The condition known to many parents as atopic eczema in childhood is, in fact, a chronic inflammation of the skin, usually accompanied by moderate to severe itching. This condition can be persistent, everyday, or recurrent in seizures with periods of inflammation. Due to the strong, sometimes unbearable itching, the child is often nervous, crying and upset. The normal cycle of night rest - the child's sleep - can be disturbed, when due to the heat of the bed the itching can intensify, so all other symptoms are followed by insomnia, which keeps both the parents and the anxious child awake. This creates a closed circle of causes and consequences, which sometimes can exhaust the whole family of such patients, says primarius Suzana Kamberova, a specialist dermatologist.

What is atopic eczema and how is it recognized?

- The term atopic eczema is broad and associated with some other diseases, which appear in the families of children with this disease (possible family inheritance). These are: pollen fever, asthma, eczema in adults and allergic eye infections. Atopic eczema usually begins in the first year of life, although the symptoms may not be very severe. Only redness on the cheeks may appear followed by dryness and peeling of the cheeks and if the parent carefully observes his child, he will notice that the baby is trying to relieve the itching of the skin by rubbing, he is nervous and cries constantly. In severe cases, the skin on other parts of the body may be affected by a rash in the form of redness, sometimes with small pimples (blisters) filled with fluid (in younger and softer skin) that quickly splash and are replaced by scabs and small peeling of the affected parts. The skin folds are more often affected, such as the elbows and knees, the face, first of all, the cheeks, then the forehead, but in more severe cases the body is also affected with similar changes. The skin of these children is drier than normal, and such dryness becomes even more pronounced when the weather is cold, so the water from the superficial layer of the skin evaporates. Then the skin cracks easily and turns red. Because the itching in the affected areas is constant and pronounced, the children are constantly itching and so additionally the skin thickens in those places and is covered with small scratches that sometimes bleed. In the case of school children, due to the constant skin problems and constant itching, the concentration and attention at school decreases.

Which children are most affected by atopic eczema?

- It seems that the disease affects more children from more industrialized countries, and in addition there has been a steady increase in the number of patients from the 1960s onwards. Whether all this is due to accelerated industrialization and pollution of the human environment is still under study and the exact causes have not been determined with precision. The first child in the family is more likely to suffer from atopic eczema in more cases than younger children, or may have a more severe form of the disease than other children. The role of contact of children in early infancy with bacteria and other microbes from the environment has been studied extensively, and there is a thesis that has been confirmed by numerous studies, that contact with these microorganisms in the neonatal period helps to mature the immune system and reduce the risk of allergic diseases. In other words, the child should not be kept in extremely sterile conditions, but should be allowed to be in contact with bacteria from the environment in which he lives, especially through the mouth (placing a hand or object in the mouth without always having to wash with boiling water), as this may reduce the risk of developing allergies.

What factors cause this disease and are they generally the same in every person? Is there anything to do with the food he consumes?

- The provocative factors that cause this disease to become visible (manifest) are diverse and numerous, and are usually different in each individual. In the earliest childhood, the causes are most often in the food. These children are generally advised to avoid foods with any artificial additives such as preservatives, additives, dyes, etc. In the food categories that are not recommended are delicacies, frozen products, drinks such as juices with artificial colors, seeds such as sesame, nuts such as peanuts, walnuts, hazelnuts, then chocolate, cocoa, but also many other foods that can be cause of a new outbreak of eczema. In addition to contact allergens in clothing (wool, dyes in fabrics), infections, some chronic and untreated foci in the body (chronic inflammation, such as frequent angina and tonsillitis), emotional stress and finally some allergic causes that enter in the body through the air (for example, dust), may be the cause of acute exacerbations of chronic foci of eczema. Often these children feel very uncomfortable because of this, and in extreme cases such incidents caused by substances in their living and working environment (school) can lead to even greater emotional burden on the young patient, social isolation and severe stress. Great understanding is needed from the parents, the wider family and the environment, and sometimes a dermatologist is involved in the treatment of these children.

How is this disease treated and when should you consult a dermatologist?

- The treatment of the disease is long-lasting and perseverance is needed in more severe cases. In most cases the condition improves as the child grows. Prevention is important in the sense of not allowing the development of chronic inflammatory foci in the body, ie to treat them and to regularly nourish the skin in periods when the condition is calm.

For each patient it is necessary to identify some fixed causes, which always without exception cause the same reaction and should be avoided. This is achieved by carefully observing and observing, if necessary, all repeated reactions caused by the same cause.

Medication is recommended in periods when inflammation or exacerbation of inflammation occurs. Basic in the treatment is soothing itching. The therapy is determined in cooperation with a doctor, and later appropriate moisturizing creams or ointments are given, which maintain the achieved condition. The skin of these children should be additionally smeared on each occasion with an appropriate product for the care of dry and sensitive skin, because, as noted above, these children have drier skin than normal and the dryness itself, if the skin is not extra oily, causes redness and itching.

Atopic eczema is an unpleasant condition, but if you learn how to control and live with it and how to nourish the skin, you can largely avoid recurrent episodes of acute deterioration and lead a normal life.