Understanding Atopic Dermatitis Know Your Skin – From the Inside Out Special Edition of ATOPIC DERMATITIS DEFINED Who We Are Allergy & Asthma Network is the leading nonprofit patient outreach, education, advocacy and research organization for people with asthma, allergies and related conditions. 8229 Boone Blvd. Suite 260 Our patient-centered network Vienna, VA 22182 unites individuals, families, 800.878.4403 healthcare professionals, industry AllergyAsthmaNetwork.org leaders and government decision- [email protected] makers to improve health and quality of life for the millions of Understanding Atopic Dermatitis people affected by asthma and – Allergy & Asthma Today Special allergies. Edition is published by Allergy & Asthma Network, Copyright An innovator in encouraging 2018. All rights reserved. family participation in treatment plans, Allergy & Asthma Network Call 800.878.4403 to order specializes in making accurate copies; shipping and handling medical information relevant charges apply. and understandable to all while promoting standards of care that are proven to work. We believe PUBLISHER that integrating prevention with Allergy & Asthma Network treatment helps reduce emergency healthcare visits, keep children in PRESIDENT AND CEO school and adults at work, and Tonya Winders allow participation in sports and other activities of daily life. MANAGING EDITOR Gary Fitzgerald Our Mission CREATIVE DIRECTOR To end needless death and suffering Paul Tury due to asthma, allergies and related conditions through outreach, DIRECTOR OF EDUCATION education, advocacy and research. Sally Schoessler CONTRIBUTORS Allergy & Asthma Network is a Allie Bahn 501(c)(3) organization. Tracy Bush Kortney Kwong Hing Join Allergy & Asthma Network Abby Lai today, as we work to help Kimberly Pellicore patients and families Laurie Ross breathe better together. AllergyAsthmaNetwork.org/join Comments and Questions [email protected] Editorial reviewed by: Luz Fonacier, MD Purvi Parikh, MD Weily Soong, MD Dennis Williams, PharmD 2 Allergy & Asthma Today Special Edition AllergyAsthmaNetwork.org INSIDE: Beyond Skin Deep ATOPIC DERMATITIS DEFINED Dry, cracked, inflamed skin. A red, bumpy rash that won’t go away. The near-constant itching and sleepless nights. Living with atopic 4 What is Atopic Dermatitis? dermatitis (AD) – the most common form of eczema – isn’t easy. It’s 7 Atopic Dermatitis Fast Facts often unpredictable, with skin symptoms arising when you least 8 The Allergic March expect it. 9 Type 2 Inflammation Maybe you’re in your mid-20s and eager to go on dates, but also apprehensive because red splotches are visible on your cheek, chin and SYMPTOMS neck. Perhaps you’re the parent of a 10-month-old girl who scratched the rough, scaly skin on her arms so hard it started bleeding. Or maybe 10 What to Watch For... you’re a 40-something with seasonal allergies, 11 A Clear Diagnosis perplexed by the onset of skin inflammation on 12 What’s Worsening My Eczema? your hands and feet. 14 When to See a Specialist Atopic dermatitis is a lifelong condition – there is no cure. The goal of care is to provide TREATMENTS & MEDICATIONS relief. More than 18 million adults and 9.6 million children have it. Doctors believe AD 15 Repair the Skin Barrier may actually be underdiagnosed – many people 16 To Bathe Or Not to Bathe? are unaware they have it or don’t seek out 17 Under Wraps medical care, thinking symptoms will go away 18 Come Together: How Doctor-Patient on their own. Partnerships Are Transforming Further, atopic dermatitis can impact Healthcare patients’ mental health and quality of life. Even those with mild 19 What’s the Best Treatment For My Atopic Dermatitis? symptoms report it limits their lifestyle and participation in social 20 Find Your Relief activities. 23 Let There Be Light Where to start in terms of managing the condition? First things first: see a doctor – specialists who treat atopic dermatitis include board-certified allergists and dermatologists. You’ll undergo MANAGING YOUR CONDITION tests to confirm the condition and find out what your triggers are. Since AD is believed to be genetic, your family history will be part of the 24 Calming the Itch discussion. 25 Sleep Tight Then you’ll work together with your doctor to develop a practical 26 The Heat Is On management and treatment plan specific to your needs and values. 26 Baby It’s Cold Outside The key, as you’ll learn in this guidebook, is to keep your skin 27 Don’t Keep It a Secret 28 Stress-Busters moisturized, regardless of the severity of the condition. If your atopic 29 Recipe for Success dermatitis persists, there is hope. New, innovative medications give 30 Coping With Eczema doctors and patients better tools to keep symptoms in check. 31 Dating and Intimacy You don’t have to struggle – physically or emotionally – with atopic 32 When Eczema Goes to School dermatitis. Clear, healthy skin is possible. Help is here. 33 Come Clean ADDITIONAL RESOURCES Tonya Winders 34 Dictionary, Websites and President/CEO Publications Allergy & Asthma Network 800.878.4403 Understanding Atopic Dermatitis 3 ATOPIC DERMATITIS DEFINED “Every time work “My 3-year- is stressful, I break old son has out in red, scaly had problem splotches. It’s really skin since he itchy and painful was born. We on my hand and bathe him every arms – it’s hard not other night with to scratch – but it’s water only, then most embarrassing moisturize and when it shows up let it soak in on my cheek and before he puts chin.” on his pajamas. – Destiny, 26 Moisturizing is really the key for us!” – Marcie, 39 What is Atopic Dermatitis? f you’ve had it, you know it: the dry, red, scaly, AD symptoms will come and go, but even when unbearably itchy skin condition called atopic your skin appears clear, there may be inflammation Idermatitis, or AD – the most common form of eczema. underneath the surface, waiting to flare. You are not alone: 18 million adults (7.2 percent) and Atopic dermatitis often develops in early childhood 9.6 million children under the age of 18 (13 percent) – appearing during the first 6 months or within the first have AD, according to the National Eczema Association. 5 years. Among children, 3.2 million have moderate-to-severe symptoms. Under the Skin Atopic dermatitis is a chronic inflammatory skin While its cause is unknown, doctors believe AD is disease. It can cause red patches on the skin that itch; related to genetics, an immune system that is sensitive dry and scaly skin; thickened skin; and open, oozing, to allergens and irritants, and a defective skin barrier crusty sores. AD symptoms often appear on the face, that allows moisture to escape and allergens and bacteria neck, hands, wrists, elbows, knees, ankles and feet. to invade. Seventy percent of people with AD report a 4 Allergy & Asthma Today Special Edition AllergyAsthmaNetwork.org ATOPIC DERMATITIS DEFINED “My skin breaks “My daughter out with red, had severe atopic itchy bumps dermatitis from when my dog birth until she jumps on me. It was about 6 hurts pretty bad months old. Within when I scratch 24 hours after it. One time it switching her diet got infected. I to a hypoallergenic try to avoid our formula, her skin dog now, but it’s was silky smooth hard.” and has been for – Dev, 16 almost two years. I encourage parents to explore food allergies if their child has atopic dermatitis.” – Whitney, 32 family history of the condition. Some people with atopic The most common TRUE OR FALSE? dermatitis may lack a specific environmental allergens that Atopic dermatitis is contagious. type of protein, called filaggrin, trigger symptoms include dust in their skin. This protein serves as FALSE! mites, pet dander, pollen and mold. a protective barrier from allergens, You cannot “catch it” or spread Food allergens are also possible irritants and infections. When it to others through physical triggers, especially in children. Irritants filaggrin is lacking, it weakens the skin contact. Atopic dermatitis such as wool or man-made fibers, barrier function of the skin. Some people does tend to run detergents, soaps, cleaning products, some with atopic dermatitis also have high blood in families, but skin care products and tobacco smoke are also levels of Immunoglobulin E (IgE), antibodies this is due to common triggers. produced by the immune system that set off genetics. Exposure to these allergens and irritants allergy symptoms. triggers immune cells to release histamines, cytokines and other chemicals to rid the irritants On the Skin from the body. The resulting inflammation signals the Early diagnosis and treatment are essential to avoid brain to move your hand to the itchy spot and scratch skin complications and improve quality of life. … and scratch. That only makes it worse, resulting in an Treatment begins with avoiding or reducing exposures endless cycle. to known allergens and irritants – immunotherapy Too much scratching can lead to infection if the to build tolerance to allergens is one option. Then, surface of the skin is broken. Signs of infection include keep your skin moisturized with creams or ointments, yellowish, crusty skin (often on top of the eczema), red, especially during hot summers and dry winters, to lock swollen bumps and pus-filled blisters. moisture in your skin and protect against future rashes. 800.878.4403 Understanding Atopic Dermatitis 5 ATOPIC DERMATITIS DEFINED “I play basketball in a men’s league The Eczema Umbrella every winter, and Eczema is often used interchangeably with about an hour after atopic dermatitis. The word has Greek origins – it the game is over, means “to boil over.” It applies broadly to a range of persistent skin conditions: my neck, arms and knee turn red, • Atopic dermatitis: a chronic and recurrent inflammatory skin condition that causes red, scaly and itchy.