Auxiliary basic therapy of atopic dermatitis in children

External treatment of allergic diseases in children

Allergic diseases in childhood are not uncommon.
Eczema, food allergies, allergic dermatitis, diathesis, urticaria, pruritus, atopic dermatitis - this is not a complete list of what a child, even a very young age, can suffer from. Among these diseases, the most persistent and difficult to treat is atopic dermatitis. Its mandatory treatment is the key to healthy skin for life. Well and competently treated at an early age, it can disappear forever by 3 years. But older children shouldn’t give up either. In treatment, internal remedies are always combined with external ones. In this publication I will focus on the features of external treatment.

In recent years, corticosteroid (hormonal) ointments have taken the leading place among the means of external therapy for atopic dermatitis, pushing aside other drugs. Every doctor has heard the names of corticosteroid ointments, and there is no longer a question of whether to use them or not. Rather, the choice is made of the most effective one, with fewer side effects and the possibility of more or less long-term use. It often does not coincide with the financial capabilities of parents who, not seeing the difference between the drugs, choose a cheaper ointment. Without denying the undoubted benefits of corticosteroid ointments during an exacerbation, I would like to note that none of them is suitable for long-term use, and an exacerbation can last for many months. In addition, there is not a single drug specifically intended for the treatment of children. In this regard, every dermatologist and pediatrician, trying to reduce the concentration of a medicinal substance applied to the skin of a sick child, uses his own “home preparations,” which generally boil down to mixing the finished medicinal product with various creams, oils, solutions or other ointments. In this case, the dosage form of the drug is disrupted, which is extremely undesirable, since this changes its physicochemical and pharmacological properties.

We agree that it is difficult to do without glucocorticosteroid (hormonal) external medications. But here are a few quite typical situations that both doctors and parents of patients have to face during the treatment of atopic dermatitis in children:

• A short (usually 2 weeks) course of treatment with corticosteroid ointments has been completed - what should I lubricate the skin with next?
• Long-term treatment with corticosteroid ointments has led to addiction - which external agents should I switch to?
• Parents resolutely refuse treatment with corticosteroid ointments (corticophobia is now a common phenomenon, and there are serious reasons for it, because the permeability of a child’s skin is much higher than that of adults, and corticosteroid ointments applied to it cannot but have a systemic effect - what can replace them ?
• The long-awaited remission has arrived, but the skin remains dry and easily irritated - how to eliminate these phenomena?

To answer these questions, let's consider what dermatologists have in their arsenal of external non-steroidal drugs for the treatment of atopic dermatitis, and what problems can be solved by using drugs from various groups. Below we present only finished drugs. The success of numerous medicinal prescriptions used in pediatric practice depends on the experience of a dermatologist working with them and has not been proven by clinical trials.

The problem of atopic dermatitis (AD) does not lose its relevance due to the high prevalence and increasing number of patients with severe disease. In pediatric clinical practice, blood pressure occupies a leading place and is under the close attention of various specialists [1, 2]. Atopic dermatitis is a systemic allergic disease with a complex pathogenesis and characteristic age-related evolution of clinical and morphological manifestations. It is characterized by a persistent course, frequent exacerbations and insufficient effectiveness of existing treatment methods [3].

Over the years, knowledge about the nature of the disease has been improved and deepened, new concepts of pathogenesis have emerged, and terminology has changed. Today, according to modern views, the development of AD is based on immunological mechanisms and a decrease in the barrier function of the skin as a result of a genetically determined deficiency of filaggrin, leading to disruption of the integrity of the water-lipid mantle, which normally provides protection of the body from external pathogenic factors. Violations of the epidermal barrier make it possible for the allergen to penetrate inside and initiate immunopathological processes in the skin. The main pathomorphological changes that occur in AD occur in the epidermis, affecting the dermis in severe chronic disease.

The immunopathogenesis of AD is caused by impaired differentiation of T-helper cells and the profile of cytokines secreted by cells [4, 5]. When directly exposed to an etiologically significant allergen/antigen, antigen-presenting cells (APCs) are activated – Langerhans cells infiltrating the epidermis, which carry antibodies to immunoglobulin E (IgE) on their surface. The binding of IgE antibodies to Langerhans cells occurs through high- and low-affinity (CD23+) receptors. Activated Langerhans cells migrate to the lymph nodes, which in turn activate Th2 lymphocytes, which secrete proinflammatory cytokines that play a major role in maintaining inflammation in the skin. In the acute stage of AD, the Th2 cell response predominates with an increase in the production of interleukin-4 (IL-4), IL-5, IL-13 and a decrease in the level of interferon γ (IFN-γ), as well as an increase in the level of total and allergen-specific IgE antibodies. In the chronic stage of the disease in patients, the activity of the Th1 response predominates, which is characterized by an increase in the synthesis of IL-12 by macrophages and eosinophils, an increase in the level of IL-8 and IFN-γ - markers of chronic inflammation in the skin. In long-term allergic processes, IL-3 and GM-CSF (granulocyte macrophage colony sulating stimulating factor) play an important role. In the mechanisms of development of AD in recent years, the role of cytokines such as IL-10, IL-19, IL-21, IL-17, IL-28, the source of production of which is not only lymphocytes, but also other cells of the immune system, has been discussed [6– 8].

Epidermal keratinocytes are essential in the development of skin inflammation in patients with AD. High production of the chemokine RANTES was established upon stimulation of these cells with tumor necrosis factor α (TNF-α) and IFN-γ [9]. Keratinocytes of patients with AD are an important source of thymic stromal lymphopoietin, which activates dendritic cells to reward naive Th lymphocytes and produce IL-4, IL-13, TNF-α [10]. Activated T lymphocytes from the skin of AD patients can trigger keratinocyte apoptosis via Fas ligand. Normally, proapoptotic markers-Fas ligand receptors (CD95) are weakly expressed on keratinocytes. In patients with AD, under the influence of IFN-γ, the expression of this receptor increases and keratinocytes become sensitive to apoptosis. The interaction of Fas ligand with CD95 is considered as the main mechanism of damage to keratinocytes by T cells with the subsequent development of spongiosis and acanthosis - characteristic clinical and morphological signs of AD.

Penetration ability of topical corticosteroids depending on dosage form

Choosing the basis of the drug depending on the location and characteristics of the skin

Thus, AD is based on genetically determined dysfunction of the epidermal barrier and immune (allergic) inflammation of the skin with the involvement of various immunocompetent cells in the immune response, interacting with the help of cytokines and surface receptors. In this regard, there is a need to use in complex therapy of the disease agents whose action is aimed at restoring the barrier function of the epidermis and external therapy drugs that have an anti-inflammatory effect.

Modern emollients - softening and moisturizing agents used for this purpose, often contain essential lipids of the human epidermis (ceramides, cholesterol and free fatty acids), which make it possible to more successfully restore the epidermal lipid barrier.

As an example of a modern emollient, we can cite the Locobase Ripea cream, which contains all three categories of essential lipids in a physiological ratio, as well as solid paraffin nanoparticles, which ensure deeper transport of essential lipids into the epidermis and give the cream matting properties. A special feature of this cream is that it lasts for 24 hours. The ability of this product to effectively restore the epidermal barrier in atopic dermatitis and other dermatoses accompanied by dryness has been proven in a number of clinical studies.

The choice of external anti-inflammatory therapy is determined by the activity of inflammation and its symptoms. Glucocorticosteroid drugs (GCS) are most widely used in the external treatment of AD. The most important effects of GCS are inhibition of the synthesis of IL-4, IL-5, IL-13, IFN-γ and other cytokines, inhibition of eosinophil migration and T-lymphocyte proliferation, reduction of vascular permeability and microcirculation disorders. GCS increase the binding of histamine and serotonin in the skin, reduce the sensitivity of nerve endings to neuropeptides and histamine, reduce the activity of phospholipase A2 and the production of eicosanoids, and also reduce the expression of cell adhesion molecules and the sensitivity of the endothelium to allergy mediators. Having a pronounced anti-inflammatory effect, GCS act on all inflammatory cells.

Corticosteroid drugs are presented in a wide range of external forms: creams, ointments, lotions, etc. The correct choice of external corticosteroids depends on the clinical manifestations of blood pressure, the activity of the inflammatory process and the location of the lesion. In this case, it is necessary to take into account the chemical structure of external corticosteroids, the mechanism of action, the rate of absorption, the characteristics of excretion, effectiveness and safety. For external therapy, the influence of the base and the amount of absorption of the active component is very important, since the amount of intradermal absorption when using different forms of the same drug can vary by 15–20 times (Fig. 1).

The choice of dosage form is largely determined by the location of the lesions (Table 1). One of the promising external corticosteroids in the arsenal of practicing doctors is hydrocortisone 17-butyrate (Lokoid), presented in the following dosage forms: cream, ointment, Lipocrem, Crelo. They differ in the amount of water contained in the medicinal base, and, accordingly, in the occlusive ability, the degree of skin hydration, and the intensity of penetration of the active substance.

Dynamics of clinical symptoms during therapy

Dynamics of the SCORAD index against the background of external therapy

Features of dosage forms of hydrocortisone 17-butyrate (locoid)

Lokoid® ointment:
• Has an anhydrous petroleum jelly-polyethylene base (95% petroleum jelly and 5% polyethylene, patented Plastibase base).

• Provides a pronounced occlusive effect, moisturizing and softening effect, deeper penetration of the active substance.

• Highly effective for severe dryness, lichenification, infiltration, hyperkeratosis.

• The absence of water in the ointment makes it possible not to add preservatives to the dosage form, which can cause skin irritation.

Lokoid Lipocrem ® :

• Unique dosage form (contains 70% fat and 30% water). Occupies an intermediate position between ointment and cream and combines the advantages of both forms.

• Lokoid Lipokrem® is easily applied to the skin, quickly absorbed, does not stain clothes, and can be washed off with water.

• Has pronounced anti-inflammatory, softening and moisturizing effects comparable to ointment. These properties of the base of Lokoid Lipokrem served as the basis for the creation of an emollient based on it (a softening and moisturizing cosmetic product for the care of dry skin) - Lokobase Lipocream, which is the basis of Lokoid Lipokrem without an active hormonal component

Lokoid ® cream :

• Oil-in-water cream with a light texture (contains 30% fat and 70% water). Intended for use in acute and subacute processes without exudation, including those localized on sensitive areas of the skin (face, folds).

• Locoid cream has a weak occlusive effect, which avoids aggravation during an acute process, and has very good cosmetic properties.

• Has a softening and cooling effect.

Lokoid Krelo®:

• The dosage form of Locoid Crelo® combines the properties of a cream and lotion.

• Can be used on large areas of exudative skin lesions and areas with hair.

• The lotion has a cooling and “soothing” effect, but does not cause dry skin.

• Contains propylene glycol and borage oil, which provide moisturizing and reparative effects.

• Due to its properties, Lokoid Crelo® is intended for use primarily in acute, including exudative, processes, as well as for application to skin areas with abundant hair.

• At the same time, unlike lotions, it does not dry out the skin (due to the absence of alcohol and the presence of a lipid phase), moreover, it helps to moisturize it and accelerate reparative processes.

Material and methods

Lokoid Lipokrem® and Lokoid Crelo® were used in 22 children aged 6 months to 2 years who were treated in the allergology department of the Clinic of the Research Institute of Nutrition of the Russian Academy of Medical Sciences. Of these, 12 children received Lokoid Lipocrem® and 10 children received Lokoid Crelo®. All children had confirmed blood pressure in a state of exacerbation of a skin process of moderate (group 1) or severe (group 2) severity of the disease (SCORAD index - scoring of atopic dermatiti - 23.8 ± 1.6 and 44.5 ± 3.4 respectively).

Distribution of sick children by severity of atopic dermatitis

The distribution of children according to the severity of the disease is presented in table. 2.

According to the localization of the skin process: in 5 children there were rashes on the skin of the face, in 9 children - on the limbs and torso, in 2 - in the groin area, in 6 - the process was widespread with localization on the face, elbow bends, extensor and flexor surfaces of the radius. wrist joints, popliteal fossae. With a moderate course of the disease, the observed children had moderate itching of the skin and sleep disturbance, moderately severe erythema and swelling, papular elements, foci of exudation, crusts, excoriations, severe dry skin and peeling on both affected and unaffected skin. In patients with severe AD, significant swelling of the skin and erythema, numerous papular and vesicular elements, excoriations, fissures, severe itching and sleep disturbance were observed. The duration of the disease was 4.7 ± 2.7 months.

External agents were applied to the affected areas 2 times a day. The duration of treatment was 10 days. The children also received diet therapy and antihistamines. To shade the scratches, a 1% solution of methylene blue was used.

The effectiveness of the therapy in the observed patients was assessed based on the results of a daily examination and an individual card, which recorded the dynamics of the skin process according to the SCORAD index in points. This index took into account the area of ​​skin lesions, the severity of clinical symptoms (erythema, papules/vesicles, exudation, excoriation, dry skin, itchy skin and sleep disturbance). At the same time, the SCORAD index from 0 to 20 points characterized a mild course of the disease, from 20 to 40 - moderate course, from 40 and above - severe course of the disease.

Research results

Studies conducted to evaluate the clinical effectiveness and safety of Lokoid Lipokrem and Lokoid Crelo® for children with AD showed their high effectiveness and good tolerability. There were no adverse reactions to these external therapy agents in the observed children. All children showed positive dynamics, which was expressed in a gradual decrease in itching of the skin, acute inflammatory phenomena, peeling and dry skin. By the end of treatment, a pronounced positive dynamics of the main objective and subjective (itching) symptoms and the prevalence of the skin process was noted.

The most pronounced effect was obtained in moderate cases of AD - a significant reduction in erythema and other symptoms by the 5th day and complete relief by the end of the 10th day of therapy (Fig. 2).

The dynamics of the SCORAD index in the observed children are presented in Fig. 3. In children with a moderate course, the index values ​​decreased to 11.2 ± 2.8, and in children with a severe course – to 18.1 ± 3.3 (p < 0.05).

In children with severe AD, mild erythema and dry skin remained at the end of treatment. The effectiveness of treatment averaged 86.4%. Excellent results were obtained in 45.5% of cases, good – in 36.4%, moderate – in 18.1%.

Thus, in the course of the study, the high efficiency and good tolerability of Lokoid Lipokrem and Lokoid Crelo were demonstrated for moderate and severe AD in young children. The use of these medications is comfortable for patients, as they have good cosmetic properties, are well absorbed and do not leave greasy marks, which entails an increase in the quality of life and adherence to treatment.

Antimicrobial and antiseptic agents

Fukaseptol and Fukortsin (solutions for external use, 10 and 25 ml in bottles) are red liquids of similar composition with a characteristic odor of aniline dye (fuchsine). Fukaseptol is manufactured using a new technology that allows the composition of the drug to be kept stable throughout the entire shelf life. The components of fucorcin may precipitate during long-term storage. Both drugs have an excellent antimicrobial and antifungal effect without interfering with healing. Used for application to scabs, scratching areas, and pustules. It is not recommended to lubricate fresh wounds, because... The alcohol contained in the composition causes a burning sensation. Large surfaces of skin should not be treated. After the solution has dried, pastes, ointments and creams can be applied to the skin.

An alcohol solution of methylene blue 1% has similar indications and application features. When applied to large areas of skin, the child’s urine turns blue.

Hydrogen peroxide 3% causes a tingling sensation when applied to the skin, but is always well tolerated. It is used to treat fresh wounds and scratches.

Furacilin solution 0.02%, made from powder and tablets of 0.2 g, belongs to another group of antiseptics - nitrofurans. Due to their weak effect and frequent cases of increased inflammation, nitrofurans in the treatment of allergic diseases have given way to stronger antiseptics - halogen-containing ones (chlorhexidine - 0.05% solution, 100 ml in a vial) and Miramistin (0.01% solution, 100 ml in a vial) .). Both solutions are aqueous, they can be used to treat fresh wounds and scratches without the risk of causing pain in the child, however, aqueous solutions take a long time to dry, and the skin treatment process, which is always unpleasant for children, is delayed.

Antibiotic ointments are used with caution for atopic dermatitis, as they are often allergenic. This group is dominated by domestic drugs, with the exception of ointments Bactroban (contains 2% mupirocin), Baneocin, Fucidin. Combined ointments Baneocin (contains bacitracin and neomycin), Levomekol ointment (contains chloramphenicol and methyluracil), Levosin ointment (contains chloramphenicol, methyluracil, sulfadimethoxin), in our experience, do not have any significant advantages. Unfortunately, the fatty base of domestic ointments with antibiotics does not contribute to the drying out and falling off of the crusts, rather softening them, so dermatologists prefer to use pastes with antibiotics (1% erythromycin, 2-5% lincomycin), prepared according to a prescription at the pharmacy. Fuzidin gel and Fucidin cream (contains 2% fusidic acid) have some advantage since there are still few resistant strains of microorganisms to the fusidic acid contained in the drug.

Silver sulfathiazole preparations are much better tolerated, although less commonly used - Argosulfan cream and ointment, containing 2% silver sulfathiazole in 40 g tubes, Dermazin cream, 1%, 50 g each, Sulfargin ointment in 50 g tubes. They should not be used Use for allergies to sulfonamide and sulfur-containing drugs.

Bismuth preparations (dermatol ointment 10%, xeroform ointment 10%) are inexpensive domestic preparations that have an excellent effect (antiseptic, drying and anti-inflammatory), however, they have a strong unpleasant odor and are rarely available in pharmacies.

Skin-cap preparations (70 and 100 ml aerosol, 50 g cream) also combine antiseptic and anti-inflammatory properties; high cost limits their widespread use.

Symptoms of atopic dermatitis in children and adults

The clinical manifestations of the disease are varied.

There is a clear seasonal pattern (exacerbations occur at the beginning of spring and end of autumn; remissions occur in the summer).

The first symptoms can appear at any age (including in newborns). More often this happens in childhood and adolescence. The likelihood of the onset of the disease after forty years is quite low.

If atopic dermatitis develops in an infant (in the first month; more often at 3–5 months), it may go away by two or three years of age or with the onset of puberty, or may remain for the rest of life.

As a rule, the disease (no matter what age it begins) has a long, wave-like course (exacerbations/remissions, the duration of which varies). But there are also short-term forms.

The severity of the manifestations of the disease (scale and depth of skin lesions, duration of exacerbation, presence of complications) and the characteristics of skin lesions (character and localization) correlate with age. The maximum occurs in infancy and early childhood; beginning of school life; puberty.

As one gets older, there is a tendency towards a decrease in the area of ​​the affected surface (up to an isolated eczema-like lesion of the hands) and a change in the nature of inflammation.

Characteristic symptoms:

1. Symptom number one is itching. Painful, remaining even after the disappearance of skin manifestations. With a tendency to intensify in the evening and night hours. Itching is a common cause of insomnia and nervousness; it aggravates the course of the disease, causing weakness, lethargy, and anxiety. In addition, there is a risk of bacterial complications in the area of ​​intense scratching.
2. Inflammation, swelling and redness of the skin.
3. The appearance of various rashes (papules, vesicles, etc.), weeping plaques, crusts. Their type and character depends on the age of onset of the disease.
4. Dryness, peeling, thickening of the skin and the appearance of a skin pattern (so-called lichenification), discoloration.
5. A decrease in the bactericidal properties of the skin can lead to the development of purulent complications (so-called pyoderma).

Localization of skin damage depending on age:

1. Infant period - skin of the face (cheeks and forehead), torso, buttocks; extensor surfaces of the shoulders, forearms and legs.
2. From two to three years of age, the rashes become more local and affect mainly the elbow and popliteal areas; dorsal surfaces of the hands, fingers and wrist joints.
3. With the onset of puberty, the process can take on a local character (eczema-like lesions of the skin of the palms; or spread to the skin of the face (affecting the forehead and nasolabial triangle), torso and upper extremities. Areas of rough, dry skin may remain in the area of ​​the elbows and under the knees.

There are also atypical forms of the disease. For example, deep cracks on the plantar surface; painful itching without visible skin lesions, etc.

In more than half of the cases, the course of atopic dermatitis can be accompanied by other allergic diseases: hay fever and bronchial asthma. This picture of the disease is called the “atopic triad.”

Malfunctions in the functioning of the immune system (its humoral and/or cellular components), characteristic of atopic dermatitis, can become the causes and conditions for the manifestation of infectious diseases, gastrointestinal disorders, blood diseases, tumor processes, etc.

Anti-inflammatory and antipruritic drugs

ASD paste 5% is an excellent drug that successfully competes in the strength of its action with corticosteroid ointments. Previously, it could be produced in a pharmacy with a prescription, but due to the strong unpleasant odor and the reduction in the number of manufacturing pharmacies, this is now very difficult to do.

Elidel (contains pimecrolimus, 1% cream, 15, 30 and 100 g) is a relatively new anti-inflammatory drug that interferes with the production and release of biologically active substances from lymphocytes and mast cells (involved in cell inflammation). Can be used in children from 3 months of age. Use is contraindicated in case of infected rashes (appearance of pustules, crusts, weeping); it is not recommended to combine with other external agents. The use of the drug is limited by its high cost.

Preparations containing zinc oxide (Zindol zinc paste and ointment suspension) have a moderate anti-inflammatory and drying effect, but are widely used in pediatric practice, since they almost never cause side effects, are cheap and accessible.

Ichthyol ointment 10 and 20% is a drug with a moderate anti-inflammatory and absorbable effect, used during the period when acute inflammation is over and skin density is preserved. The effect of the ointment is enhanced by applying occlusive dressings (compress paper or a piece of cellophane is placed on top of the ointment and covered with a bandage), they also prevent the laundry from staining the dark brown color characteristic of this ointment.

Naftaderm

(10% naftalan oil liniment in tubes of 35 g) is an anti-inflammatory, antipruritic, analgesic, wound-healing drug, which also has the property of enhancing the effect of other externally applied agents, therefore it is usually used in combination with other external drugs. Its disadvantage is a specific oily smell.

Ointments related to non-steroidal anti-inflammatory drugs (indomethacin ointment 10% and gel 5% and 10%, Butadione 5%, etc.) are rarely used for treatment, as they are not effective enough and sometimes cause allergic skin reactions.

The use of Lead water or lotion (0.5% solution of lead acetate - 100 ml per bottle) is one of the ancient ways to relieve acute inflammation. Other preparations for lotions are not currently available in finished form.

External antihistamines, for example, Fenistil (1% gel in tubes of 20 and 30 g), unfortunately, are not often effective for atopic dermatitis. They are useful in the first hours of an exacerbation, as well as with concomitant urticaria or a hyperergic reaction to insect bites in the summer.

How to care for a child’s skin if he has atopic dermatitis?

Let's figure out together what kind of care skin prone to AD requires. The first main problem is excessive dryness.

, which is caused by disturbances in the lipid layer.
As a result, elasticity is lost, which leads to damage. Violation of the barrier function makes the skin defenseless against the penetration of pathogenic bacteria, viruses and fungi. That is why the main rule in the fight against AD is cleansing, softening and moisturizing.
The second problem is the increased sensitivity of the skin to various irritating factors.

The skin of children with atopic dermatitis is highly susceptible to harmful environmental influences, therefore, when starting systematic care for it, try to eliminate irritating factors that can cause aggravation or maintain itching. Use a few practical tips:

• Avoid contact with the skin of fruit juices, vegetables, acidic liquids, chemicals (solvents, paints, varnishes, adhesives, various cleaning products for furniture, floors, carpets, etc.);
• Replace wool and synthetic clothing with hypoallergenic materials;
• Avoid stress and excessive physical activity, which increases sweating and itching;
• To reduce skin scratching by young children, use socks and gloves. You should also cut your fingernails short and treat the area of ​​the fingertips near the nails with disinfectants;
• Avoid exposure to extremes of temperature and humidity.

Don't forget that healthy skin is one that is sufficiently saturated with water.

. Controlling skin moisture reduces dryness and inflammation.

Need to remember:

• The air in the room where the child lives must maintain humidity within 60%; during the heating season it is simply necessary to resort to the help of air humidifiers
  .
• Daily bathing should not bring unnecessary stress to the skin of a child with AD: wash the bath thoroughly using specialized hypoallergenic products
  that do not contain chlorine.
  Remember, cosmetics can only be applied to clean skin! disinfectant wipes
  to cleanse the skin .
• For bathing and showering, do not use hot or cold water; the water temperature should be low 35-36°C. It has been proven that hot water provokes inflammation of dermatitis. It is recommended to bathe for 15-20 minutes, which is the optimal time to saturate the stratum corneum with water.
• Before bathing, leave tap water in the bath for 1-2 hours (to remove chlorine), followed by warming or adding hot water. You can also use water that has been purified using special filters.
• Use a wet compress if bathing in the bath causes pain (an additional measure to combat nighttime skin itching). For the compress, only well-purified water should be used.
• Maintain adequate skin hydration throughout the day by irrigating with special water.
• If bathing irritates the skin, use specialized products that soften the water and relieve irritation (bath gels and creams).
• Wash your child only with cosmetics that have a slightly alkaline or neutral pH.
• Use specialized medicinal and cosmetic moisturizers.
• Follow the recommendations of your doctor and carefully read what is written on the packaging, even if you buy baby soap that seems completely harmless to you.

Moisturizing the skin has a beneficial effect on the fight against dryness and itching, and also increases the effectiveness of therapy for atopic dermatitis in general.

Prevention

Atopy is translated from Latin as strangeness. The causes of the disease cannot always be determined. But long-term observation of patients and members of their families has revealed that it develops more often:

• with a genetic predisposition - if the parents are healthy, the probability of developing dermatitis in the child is 20%, if one of them is sick - 50%, if both are sick - 80%;
• in case of unfavorable pregnancy, active or passive smoking of the expectant mother, consumption of food that provokes allergy attacks, use of certain medications;
• when a newborn is in a dusty room, insufficient care for his personal hygiene;
• with prolonged exposure to allergens that enter the child’s body with food through the respiratory tract.

Breastfeeding for up to 6 months and avoiding allergy-provoking foods reduces the likelihood of developing atopic dermatitis.

Treatment of atopic dermatitis with homeopathy in children and adults

Hormonal therapy (both external and internal) has a powerful, time-tested anti-inflammatory effect. But she (in some cases) works with the consequences, and not with the cause of the disease. Therefore, its use allows you to get rid of the external disturbing manifestations of the disease, but does not guarantee that the disease will not “change its appearance” and go deeper, turning over time into a seemingly independent pathology.

Atopic dermatitis, like any other systemic disease, is very individual both in origin and course. And only the organism itself suffering from the disease “knows” its real causes and the right ways to eliminate them.

Traditional holistic medicine adheres to this point of view. Therefore, the focus of her various methods is not on the diagnosis, but on the patient. And therapeutic efforts are aimed at helping the body itself understand the individual cause-and-effect tangle of the disease and find the only correct way out of it with the least losses. And also - to strengthen his strength for this difficult path.

Homeopathy is one such treatment method for both children and adults. Including people suffering from atopic dermatitis.

It is based on:

• individual approach;
• choosing the optimal (effective and tolerable) homeopathic remedy, taking into account not only the clinical picture of the disease, but also the characteristics of its perception by a person;
• increasing vitality and adaptive capabilities of a person, etc.