Atopic Dermatitis: Symptoms, Causes & Treatment

Abstract

Atopic dermatitis (AD), a common type of eczema. It is the leading chronic inflammatory skin condition. Its development is influenced by a combination of genetic predisposition and environmental triggers, resulting in disruptions in both the skin’s surface (epidermis) and the body’s immune response. It is a long-lasting skin condition that may flare up intermittently over the years or persist throughout a person’s life, often overlapping with other forms of eczema. In individuals with atopic dermatitis, the immune system becomes imbalanced and overly reactive, leading to inflammation that weakens the skin barrier. This results in dry skin that is more susceptible to itching and rashes. People with severe atopic dermatitis also face an increased risk of developing food allergies, asthma, and allergic rhinitis (hay fever), which are commonly seen together as part of the atopic march—a progression of allergic conditions. In this article we will discuss this in detail and we will discuss its Ayurvedic Overview with its management.

Introduction

Atopic dermatitis (AD), a distinct type of eczema, is the most prevalent chronic inflammatory skin condition. This long-term condition, often linked with intense itching, typically begins in early childhood and manifests with dry skin, eczematous patches, and thickening of the skin. Atopic dermatitis is thought to be connected with other immune-mediated conditions such as allergic rhinitis, asthma, and food allergies. The condition is associated with considerable morbidity, and studies suggest that its prevalence has been rising in recent decades.

Causes

Atopic dermatitis (AD) is caused by a mix of various factors, including

1. Genetic Factors
   • A family history of allergic conditions such as asthma, hay fever, or food allergies increases the likelihood of developing Atopic dermatitis.
   • Specific genetic variations, especially in the filaggrin gene, which helps maintain the skin’s protective barrier, are linked to the condition.
2. Immune System Overactivity
   • Atopic dermatitis is associated with an overactive immune system that mistakenly responds to harmless substances, causing skin inflammation and irritation, which leads to the symptoms of the disease.
3. Compromised Skin Barrier
   • People with Atopic dermatitis often have a weakened skin barrier, which makes the skin more prone to dryness and allows allergens and irritants to enter more easily, causing flare-ups.
4. Environmental Triggers
   • Pollutants, extreme temperatures, dust, pet dander, and pollen can all trigger or worsen Atopic dermatitis by irritating the skin or increasing inflammation, leading to flare-ups.
5. Microbial Influence
   • The skin of Atopic dermatitis sufferers is often colonized by Staphylococcus aureus bacteria, which can further irritate the skin and cause infections, worsening symptoms.
   • Fungal infections may also contribute to flare-ups.

Risk Factors for Atopic Dermatitis

Certain factors increase the risk of developing or triggering Atopic dermatitis, including

1. Family History of Allergies
   • If someone in your family has asthma, hay fever, or food allergies, you are more likely to develop Atopic dermatitis.
   • Genetics plays a major role in this condition.
2. Age
   • Atopic dermatitis often appears in infancy or early childhood, though it can begin at any age or continue into adulthood in some individuals.
3. Environmental Exposure
   • Living in areas with high levels of air pollution or being exposed to harsh weather and chemicals can increase the chances of developing AD or causing flare-ups.
4. Sensitive Skin
   • People with naturally dry or sensitive skin are more vulnerable to developing Atopic dermatitis.
   • Their skin’s natural defense against irritants and moisture loss is weaker.
5. Climate and Seasonal Factors
   • Extreme temperatures, whether cold and dry in winter or hot and humid in summer, can aggravate Atopic dermatitis symptoms.
   • These conditions dry out the skin or cause sweating, both of which can trigger flare-ups.
6. Food Allergies
   • Certain foods, like eggs, dairy, peanuts, and soy, can act as triggers for Atopic dermatitis flare-ups.
   • This is particularly common in children who are sensitive to these foods.
7. Stress
   • Emotional or psychological stress can exacerbate Atopic dermatitis.
   • It may increase inflammation and skin irritation, making flare-ups more frequent and severe.
8. Gender
   • Atopic dermatitis tends to affect boys more often during childhood.
   • In adulthood, it is more common in women, though it can occur in both genders at any stage of life.

Symptoms

The symptoms may vary from person to person. Some of the common symptoms may include

• Itching (Pruritus)
• Dry Scaly skin
• Redness and inflammation
• Rashes
• Thickness of skin
• Blisters and Oozing
• Crusting and Scabbing
• Pigmentation Changes
• Swollen Lymph Nodes
• Increased sensitivity

Flare-ups and triggers

Atopic Dermatitis often goes through cycles of flare-ups and periods of remission. Triggers for flare-ups includes

• Allergens (pollen, pet dender, Dust mites)
• Irritants (E.g. Certain soaps, detergents, fabrics like wool)
• Stress
• Weather (Cold weather)
• Infections
• Dry skin
• Dietary Factors

Age Specific symptoms

• In Infants and Children : Atopic dermatitis often begins in infancy and may present as dry, red patches on the face, scalp, and other areas of the body.
• Adults : In adults, the condition is often localized to areas such as the hands, neck, and around the eyes. The rash tends to be more persistent and may be accompanied by thickening of the skin.

Diagnosis

The Diagnosis of Atopic dermatitis (AD) is primarily based on a thorough clinical Assessments which includes reviewing medical history and performing a physical examination. There are no definitive lan tests for this condition, but there are several methods to identify the condition.

1. Medical History
   • Family Background : A history of allergic conditions like asthma, hay fever, or eczema in a family can be the reason as these conditions often run together.
   • Personal Health History : The presence of itchy skin, skin rash, or a history of flare-ups.
2. Physical Examination
   • Examine the skin for characteristic signs of Atopic dermatitis.
3. Diagnostic Criteria (e.g., Hanifin and Rajka Criteria)

   The Hanifin and Rajka criteria are often used to diagnose Atopic Dermatitis. This involves both major and minor criteria

   Major Criteria
   • Itching : The main symptom of Atopic dermatitis.
   • Chronic or Recurrent Skin Inflammation : Rash or skin irritation that is long-lasting or returns frequently.
   • Typical Rash Distribution : Common areas affected include flexural regions (inside elbows, behind knees), face, and hands.
   • Family or Personal History of Allergies : A history of asthma, hay fever, or food allergies can be relevant.
   Minor Criteria
   • Dry Skin : The skin appears extremely dry and flaky.
   • Frequent Skin Infections : Due to scratching, the skin can be more prone to infections.
   • Hypopigmented Patches (Pityriasis Alba) : Light-colored patches often seen in children with AD.
   • Keratosis Pilaris : Bumps on the skin, usually on the arms or thighs.
   • Irritation from External Triggers : Sensitivity to soaps, certain fabrics, or weather conditions.

Treatment

The treatment plans may differ based on the severity of the symptoms, age and specific triggers. Some common line of treatment includes

1. Moisturizing (Emollients)
   • Petroleum jelly
   • Aquaphor
   • Eucerin
2. Topical Steroids (Corticosteroids)
   • Hydrocortisone
   • Betamethasone
3. Topical Calcineurin Inhibitors
   • Tacrolimus
   • Pimecrolimus
4. Antihistamines
   • Diphenhydramine
   • Cetirizine
   • Loratadine
5. Antibiotics
   • Dicloxacillin
6. Phototherapy

Ayurvedic Overview

In Ayurveda, Atopic dermatitis is compared with Charmdala. Charamdal Kushta presents with boils, itching and redness all around the lesion. Charamdal is a skin condition caused by the dominance of vata dosha, which leads to the cracking or splitting of the skin. This condition is characterised by tears, fissures, and abrasions on the skin’s surface. The presence of Vayu in excess causes the skin to become dry and prone to cracking. This results in breakage and splits across the skin due to the influence of the Vayu dosha itself.

Acharya Kashyap mentioned four types of Charamdala

1. Vataja
2. Pittaja
3. Kaphaja
4. Sannipataja

Symptoms

Vataja

• Itching
• Dryness of mouth
• Diarrhea
• Horripilation
• Convulsions
• Rough, blackish patch

Pittaja

• Dryness of mouth
• Vomiting
• Proctitis
• Diarrhea
• Cracking of skin and flesh
• Blackish yellow patch

Kaphaja

• Itching
• Pricking pain
• Anorexia
• Cough
• Heaviness of body
• Loose motion with solid stool

Sannipataja

• Putrid and stink like carcass
• Blackish and red coloured patches
• Burnt jaggery appearance

Treatment

Line of treatment for Charamdala Kushta is

Shodhana Chikitsa

• Vamana (Emesis)
• Virechana (Purgation)
• Asthapana Basti (Decoction enema)
• Anuvasana Basti (Oil Based Enema)
• Nasya
• Dhumapana (Smoking therapy)
• Raktamokshana (Bloodletting)
• Kshara Prayoga (Application of Alkalis)

Shaman Treatment (Palliative Measures)

• Patolamooladi Kashayam
• Mustadi Churna
• Triphala Churna
• Gandhak Rasayan
• Madhasava
• Kanakabindvarishta
• Triphalasava
• Kushtadi Lepa

Herbal remedies for Atopic dermatitis by Planet Ayurveda

Planet Ayurveda is a GMP certified ayurvedic company. They provide a wide range of natural, herbal formulations to support health and manage chronic disease. Planet Ayurveda’s Formulations are 100% pure, natural, chemical free and safe to use. All their formulations are prepared under the supervision of MD (Ayurveda) scholars. Their products focus on holistic care, addressing the root cause of ailments through personalised treatment, and lifestyle modification. Planet Ayurveda helps to manage many chronic diseases through their formulations they offer completely natural and effective solutions.

Product description

1. Gleaming Skin, Hair, Nails Formula
   This capsule is a standardised pure extract of Manjistha (Rubia Cordifolia), Pit Papda (Fumaria Officinalis), Ghritkumari (Aloe Barbadensis), Sariva (Hemidesmus indicus). It supports the health of your skin, nails, and hair. Known for its natural detoxifying properties, it aids in eliminating toxins from the body.
   Dosage : 1 capsule two times a day with warm water, after a meal.
2. Navkarshik Churna
   This herbal powder is a blend of Amla (Emblica Officinalis), Haritaki (Terminalia Chebula), Bahera (Terminalia bellirica), Vacha (Acorus Calamus), Neem (Azadirachta Indica), Manjistha (Rubia Cordifolia), Katuki (Picrorhiza Kurroa), etc. These herbs have detoxifying and anti-inflammatory properties. This formulation helps skin to heal and supports the immune system, making it very effective in this condition.
   Dosage : 1 tsp two times a day with warm water after a meal.
3. Gandhak Rasayan
   This tablet is prepared from pure extract of Gandhak (Sulphur). It has anti-inflammatory, antifungal, and antibacterial properties. It exfoliates and helps the skin to heal while removing toxins from the body due to its detoxifying effects.
   Dosage : 2 tablets two times a day with warm water after a meal.
4. Kushta Rakshas Tel
   This oil is prepared from pure extracts of Parada (Purified Mercury), Gandhak (Purified Sulphur), Kutha (Dolomiaea Costus), Saptaparna (Alstonia Scholaris), Chitrakmool (Plumbago Zeylanica), Nag Sindoor, Lashun (Allium Sativum), etc. It helps moisturize the skin and contains detoxifying, anti-inflammatory, antifungal, and antibacterial properties. It is beneficial in conditions like Atopic Dermatitis.
   Dosage : 3 ml two times a day for local application.
5. Royal Honey Shower Gel
   This shower gel combines Honey, Vitamin E, Aloe Vera extract (Aloe Barbadensis), Tea Tree extract (Melaleuca Alternifolia), Elfan AT84, Celquat SC 230 M, FM-1200, and glycerin. It provides deep moisturizing and rejuvenation while promoting softer, healthier skin. It is beneficial in Atopic Dermatitis by helping to repair the skin.
   Dosage : Use this for bathing.

Conclusion

In a nutshell Atopic dermatitis is correlated with Charamdala Kushta in Ayurveda. Ayurvedic treatment offers a holistic and natural approach to manage Atopic dermatitis by addressing its root cause and symptoms. Ayurveda emphasizes balancing the doshas. Shaman, Shodhan Therapies and Planet Ayurveda’s Atopic dermatitis care pack focus on detoxifying the body, soothing the skin, and restoring the skin’s natural balance.