Atopic dermatitis is quite common in babies under 5 years old. For the first time, the disease can debut from the first days after birth. The course of the disease in infants has a slightly different character than in older children. Treatment of babies in the first year of life requires a softer approach, without the use of strong medications.
What it is?
With atopic dermatitis, systemic inflammation occurs in response to the ingestion of a provoking factor - an allergen. Often, babies with similar diseases have a certain genetic predisposition. If a child has both parents - allergies, then in 80-90% of cases he may show signs of atopy. If only dad or mom have allergic reactions, then the probability of inheriting the trait is 40%.
Causes of occurrence in newborns and infants
Researchers have not come to a unanimous opinion about the cause of the disease. They found that several provoking factors can influence the development of the disease. It is impossible to predict how the child's body will react to the ingress of this or that allergen. It directly depends on the individual sensitivity and characteristics of the baby's immune system.
Several factors can influence the development of the disease at once:
Genetic predisposition to the development of atopic dermatitis. Several polymorphic genes are considered responsible for hypersensitivity to various provoking agents. They are responsible for the functioning of the immune system and the body's recognition of foreign substances. Close relatives in atopic families have an identical set of genes.
Reduced level of immunity. As a rule, it can be congenital or acquired immunodeficiency. In such situations, the ingress of any antigen into the body in the presence of an individual predisposition can cause a violent response.
Chronic diseases of the digestive system. It is noted that in babies suffering from pathologies of the gastrointestinal tract, the risk of developing atopic dermatitis increases many times. In newborns, such pathologies are often congenital. Atresia of the cardia or a violation of the structure of organs can lead to disruption of the normal functioning of the digestive system. This condition also leads to a change in the intestinal microflora, and hence the suppression of immunity.
Manifestations of dermatitis after the introduction of complementary foods. Often, the first skin problems begin to occur in babies after adding new foods to the diet. There is no idiosyncrasy to breast milk. In terms of its composition, it is an excellent and complete protein product. Breast milk is 99.8% absorbed by the child's body. With the introduction of mixtures, the baby may experience manifestations of allergies and atopic dermatitis.
In more rare cases, house dust or household mites can act as a provoking factor. These tiny microorganisms live in pillows and bedding. In summer and hot seasons, their number can increase several times. Getting on the delicate skin of the baby, they can easily cause a strong allergic reaction and provoke the appearance of atopic dermatitis.
Direct contact with chemicals. Often, hygiene products or household chemicals become such provoking factors. Babies may have contact atopic dermatitis on their clothing. As a rule, the reason for such a reaction is an allergic reaction to the components of the washing powder. Wearing diapers is also a common cause of this type of dermatitis.
Parasitic invasions. They are found in babies closer to a year. At this time, mothers begin to give children fresh fruits and berries as complementary foods. Insufficient hygienic processing can lead to infection of the child with various helminths. When they settle in the intestines, they release dangerous toxins. These substances can become a provoking factor for the onset of an allergic reaction. Parasitic diseases, as a source of atopic dermatitis, are quite common in children's practice.
The main symptoms
Atopic dermatitis can manifest in different ways... The severity of clinical signs will depend on the severity of the course of the disease. The development of the disease can be divided into several stages:
Initial stage
During this period, the disease is manifested by the appearance of various red spots or hyperemia. More often with contact forms of dermatitis, they appear at places of contact with clothing. Diffuse forms are characterized by the spread of spots throughout the body. A large number of bright redness is noted on the back of the neck, cheeks, in the places of the elbow fossa and under the knees.
The acute height of the disease
At this time, the baby looks very painful. Severe itching joins the skin manifestations. Babies begin to comb the damaged skin. With a severe course of the disease, weeping wounds begin to form. Multiple papules or vesicles with serous contents may appear on certain parts of the body. The skin in the affected areas becomes hot, reddens. The general condition of the baby is disturbed. He becomes more lethargic, moody. May give up breast. Babies do not sleep well due to severe itching. At night, the condition improves somewhat.
The period of abatement of the inflammatory process and the onset of remission
At this time, all the bright symptoms of allergy disappear and are replaced by new skin manifestations. Crusts appear at the site of weeping wounds. The skin becomes thickened, its architecture and structure change.
With a prolonged course of the disease and long-term use of hormonal drugs, areas with thinner skin can form. As a rule, thin white or red stripes remain at the site of combs.
The pattern of the skin changes somewhat, it becomes more dense and rough. Some babies develop severe scaling on the scalp. The skin becomes drier and requires constant moisture.
In order to properly prescribe treatment, additional diagnostics are required. Elimination of the provoking factor is an important therapeutic procedure in the treatment of atopic dermatitis. Even despite the ongoing treatment, it is often not possible to achieve complete remission without eliminating the action of the allergen.
Diagnostics
Usually, the appointment of additional examinations is done by an allergist-immunologist. If the child has the first signs of the disease, it is imperative to show him to a specialist. Newly diagnosed atopic dermatitis requires additional research.
General blood analysis
Allows you to accurately and quickly establish the allergic form of the disease, as well as distinguish atopic dermatitis from various infectious diseases. A pronounced increase in the level of leukocytes and eosinophils indicates the presence of an allergic reaction. Almost all variants of atopic dermatitis occur with accelerated ESR.
In the midst of the acute stage of the disease, there may be a slight increase in the level of lymphocytes. This indicates the activation of the cellular link of immunity and the onset of an allergic reaction. Also, the indicators of the leukocyte series will tell the doctor about whether a secondary bacterial infection or complications of the disease have joined.
Provocative allergic tests
Are not informative in infants. Studies with scarification tests are recommended only for babies from the age of three. Performing such studies in infants is not informative and does not give an accurate reliable result. It is also very difficult to technically conduct a scarification test on an infant. An alternative to these studies is serological tests.
Determination of specific antibodies
It is used in babies with a severe course of the disease. Usually such tests are recommended by doctors for older children. However, with frequent exacerbations of the disease, when the specification of the allergen is required, serological studies are also used in infants. The analyzed material for analysis is venous blood. When performing this laboratory test, several groups of allergens can be checked at once. The analysis period is usually 3-4 days.
With the help of such a test, the doctor can give the most accurate recommendations about what provoking factors cause atopic dermatitis in the baby. This test also identifies all cross-allergens. A significant disadvantage of such an analysis is its high cost. For each group of allergens, you will need to pay about 5,000 rubles.
Treatment
To date, many different medicinal substances are used for the treatment of atopic dermatitis. Many of them are applied topically to damaged skin. With a more complicated course of the disease, drugs are prescribed in the form of injections or tablets. Treatment courses for atopic dermatitis are usually long. Medicines can be prescribed from 10 days to several months.
Local treatment
For these purposes, various ointments, creams or suspensions are used that have anti-inflammatory effects. For dry skin, oily creams or ointments are preferred. Such dosage forms perfectly penetrate into all layers of the skin and can effectively eliminate inflammation.
Among the most commonly used drugs are anti-inflammatory. These include: "Bepanten", zinc ointment, "Elidel", "Emolium", as well as many others. These drugs help not only eliminate inflammation, but also have a positive effect on the skin. For example, zinc ointment has a drying effect. It can be applied to weeping lesions.
The use of hormonal ointments helps to quickly cure exacerbations of the disease. These drugs are usually based on prednisone or beclamethasone. You should not be afraid of the side effects of such drugs! The content of the active form of hormones in them is minimal. They will not be able to cause a pronounced systemic effect.
It is better to use hormonal ointments only after consulting a pediatrician, since for a number of drugs there are certain contraindications for use.
Systemic use of drugs
Prescription of medicines for the treatment of atopic dermatitis in infants is carried out taking into account the adverse symptoms of the disease. Usually, treatment is carried out in a complex manner using various groups of drugs. To eliminate severe itching, babies are prescribed antihistamines. These include: "Zirtek", "Fenistil", "Tsetrin" and many others. Also, calcium gluconate will help reduce unbearable itching and calm the baby. The use of this medication does not cause adverse reactions and is well tolerated by the child's body.
Various enterosorbents are widely used to eliminate toxins and biologically active substances that are formed during allergic inflammation. The safest and most effective: Polysorb, Laktofiltrum, Enterosgel. Reviews after using such drugs are usually the most positive. Thanks to the use of these sorbents, the disease goes away in a shorter time.
To normalize the intestinal microflora, various preparations are used, enriched with lacto - and bifidobacteria. Usually they are prescribed after a course of taking sorbents. The probiotics that are part of such preparations have a stimulating effect on the growth of beneficial microflora in the intestine. It is worth using such medicines for a long time, for a month. The courses should be repeated 2 times a year.
For babies who develop manifestations of atopic dermatitis after the introduction of new complementary foods, the diet should be changed. Hypoallergenic mixtures are the best choice. Their composition is selected in such a way that all substances with strong allergenic properties are completely excluded. Babies, receiving such food, feel great. Their bowel function is normalized, immunity is restored and all adverse skin rashes disappear.
For babies in the first year of life, you can choose various nutritional ready-made mixtures with low allergenic properties. All components of cow's milk are absent in the "Frisopep" diet. For babies with lactase deficiency or intolerance to cow protein, such a product will be an excellent choice for composing a diet. This formula can be used from the first days after your baby is born. It is also great for premature babies or low birth weight babies.
What is used for home treatment?
To eliminate the adverse symptoms of atopic dermatitis, mothers often use various traditional medicine. In such cases, you need to figure out which of these methods will not harm the baby.
The skin of a newborn baby is very sensitive. Any exposure to harsh chemicals can cause severe irritation. With an individual predisposition to atopic dermatitis - such contact with a substance can exacerbate the disease.
Therefore, to eliminate the unfavorable symptoms characteristic of allergic skin diseases, at home, you can use medicinal plants or products that are not strong allergens.
Bay leaves have antiseptic properties. A weak cooked decoction from this plant can be added to the baths when bathing. This will protect the baby's delicate skin from possible bacterial infection. Before carrying out such a bath, be sure to check the baby's reaction.
To do this, run the diluted bay leaf decoction over the child's skin. Assess the reaction after 10-15 minutes. If the skin remains clean and there is no irritation, you can safely use this broth. Check the baby's skin reaction this way every time you use a new product. Note in your diary all the negative consequences after using different means. This will reveal many possible factors provoking an exacerbation of the disease.
Aloe juice preparations are good anti-inflammatories. Try to choose foods that are labeled to be used from the first days after birth. Aloe has excellent antiseptic properties, and also promotes faster skin regeneration and restoration after severe inflammation. Such funds are used, as a rule, in a course of 14 days.
After the inflammatory rash subsides, dense crusts or scales often remain on the skin. They are difficult to remove and exfoliate. Use sea buckthorn oil to soften skin... It will help moisturize and nourish all skin layers. When using this oil, the skin becomes more hydrated, all crusts disappear.You can also apply this product to scratched areas. It will help restore the skin structure and slightly reduce scars.
For babies who develop atopic dermatitis as a result of intolerance to cow protein, goat milk can be used. It should be added to various cereals, mashed potatoes. It can also be mixed into various hypoallergenic mixtures to obtain a uniform consistency. Goat's milk is an excellent choice for toddlers with lactose intolerance. A variety of yoghurts, cheeses and other fermented milk products are made on the basis of such a product. It perfectly saturates the child's body with protein and promotes active growth.
Prevention
Daily adherence to preventive measures will help reduce the risk of exacerbations of atopic dermatitis. You need to follow these rules from the first days after the birth of the baby. If in the family one of the close relatives had manifestations of atopic dermatitis, then prevention must be carried out without fail.
To prevent exacerbations of atopic dermatitis, you should:
Try to keep breastfeeding as long as possible. Mother's milk is the most hypoallergenic product for any baby. This wonderful natural food product is assimilated by the child's body by 99.8%. Usually, the first manifestations of atopic dermatitis begin to occur when breastfeeding is stopped or switching to various adapted formulas. Long-term lactation is the key to the baby's excellent well-being and the formation of full-fledged immunity.
Treatment of exacerbations of other chronic diseases. Any infections in babies - babies must be identified and treated. Especially with pathology of the gastrointestinal tract. Delayed treatment can lead to severe dysfunctions of the internal organs and, as a result, a decrease in immunity. Acquired secondary immunodeficiencies may appear in children who are ill for a long time. Such conditions often provoke the appearance of any allergic reactions.
Strengthening the immune system. Proper functioning of the immune system avoids various overly acute inflammatory reactions. Active walks in the fresh air help the baby to strengthen the immune system. In the warm season, it is not worth wrapping a newborn or nursing child excessively. A little hardening is a great way to boost your immune system. Choose clothes for the weather.
Introduction of hypoallergenic products as complementary foods. As a rule, doctors advise to introduce the first new products in green or white colors. Great: cauliflower, broccoli, or zucchini. These products will practically not be able to cause dangerous allergic reactions in babies. For children who have already been diagnosed with atopic dermatitis, adherence to a hypoallergenic diet is required regularly throughout their lives.
Severe adverse symptoms of an allergic disease in infants can cause real shock to parents. Don't panic! Atopic dermatitis is now well diagnosed and treated.
A huge arsenal of medicines allows you to quickly eliminate all the unfavorable symptoms of the disease, which bring severe discomfort to the baby. Comprehensive treatment of the disease and adherence to a hypoallergenic diet will allow the baby to be practically healthy and active.
How to treat atopic dermatitis in an infant, see the program of Dr. Komarovsky
