Adam Reich, Professor, Habilitated Doctor of Medical Sciences

Department and Clinic of Dermatology, University of Rzeszów

Atopic dermatitis most often affects children and is manifested, among other things, by severe itching. To help the patient, specialist treatment should be implemented.

Who is most likely to suffer from atopic dermatitis?

It is a disease that most affects children. Over time, in some patients, the disease process gradually disappears, although we also know that some people who are ill in childhood also suffer from it in adulthood. In some people, there is a period of complete silence of the disease, e.g. during puberty, but later the disease may return. Late-onset atopic dermatitis is also increasingly reported in people who have no history of atopic dermatitis and suddenly become ill in adulthood. Atopic dermatitis affects up to 5% of adult population. However, in childhood we observe a gradual increase in the incidence of the disease – up to 30 percent children, which means that it is a very common problem.

What are the most common symptoms of this disease?

The disease has three periods: infancy, childhood and adult. In these particular periods, the localization of skin lesions and clinical manifestations differ slightly. Undoubtedly, the basic symptom concerning almost all patients is pruritus. It must be remembered that this is not a trivial symptom, as it is often compared by patients to chronic pain. The second feature of atopic skin is excessive dryness, which results from various types of genetic microdefects. These, in turn, lead to damage to the epidermal barrier, which promotes the penetration of allergens and some microorganisms, resulting in inflammation. In the elderly, AD changes are localized in the flexion areas, i.e. the elbow and popliteal fossae, on the neck and face.

Why are baths in sodium hypochlorite recommended as a support for classical anti-inflammatory treatment in people with atopic dermatitis?

Baths in sodium hypochlorite, i.e. in active chlorine, used in children and adults, have an antibacterial effect and thus alleviate the symptoms of AD. If used properly, such baths are safe. It is worth noting that the skin of people with atopic dermatitis often shows another defect – it does not produce natural antibiotics on its own that could protect it against bacteria. Thus, Staphylococcus aureus is very common on the skin of AD patients, which, although it does not cause damage on healthy skin, causes inflammation in AD patients. Thanks to a delicate bath with the addition of sodium hypochlorite solution of appropriate concentration, bacteria are destroyed, thus enabling the formation of proper bacterial flora, which in turn alleviates the symptoms of AD. It is important that after a short bath, the skin dried thoroughly and an emollient is applied.

Why is it so important to implement bathing and other forms of treatment? What are the consequences of not treating atopic skin?

It has been shown that if AD is uncontrolled, the risk of developing bronchial asthma and other allergic diseases increases. Therefore, if we treat a patient, we not only improve the condition of the skin and reduce or completely remove the symptoms of the disease, but also protect the patient from other serious diseases.

Should patients with this condition pay more attention to the care of their problematic skin in the context of the upcoming summer?

Recommendations for all people are to protect the skin from the sun, which contributes, for example, to the formation of cancerous changes on the skin. In addition, in some AD patients, the skin condition deteriorates under the influence of the sun, so they should avoid the sun and remember about appropriate sun protection.

Author: Sonia Młodzianowska