Atopic dermatitis / Atopic eczema / Endogenous eczema

Atopic dermatitis is a chronic, or chronically recurring, inflammatory, non-infectious skin disorder that is accompanied by itching. It frequently occurs within families, on its own, or together with hay fever and/or asthma bronchiale. These three conditions are known as atopic illnesses.

Atopic dermatitis is one of the most common skin disorders in children (10 – 20 %) and this trend is on the increase. There are great differences in the manifestation and severity of the skin condition. Mild forms, with few symptoms, are frequent, even in children. However, variable right through to severe forms, affecting large areas and requiring continuous intensive therapy, also occur. The causes of the disorder have not yet been fully clarified. There is a genetic predisposition which affects a number of genes (polygenic inheritance).

In addition, various environmental influences frequently play an important role in triggering atopic dermatitis. These include irritant and pseudoallergic factors, such as certain textiles, foods and food additives, household cleaners (detergents), perspiration, irritants in the air (aeroallergens) and hard water.

Microbial factors, such as certain bacteria (e.g. staphylococcus aureus) and infections, as well as psychological factors, also rank among the provocation factors of atopic dermatitis. UV light, hormones and certain climatic conditions may have an unfavorable effect on the disorder, too.

People suffering from the illness have disturbances of the immune system (disturbed T-cell regulation), vegetative nervous system and epidermal barrier function. The disturbed skin barrier leads to increased transepidermal water loss (TEWL) (direct and uncontrolled through the outer layer of skin and not, for example, controlled through openings in the sweat glands) and therefore to skin dryness which, in turn, causes itching, often very severe.

Scratching may provoke eczema-like skin lesions (redness, flaking, sometimes blistering, thickening of the skin, sometimes areas that have been scratched open, are bleeding or are scabbed). This eczematized skin and, to a lesser extent, the remaining, unaffected, skin, is also hypersensitive to a wealth of irritant and immunologically effective environmental stimuli (see above). There is evidence that the production of certain skin lipids (= fats, especially ceramides) is lower, and perhaps even modified from a quality point of view, in people who suffer from atopic dermatitis. One of the things that is also assumed is that the concentration of gamma-linolenic acid (an important component of skin lipids) and urea, as a natural moisturizing factor, is reduced.

Modern treatment approaches: 

A personal consultation with a dermatologist, and an individually adapted holistic therapy corresponding to the specific stage of the disorder, are of particular importance for atopic dermatitis. Clarification of individually relevant provocation factors is a key component.

Modern treatment concepts are based on

  • a regular, accompanying basic therapy consisting of skin care products and bath oils to improve the skin’s barrier function (the skin’s “protective mantle”) on the entire body,
  • advice on organizing living environment and lifestyle to avoid individually relevant provocation factors, and, depending on the condition of the skin,
  • a specific, topical (external) anti-inflammatory and antimicrobial (germicidal) therapy appropriate to the stage of the disorder,
  • if applicable, phototherapy, and
  • a systemic (internal) anti-inflammatory, antimicrobial and antipruritic (to relieve itching) therapy.

For the specific, external anti-inflammatory therapy, topical glucocorticoids (cortisone preparations) and calcineurin antagonists (= immunosuppressives from the macrolactam group), such as pimecrolimus and tacrolimus, are the main treatments which are successfully deployed.

Basic dermacosmetic care: 

The strict basic care recommended by the dermatologist, and consisting of lipid-restoring ointments or creams and bath oils, is an essential component of a successful treatment for atopic dermatitis. Its objective is to counteract skin dryness caused by the disturbed skin barrier and induced by the illness, as well as torturous accompanying itching. Stabilization of the skin barrier by the care also helps to suppress new attacks and saves on specific medicines.

Suitable care products with a high oil content and the ability to bind moisture should be chosen. These should also be free of irritants. This is why fragrance-free and preservative-free products are to be recommended. To stabilize the skin barrier, ointments particularly rich in oil and containing high amounts of water, creams (W/O creams, thick, oily creams) or lipid lotions containing superior oils, are suitable. The thicker the cream or ointment is, the more difficult it is to spread over large or hairy areas. Therefore, lotions (= balms) rich in oil should be used in these cases. The care products should be applied to the entire body at least twice a day (in the morning and evening).

Bath oils can also be used to help restore lipids to the skin. These leave a lipidic film on the damp skin which, after bathing, protects against moisture evaporation and dryness. It is also recommended to apply a cream to the skin while it is still damp. The temperature of the bath water should not exceed 32 - 37°C and the bath should not last longer than approximately 15 minutes.

To cleanse the skin or to shower, lipid-restoring creamy shower oils that are kind to the skin, have a neutral to slightly acidic pH value, and which do not dry the skin out, are suitable. A cream should then be applied to the skin while it is still damp.

 

DADO SENS care recommendation:

  • Dry skin:

ExtroDerm

  • Mature facial skin

ExtroDerm + Ectoin Anti-Aging Fluid

  • Severely irritated areas:   

ProBalance Akut Soothing Acute Cream / ProBalance Akut Soothing Acute Spray

  • Sun protection:

Sun Cream SPF 50 / Sun Cream Kids SPF 30 / Sun Cream Kids SPF 50 or Sun Lotion SPF 30