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Atopic Eczema

Treatment at Auro Skin Clinic

The treatment options available for Atopic Eczema Treatment at Auro Skin Clinic are:

  • General examination with detailed history and lifestyle and other comorbid conditions is first done for all Atopic dermatitis patients. 

  • Generally a medical line of treatment is prescribed. Sometimes blood tests and then medication accordingly is given according to the disease severity. 

  • Biopsy is rarely required but if needed can be added to diagnosis. 

  • For localised Eczema areas, Auro skin clinic provides Excimer light treatment, a form of phototherapy.

  • Parents counselling stays the baseline management and a paediatrician is always kept in loop.

What is Atopic Eczema?

  • Atopic Eczema or Atopic dermatitis is a very itchy chronic skin condition.

  • It often presents in infancy or early childhood, but can start in adult life too. 

  • Around the world, 10-20% of children and 3-4% of adults suffer from Atopic dermatitis. Atopic Dermatitis is much more common today than it was 30 years ago.

How can one get Atopic dermatitis? What happens to the skin in Atopic dermatitis?

  • Getting Atopic dermatitis is a kind of tendency. 

  • There may be a family history of Eczema, asthma, allergies or allergic rhinitis.

  • Alterations in the immune system occur and cause a reaction or inflammation in the skin, which is manifested as Atopic dermatitis. 

  • The skin is an envelope that keeps body fluids within. It also protects from invading germs, chemicals and injury.

  • In Atopic Dermatitis, the skin is a bit different. The water holding capacity is defective, resulting in an extremely dry skin. It allows allergens and infections to gain entry into the skin. It is suspected that allergens entering the skin may be responsible for asthma in later life. This means that treating Eczema effectively early on may in all likelihood help against development of asthma later on rather than the other way around as it is spread by people practising alternative medicines.

  • Atopic skin has a very low itch threshold. In Atopics the slightest itch stimulus gets magnified and translated into bouts of frenzied itch. In Atopics, touch also gets converted to itch on inflamed skin. Mothers should be advised not to kiss or peck their children on the cheek if there is frank Eczema.

What are the trigger factors in Atopic dermatitis?

​Triggers are those factors that the skin is not comfortable with and cause worsening of Eczema. These include:

  • Extremes of climate-very cold and dry weather and hot, humid climate 

  • Sweating is a potent stimulator of itch 

  • Strong soaps and shampoos

  • Cloth detergents and fabric softeners 

  • Woollens, synthetic fibres, rough and ill-fitting clothes 

  • Furry soft toys 

  • Exposure to pets 

  • House dust

Foods that can cause allergies are common in infant and younger children. But the role of foods in worsening Atopic dermatitis is often dubious. Food causality in individual cases should be closely discussed with the treating dermatologist.

Emotional stress, exposure to contact irritants and allergens, antiseptics in baths can aggravate Atopic dermatitis.

How does the skin appear in Atopic dermatitis?

  • There is severe itching in Atopic dermatitis. An itching paroxysm may get triggered off anywhere and can be quite embarrassing. 

  • It may be red, flaky, sometimes oozing and covered with scabs.

  • The skin is extremely dry. 

  • In infants, the face, scalp, and the extensor surfaces of the limbs are affected. As the child grows older, the rash gets localised to the folds on the extremities, flaky dry skin may be seen behind the knees, thighs and the neck area may appear dark. In many children it subsides as the patient grows older. In adults, there may be severe thickening of the skin and dryness on the limbs and face. It can get aggravated on exposure to irritant substances.

What should one do if he/she gets Atopic dermatitis?

  • Consult a dermatologist since it can be easily diagnosed by the dermatologist by the clinical appearance of the lesion.

  • Appropriate counselling, emollient therapy and medications will be recommended by the dermatologist as per the needs.

Are there tests to confirm the diagnosis of Atopic dermatitis? 

  • Regular use of moisturisers and avoiding the trigger factors play a key role in treating Atopic dermatitis.

  • Working around the trigger factors improves Atopic Dermatitis and reduces the need of medications. 

  • Topical moisturisers (to avoid dryness), topical steroids and immunomodulators (to reduce inflammation in the reactive skin), antihistamines (to reduce the itch) are the chief treatment options. Moisturiser should be always lanolin-free, and fragrance-free.

  • Systemic antibiotics (in cases of infection) or systemic drugs (such as cyclosporine, methotrexate, and steroids to suppress the immune response) may be recommended in severe cases. 

  • Phototherapy such as Narrow band ultraviolet B therapy can also help in reducing the disease intensity. 

  • It is important to consult and follow up with the dermatologist and not self-medicate.

Can Atopic dermatitis recur?

  • Atopic dermatitis can recur if one is exposed to the trigger factors or the skin remains excessively dry. 

  • Regular use of moisturisers, identifying and working around means to avoid the triggers goes a long way in preventing recurrences in Atopic dermatitis.

What are the tips for the family members to win over Atopic dermatitis?

  • When a child has severe Atopic Dermatitis, the whole family bears the brunt. Thechild bothered by a constant itch is cranky, irritable, and fidgety with a limited attention span. 

  • The parents, having stayed awake for nights together with the child, are wrecks fighting anxiety and depression. Likewise, the family that fights Eczema together is more likely to emerge victorious.

Tips for the family include:

  • Avoid the blame game (comments like “How many times have I told you not to itch”, “I told you not to do so and so! Now suffer” serve no real purpose and undermine the child’s confidence). 

  • Fighting a common enemy (the whole team including Eczema sufferer, the family and the treating physicians will all play their role) 

  • Praise the slightest achievement (children with Eczema have to endure a lot. Each time they comply with treatment, acknowledge the act. Again the praise should be genuine and not come across as put on or fake) 

  • Have your own ideas regarding what to do when the itch really goes out of hand 

  • Think clear skin (like people who are battling obesity from imagining how they would look if they were slim, imagining a clear smooth skin can motivate Eczema sufferers to be regular with treatment schedules). 

  • Involve children in treating themselves.

  • Make moisturising a fun activity.

  • Be proactive (rather than fire-fighting, when the Eczema really goes out of hand, regular use of moisturisers on apparently normal skin and other measures suggested by your dermatologist can go a long way).

Consult your skin specialist or child specialist for proper guidance.

Finally, there is one sweet word in Eczema management: REMISSION. It is that phase when Eczema does not require active treatment for weeks to months. All the efforts should be centred on getting people with Eczema to this sublime state.


The above clinical content is published by The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) for circulation amongst patients for their education purposes.


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