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How To Manage Atopic Dermatitis (eczema) And Asthma
Understanding the connections between atopic dermatitis and asthma and recognizing the triggers may help manage both conditions.
Atopic dermatitis, also known as eczema, is a skin condition that causes dry, flaky, and itchy skin. Asthma is a lung condition that causes breathing difficulties, and both conditions have links with inflammation and reactions to various allergens.
This article examines the connection between atopic dermatitis and asthma, including how best to manage the associated symptoms.
Atopic dermatitis is an inflammatory skin condition that affects about 10% of people in the United States. Many cases resolve on their own during early childhood or adolescence, but many people may experience persistent symptoms or flare-ups well into adulthood.
For some people, atopic dermatitis is the first step in a series of allergic conditions. This is known as the "atopic march." In addition to atopic dermatitis, conditions involved in the atopic march may include:
Studies suggest that over 25% of people with atopic dermatitis develop asthma. This is a rate more than three times higher than in the general population. The risk of asthma is higher with increasing severity of atopic dermatitis.
The sections below look at some management options for atopic dermatitis and asthma.
Learn more about atopic dermatitis and asthma.
One of the best ways to manage allergic conditions is to avoid the triggers that lead to symptoms.
Many of the most common triggers for atopic dermatitis and asthma overlap, including:
Other common asthma triggers may include:
Each individual's experience of asthma and atopic dermatitis is different. One person may have several triggers, while another may have only one or two.
It is important for a person to carefully track their symptoms to determine what causes them to flare up.
Learn more about eczema, asthma, and allergies.
Symptoms of atopic dermatitis are manageable or preventable with lifestyle measures, such as taking lukewarm baths and using fragrance-free moisturizers.
Topical creams and ointments can also help manage flare-ups.
People typically treat asthma with a combination of quick relief and controller medications to help prevent flare-ups and treat them as needed. These medications are available in the form of inhalers, nebulizers, and pills.
Many atopic dermatitis and asthma treatments work by reducing or managing the inflammation that drives disease. People can use these drugs continuously to prevent flare-ups or on an as-needed basis to manage flare-ups when they occur.
For people with moderate or severe disease that does not respond well to treatment, the use of biologic therapy may be necessary. These are injectable treatments available in the form of a shot or an infusion administered every few weeks. They target specific molecules in the body that cause inflammation.
These treatments are not for everyone, and their use depends on the type and severity of an individual's asthma or atopic dermatitis.
Several biologics are available for either atopic dermatitis or asthma, but only one — dupilumab — has approval for both conditions.
A healthcare professional can help people decide which treatment is right for them based on their symptoms.
Atopic dermatitis and asthma are both inflammatory conditions. This means that they are due to overreactions of the immune system.
In some people with atopic dermatitis, this overreaction occurs in response to an environmental trigger or an allergen. This is "allergic atopic dermatitis."
Although healthcare professionals do not fully understand the causes of the condition, genetic mutations that affect how well the skin barrier works are common in people with atopic dermatitis. A protein called filaggrin is typically low in people with atopic dermatitis, leading to drier and itchier skin. A leaky skin barrier allows external allergens and irritants to enter the body more easily, making people more vulnerable to developing allergic reactions to them, which drives inflammation.
Together, this can cause skin discoloration, itchiness, and dry skin that is characteristic of atopic dermatitis.
Similarly, overreactions to allergens in the airways are the basis for the breathing problems associated with asthma. Inflammation causes tightening and narrowing of the airways, which can lead to:
The exact causes of asthma are not well defined, so it is difficult to know for certain how atopic dermatitis, asthma, and inflammation are related.
However, the association of atopic dermatitis with other atopic conditions suggests it may be that skin sensitization to an allergen early programs the immune system to overreact in other parts of the body as well.
Children with atopic dermatitis without allergic features are no more likely to develop asthma than children without atopic dermatitis. On the other hand, children with allergic atopic dermatitis are seven times more likely to develop asthma by 3 years of age.
The progressive nature of the atopic march has led many to wonder whether or not there are preventive measures that can interrupt this progression and potentially reduce the chance of asthma and other allergic conditions in children with atopic dermatitis.
There are limits to evidence supporting asthma prevention in patients with atopic dermatitis. This is partly because asthma tends to develop later in the atopic march — typically during late childhood or early adolescence — requiring long periods of observation to identify an effect.
The American Academy of Pediatrics recommends exclusive nursing of newborns for at least 3–4 months, which studies suggest is protective against wheezing in the first 2 years of life. Some evidence also suggests that nursing for longer than 3–4 months may protect against childhood asthma, but more research is necessary to confirm this.
Not everyone with atopic dermatitis develops asthma, but having atopic dermatitis does increase the likelihood that a person will develop asthma. This is especially true if the person has symptoms that suggest that their atopic dermatitis is due to allergies.
For many people, taking steps to avoid triggers can help reduce asthma and atopic dermatitis flare-ups. It is important for a person to understand the individual nature of their condition and to make adjustments that suit their needs and lifestyle. People can also use medications to help prevent and manage symptoms.
If a person's atopic dermatitis or asthma is not well managed with their current treatment plan, it is advisable to talk with a healthcare professional to determine if other treatment or management options are available.
Is Eczema Contagious? And 5 Other Facts To Know About The Skin Condition
Eczema, or atopic dermatitis, is a chronic skin condition that has a lifetime prevalence of about 15–30% in children and 2-10% in adults, as per StatPearls Publishing. Surprisingly, about 60% of the cases will develop within the first year of life.
According to Dr Pallavi Singh, Consultant Dermatologist, Max Multi-Speciality Centre, Panchsheel Park, eczema can be either caused by genetic and intrinsic factors (endogenous) or environmental factors (exogenous). While dry skin and compromised skin barrier are some of the most common causes of endogenous eczema, irritants and allergens, such as nickel, detergent, fragrance, and environmental factors, such as ultraviolet (UV) radiation, are common causes of exogenous eczema, says Dr Singh.
If you're someone who has eczema, understanding and being fully aware of the condition is of utmost importance, as it may aid in receiving proper and appropriate treatment. Here are a few interesting facts everyone should know about it.
Eczema Has Several Different TypesEczema is not just one condition, but rather an umbrella term for a group of skin conditions. According to the US National Eczema Association, there are seven different types of eczema. These include:
Atopic dermatitis: This is the most common form of eczema, according to the American Academy of Dermatology Association (AAD). It causes inflammation, dryness, and itchy skin.
Contact dermatitis: This form of eczema, also called allergic contact dermatitis, can be triggered by environmental factors.
Dyshidrotic eczema: This type of eczema dries out the skin, leading to a burning sensation, rashes, and blisters.
Neurodermatitis: Also called discoid eczema, neurodermatitis affects small patches of skin, causing itchiness and scaly patches.
Nummular eczema: Also called nummular dermatitis, this form of eczema forms small, rounded lesions all over the body, especially on arms and legs.
Seborrhoeic dermatitis: This is an inflammatory form of eczema that affects your scalp.
Stasis dermatitis: Stasis dermatitis leads to skin discolouration on the legs, which looks similar to varicose veins.
Who Is At Risk?According to the American College of Allergy, Asthma, and Immunology, eczema is most often hereditary, and about 60% of those with eczema will experience symptoms by age 1, whereas 30% will develop symptoms by age 5.
Those born into families with a history of allergic diseases such as asthma or hay fever are at increased risk of developing eczema.
Eczema Is Not ContagiousUsually, when we come across painful-looking skin rashes, we assume that they are contagious. But that is not the case with eczema. Dr Singh says eczema is not contagious and cannot spread from one person to another. However, she notes that it can flare up and spread in the same individual as the condition worsens.
Not All Eczema Is Atopic DermatitisIt is important to understand that atopic dermatitis is a common form of eczema that presents with itching and a rash over the skin. However, not all eczema is atopic dermatitis, says Dr Singh.
Scratching May Worsen EczemaMost skin conditions flare up when scratched or constantly touched. When it comes to eczema, scratching worsens the symptoms by perpetuating them further. Moreover, it creates cracks and fissures in the skin, making it more susceptible to infection.
Can Eczema Be Cured?Unfortunately, there is no cure for eczema. While there are treatments, they can only help manage the condition but cannot completely eliminate it. It is important to identify the type of eczema and address the underlying issues. Moreover, one must avoid triggers and use gentle and sensitive skin moisturisers throughout the day. Consulting a dermatologist may give you a good understanding of your treatment options, depending on the severity of your condition.
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National Jewish Health Study Looks To Prevent Food Allergies From Ever Developing
National Jewish Health is looking for more parents to enroll infants into the new study.
DENVER — National Jewish Health (NJH) is looking to enroll infants into a new study they believe could be life-changing. Doctors at NJH said they've found new clues that can tell if a child is more likely to develop food allergies.
This new study is hoping to stop any of those allergies from even starting.
Talia Haykin enrolled her son Avi into the study.
"When he was born we didn't think he had anything either. But by the time we started the study and got here, he had some outbreaks on his head and on his arm. And so turns out he does have eczema," Haykin explained. "They scratch a lot and they are uncomfortable and you want to make them comfortable and you don't know how."
That's where people like Dr. Jessica Hui come in. Hui is leading a study on how to prevent food allergies. Many kids who develop them often have eczema first.
"So we found that in just looking in the skin of small infants that there are markers within the skin that will predict who might go on to develop food allergy," Hui explained. "So for an intervention piece we want to see if we use certain creams early in life, does this decrease the risk of developing eczema and food allergy and respiratory allergy like asthma."
According to the Centers for Disease Control and Prevention, one in 13 children - or about two students per classroom - have a food allergy. The bodies response to a food allergy can be considered life threatening. It's why Haykin decided to enroll her son into the study.
"When I have friends who have kids years from now and this comes to fruition, to know that their treatment for eczema came from our work slathering him with cream twice a day is a really neat feeling," Haykin said.
Credit: National Jewish Health Hospital
The study is called the SEAL Study: Stopping Eczema and Allergy. National Jewish Health is looking to enroll newborns into this study. Any baby up to 12 weeks old that has dry skin or eczema is eligible. The study will last three years and include six clinic visits and weekly or monthly phone calls with researchers. Those leading the study said there is some compensation.
Hui hopes more parents believe in the cause she said would likely make history.
"It's going to be a landmark study and really be able to change how we treat and not just treat but prevent allergies," she said. "I would say this is a revolutionary study because you know we're not doing anything hugely invasive we're simply applying creams and if that can really prevent the course of someone's allergic history that will be huge."
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