I sure do love spring, but not so much of what comes right along with it … allergy season. Seasonal allergies can act as a trigger for many conditions here in dermatology. As we approach the spring allergy season, I want to touch on one of the most common conditions that we see in the office: atopic dermatitis.
First, a little background info: “dermatitis” and “eczema” are two terms used interchangeably, and simply mean inflammation or irritation of the layers of the skin. Atopic dermatitis, or atopic eczema, refers specifically to a chronic, itchy skin condition. It is caused by a combination of several factors: genetic predisposition, skin barrier disruption, and environmental triggers. Triggers include allergens, like dust mites and pollen (hello, spring!), changing weather, certain types of clothing, heat, and emotional stress.
Patients with atopic dermatitis (AD) typically come to the office with dry, itchy skin, and the subsequent development of red or pink, bumpy or scaly rashes (hence, why AD is known as “the itch that rashes”). The rashes that develop lead to more itching, which worsens the rash, leading to a vicious itch → scratch → rash cycle. It’s frustrating! The rash of AD can also present much differently depending on the patient’s age and skin type. In general, it tends to love skin folds and “flexural” areas (like the elbow crease and behind the knees).
Treatment for AD aims to restore the skin barrier and decrease the underlying inflammation present in affected skin. To restore and protect the skin barrier, we typically recommend frequent use of unscented, gentle moisturizing products that contain key ingredients such as glycerol, urea, lactic acid, petrolatum, and/or ceramides. To fight inflammation, prescription treatment options include topical steroid creams for short-term use and topical nonsteroid anti-inflammatory creams for more long-term use (such as tacrolimus, pimecrolimus, Zoryve, or Opzelura). If topical therapy does not work as well as we’d hoped, there are several advanced oral and injectable biologic medications (like Skyrizi, Ebglyss, and Nemluvio) that we can use to specifically target key players of the immune system involved in the pathogenesis of AD.
Here at Hamilton Dermatology, we see all ages & stages of atopic dermatitis. If you or your child is battling the notorious itch that rashes, schedule an appointment with one of our providers!
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