Eczema (Atopic Dermatitis)
Atopic Dermatitis (AD) is an itchy, skin rash that commonly shows itself on areas where the skin folds (the crooks of the elbows and knees, the sides of the neck, and eyelids) but really can show up anywhere. AD affects up to 17% of Canadians and 90% of those tend to be under the age of 5. 10% of school aged children are affected by AD and 1-3% of adults suffer from this condition too.
What is going on within eczema prone skin is quite a fascinating part of dermatology. A complex interaction between immune system “confusion” known as dysregulation, as well as a defective skin “barrier” all mixed together with environmental influences results in the development of atopic dermatitis. What is really cool is that there are higher rates of atopic dermatitis in urban centers compared to rural communities. This is explained by the “Hygiene Hypothesis” which basically translated = let your kids roll in the mud and cuddle barn creatures while sticking their fingers in their mouths, and you will help them create protection against developing atopic dermatis (score to my parents who let me get dirty on the farm growing up).
We are learning more and more about the complexities of the epidermal barrier and how it is altered in eczema prone patients. The pH balance, the lipids, the water content, the function of proteolytic enzymes and numerous other cellular level processes contribute to the development of atopic dermatitis. It is an exciting time for research surrounding the understanding of this complex science as new therapies are on the horizon (is it obvious how excited this makes me?).
Living with atopic dermatitis, either personally, or through someone you love and care for, is a challenge. Effective care of atopic dermatitis takes commitment, time, and a lot of work. In the dermatology clinic we believe in educating patients in proper skin care that will set them up for minimal flaring of their eczema over time. We support your efforts through guidance on use of moisturizers and medications, avoidance of triggers, teaching you how to monitor and seek help when an infection shows itself, and how to do things in your every day that can drastically improve eczema. Something as simple as wearing your mittens in the cold Winnipeg winters can make a big difference to those eczema prone hands. If that doesn’t work, you can always move to a warmer, more humid climate, (Barbados anyone?). We have options these days for controlling atopic dermatitis medically and I am hopeful that more choices for treatment will soon be available to patients.