eczema is not psychologically conditioned in this sense. But it can be triggered by mental stress or stress or strengthen.
The treatment of atopic dermatitis is an important pillar of treatment for many patients. Commonly used are so-called glucocorticoids such as amino-surfactant, betamethasone, dexamethasone, prednisolone and prednicarbate in the form of ointment or creams. In the treatment with these cortisone albums recurring breaks are recommended, otherwise there is likely to be a loss of effect of cortisone.
Severe episodes of eczema sometimes have to be treated with tablets. In this case, the immune system helps oppressive drugs (so-called immunosuppressants) such as glucocorticoids and cyclosporin. Bacterial infections are sometimes treated with antibiotics such as clindamycin and gentamycin. Anti-inflammatory are also shaking mixtures with zinc and tar compounds and shale oils. Antiseptics such as chlorhexiditin and triclosan have a disinfectant effect.
Two other drugs are the calcineurin inhibitors pimecrolimus and tacrolimus. These target certain defense cells (T-cell lymphocytes), which stops the inflammation.
Climatotherapy and UV radiation
Climatic therapies in the high mountains and at sea as well as radiation therapies with UVA and UVB light can support the healing of neurodermatitis. If allergies are a trigger factor, they must be treated.
Self-help in atopic dermatitis
Atopic dermatitis manifests itself in many ways - and individually very differently. This is evident in the classic treatment methods, but also applies to self-help. So sometimes you will have to experiment for a while, until you know what is helping you against the symptoms of atopic dermatitis.
Avoid trigger factors and stress
It is undisputed among experts and stakeholders that certain trigger factors favor relapses of atopic dermatitis. Allergies are among the most common trigger factors. Therefore, avoiding allergen is one of the pillars in many cases of atopic dermatitis.
Neurodermatitis is - contrary to some curious information - not a mental illness. The sometimes described atopic dermatitis personality does not exist. Nevertheless, mental factors may favor the onset of the disease or aggravation. In this respect, it is not surprising that many neurodermatitis with strategies against stress can positively influence the course of the disease.
Adjust skin care
The severely irritated skin in atopic dermatitis needs special care. Pay attention to regular skin care. Recommended are creams, lotions and moisturizing oil baths with almond, soy, evening primrose and peanut oil, low-viscosity paraffin and unsaturated fatty acids.
Itching-reducing preparations have externally applied preparations with urea and polidocanol, anesthetic sulfone and tannolact. For oral use - in consultation with the doctor - drugs with H1-antihistamines such as cetericine and loratadine into consideration.
Over-the-counter ointments containing hydrocortisone and dexamethasone inhibit (temporarily) inflammatory reactions and help heal eczema.Anti-inflammatory also affects the drug bufexamab.
Medicinal plants for atopic dermatitis
For mild skin lesions it helps to rub the affected areas with calendula marigold. You can also try to rub inflamed (not purulent!) Skin with St. John's wort oil. Even envelopes with beetroot juice to bring success.
Oak bark is astringent (astringent). Pour 10 grams of oak bark with 1/4 liter of water and bring to a boil. After cooling and straining, moisten towels with the broth and place on affected skin.
Some sufferers report good results with a tea mixture of equal parts of field horsetail, birch leaves, nettle and yarrow. Boil a teaspoon of this mixture with 1/4 liter of water and drink the tea slowly and in small sips.
More tips for self-help
- Salt baths with Dead Sea salt twice a week are also recommended for atopic dermatitis. Or make it like Cleopatra and add 1/4 liter of milk (or cream) and 1 tablespoon of olive oil to your bath water.
- Many patients swear by the natural urine therapy.
- Use clothing made of natural fibers (especially in case of direct skin contact), do not use wool and strong scratching substances.
- Avoid scratching if possible. Babies and toddlers use over-the-top mittens and short-cut fingernails to help prevent skin scratching.
- You can temporarily relieve severe itching with crush ice (in a plastic bag).
- Neurodermatitis support groups help to deal better with the disease. Exchanging information with other people is considered helpful by many patients.
Homeopathy in atopic dermatitis
In atopic dermatitis, homeopathic remedies are probably the most widely prescribed homeopathic remedies Sulfur. In addition, the following homeopathic remedies are used:
- Arsenicum (for dry and floury skin)
- Calcium carbonicum (also with milk scab and if the skin is covered with pustules)
- Graphitis (in dry, itchy and burning eczema)
- Kerosene (with cracked skin and eczema behind the ears)
- Rhus toxiconn (especially for skin changes on the hands and wrists)
- Silicea (especially with miraculous scalp and sweaty people).
Atopic dermatitis can not be prevented causally. If both parents are neurodermatitis, the baby should be presented early to an allergist. Parent genes, passive smoking and excessive hygiene increase the risk of allergies in children.
There is evidence that consistent six months of breastfeeding can help reduce the risk of outbreak of eczema. However, this assumption is not really substantiated. If breast-feeding is not possible, many experts recommend hypoallergenic baby foods (so-called H.A. food).