A common childhood disease, atopic dermatitis affects 2 out of 10 children under the age of 5

Irritated, dry, red skin, hypersensitivity and itching are the first signs and symptoms of atopic dermatitis, a chronic inflammatory condition that affects around 20% of children, of whom 60% manifest the disease in the first year of age, according to the Brazilian Association of Allergy and Immunology (ASBAI). The disease is not contagious and generally persists until school age, alternating between periods of improvement and worsening. Prof. Dr. Persio Roxo Junior, a paediatrician and allergo-immunologist, professor and head of the Division of Paediatric Immunology and Allergy at the Ribeirão Preto Medical School of the University of São Paulo, warns that during this phase red, scaly lesions can appear on the face, trunk, legs and arms, while in older children the lesions tend to be drier, darker and located in the folds of the body.

Atopic dermatitis is caused by genetic changes that compromise the skin's protective layer, making it more susceptible to the penetration of potentially sensitizing and irritating substances, which trigger inflammation. "Dry skin itself causes itching and, when the child scratches, it allows irritants and sensitizers to enter, further increasing itching and inflammation. This vicious cycle is continuous and can extend over a long period, significantly impairing quality of life, causing sleep disturbances, irritability and low self-esteem," explains Prof. Persio.

The pediatric immunologist adds that this inflammation can manifest itself continuously and, in the long term, flare-ups can be spontaneous or triggered by external factors, such as allergens (inhalants and/or food) and irritants, including wool and synthetic fiber clothing. Infections, emotional stress and environmental factors such as pollution, sudden variations in temperature and prolonged bathing in hot water can also contribute to flare-ups. High temperatures cause increased perspiration and bathing becomes more frequent, intensifying the appearance of irritation. In winter, more frequent hot baths and low humidity contribute to dry skin. For this reason, the specialist recommends opting for warm, quick baths.

During this period, the skin tends to become more sensitive and dry and the professor advises vigorous moisturizing of the skin, frequent fluid intake and avoiding the use of loofahs during bathing. "For children, liquid soaps are preferable, as they help prevent bacterial infection, which is quite common in children with atopic dermatitis. To restore the skin barrier, it is recommended to use gentle moisturizers, with formulations rich in emollients, which increase water retention in the skin and preferably do not contain preservatives, parabens and fragrances. Formulations containing bisabolol and allantoin help in the processes of skin healing, cell renewal and tissue regeneration. This moisturizing should be done daily, 3-4 times all over the body," emphasizes the specialist.

The professor explains that allantoin forms a film on the skin, preventing the evaporation of water and, consequently, dehydration. Bisabolol acts as an anti-inflammatory, repelling the molecules responsible for inflammation, calming the skin and reducing skin irritation. Continuous use improves sensitivity, redness and burning.

For the treatment to be successful, other recommendations should be combined with the use of moisturizers. For example, when washing clothes, give preference to coconut soap and avoid using fabric softeners. However, the specialist warns of the need to investigate the possible causes of the patient's sensitization. "It's important to consider the possibility of a milk protein allergy, especially in infants, as it may be during the introduction phase of this food that the first symptoms appear."

Atopic dermatitis in children is a challenging condition. But with the right treatment and special dermatological care, it is possible to control the symptoms and improve the quality of life of affected children. "Guidance for parents and caregivers and proper medical follow-up are fundamental during this phase, as well as following the recommendations of specialists and keeping the skin hydrated at all times," concludes USP professor Persio Roxo Junior.