Eczema (Atopic Dermatitis) Treatment in Indore

Atopic dermatitis, also known as eczema, is a chronic inflammatory skin disease characterised by dryness, itchiness, and the presence of inflamed skin patches. This is one of the most common skin disorders, especially in children, and often follows a relapsing-remitting pattern in which symptoms flare up and then temporarily improve.

1. What is Atopic Dermatitis?

Atopic dermatitis is chiefly a problem of:

Skin barrier dysfunction

Immune system overactivation

Genetic susceptibility

Environmental triggers

The skin of a person with eczema is not able to adequately retain moisture; therefore, it is sensitive to irritation and allergic factors.

2. Causes & Underlying Mechanisms

Eczema is multicausal; no single cause. Key contributors include:

1. Skin Barrier Dysfunction

People with eczema have defects in the skin's natural barrier:

Lower levels of ceramides, or skin lipids

Loss of natural moisturising factors

Impaired integrity due to filaggrin gene (FLG) mutations

This leads to:

Excessive loss of water (xerosis, or dry skin)

Microcracks in the skin

Increased penetration of irritants, allergens and microbes

2. Immune Dysregulation

Eczema is strongly associated with an overactive Type 2 immune response:

Increased IL-4, IL-13, IL-5

Increased IgE levels

Heightened allergic tendencies

This causes:

Itchiness

Red, inflamed skin

Sensitisation to allergens

3. Genetic Factors

A family history of:

Eczema

Asthma

Allergic rhinitis

increases risk because of shared genetic traits, the atopic triad.

4. Environmental & Lifestyle Triggers

Common triggers include:

Soaps, detergents, perfumes

Dust mites, pollen, pet dander

Dry or cold weather

Heat and sweating

Stress

Wool or rough fabrics

Food allergens, in some children

3. Symptoms of Atopic Dermatitis

Core symptoms

Intense itching (major hallmark)

Dry, rough or scaly skin

Red or inflamed patches

Cracked, thickened, or leathery skin (chronic)

Oozing or crusting (acute flare-ups)

Darkening or lightening of the skin following flares

Distribution by Age

Infants (0–2 years)

Cheeks, forehead, scalp

Extensor surfaces of limbs

Frequently crusting or oozing

Children (2–12 years)

Flexural areas (elbows, knees)

Wrists, ankles

More lichenification, or thickening from scratching

Adults

Neck, eyelids

Hands (hand eczema is common)

Flexural folds

More chronic dryness and cracking

How It Appears in Different Skin Tones

Light skin: red and pink patches

Dark skin: purple, grey or dark brown patches

Post-inflammatory hyperpigmentation is more common in darker skin.

4. Types of Eczema (Related to AD)

Although “eczema” often means atopic dermatitis, other types include:

Atopic dermatitis - chronic allergic-type eczema

Contact dermatitis - irritant or allergic reactions

Nummular eczema - coin-shaped patches

Dyshidrotic eczema - small blisters on hands/feet

Seborrheic dermatitis – oily, flaky patches (scalp, face)

Atopic dermatitis is the most common and can frequently coexist with allergies.

5. Disease Process (How It Develops)

Trigger (irritant, allergen, stress, climate)

Skin barrier injury → loss of moisture

Entry of irritants/allergens/microbes

The immune system overreacts

Inflammation → redness, itching

Scratching worsens barrier damage.

Continued itching → chronic thickening, scaling

This is known as the itch-scratch cycle.

6. Diagnosis

Diagnosis is clinical:

Pruritic dermatitis, persistent or recurrent

Distribution typical of eczema

Skin appearance (dry, inflamed, lichenified, or oozing)

Personal or family history of atopy

Exclusion of other rashes: psoriasis, infections, contact dermatitis

Tests may be utilised in selected situations:

Allergy testing

Patch testing

Skin swabs if infection is suspected

7. Possible Complications

1. Skin Infections

A fragile skin barrier and scratching lead to:

Bacterial: Staphylococcus aureus, Streptococcus

Viral: eczema herpeticum (from HSV)

Fungal: yeast infections in folds

2. Thickening of the Skin (Lichenification)

Results from chronic rubbing and scratching.

3. Sleep Disturbance

Itching tends to worsen at night.

4. Changes in Pigmentation

Hyper-pigmentation (darker spots)

Hypopigmentation (lighter spots)

These can last even after the resolution of the rash.

8. Long-Term Course

Often begins in early childhood

Many children improve with age.

Some continue into adulthood.

Chronic condition with flares precipitated by the environment, stress, or irritants

Manageable with proper care

9. General Management Principles (Educational Overview)

(Not individual medical advice.)

Daily Skin Care

Regular moisturising (2–3x/day)

Use fragrance-free products

Short baths or showers - lukewarm

Pat skin dry, then apply moisturiser immediately (3-minute rule)

Trigger Avoidance

Limit soaps and detergents

Avoid wool or rough fabrics

Reduce exposure to allergens, if applicable

Maintain humidity

Manage stress

Medical Therapies (Provided by Clinicians)

May include:

Topical anti-inflammatory agents

Anti-histamines (for sleep/itch

Medications for severe cases: biologics, immunomodulators

If you'd like, I can provide a comprehensive overview of a treatment plan, moisturiser guide, or step-by-step flare management.

10. Prevention Strategies

Smearing consistently, especially during dry seasons.

Gentle skincare routine, avoid known triggers, maintain good humidity levels, and treat flares early to prevent worsening.