Skin Care in atopic dermatitis
Since one of the main causes of atopic dermatitis is skin that lacks lipids and protein filaggrina, proper care for it often leads to the complete disappearance of symptoms or to their minimum manifestation.
bacteria, viruses and other exogenous substances usually penetrate the body through the intercellular intervals of the stratum. These gaps in a person with healthy skin cover the lipids, ensuring the integrity of the skin. Filaggrin protein, in turn, prevents excess skin loss of moisture, and also helps maintain the barrier properties of the skin.
Thus, dry, not protected from external influences, the skin will be constantly irritated even from mechanical friction at crawl, from sweat, from saliva, etc. Therefore, in the treatment of atopic dermatitis should always take into account this feature of the skin Atopikov and try to avoid the effects of irritating factors on the skin, as well as not allow it to become too dry. This is not a "puttying" problem, it is the restoration of the natural protective functions of the skin, which for some reason are not performed in full.
Creating an optimal external environment
The first thing to do to improve the condition of the skin prone to atopy is to create optimal conditions for the environment.
In the room where the child is to keep the temperature not more than 18-22 degrees, and the humidity of 40-60%, while the child minimum clothing (at a temperature of 20-22 degrees my daughter is wearing only a T-shirt and a diaper (both day and night)). If the child is hot-his body spends a lot of moisture, including on the allocation of sweat, respectively, the skin dries. In addition, the sweat itself is a strong irritant, with it released toxins and allergens. As for the humidity of the air-it is good not only to maintain the skin in a wetted state. bacteria, viruses and allergens are much more actively moved in a dry warm room than in a cool moisturized. However, it is not possible to overdo it with humidity, because it can have mould.
To maintain the temperature in winter, close the batteries with Styrofoam, put regulators, ventilated. In hot weather we use air conditioning.
To maintain humidity we buy a hygrometer, often my floor, put on the corners of the basins with water, hang wet towels on the batteries, ideally use a humidifier. The hygrometer costs about 100-300 rubles, so to acquire it is not such a big problem. Often hear "We have a moisturizer running, so with the humidity problems are not." Unfortunately, a working humidifier is not an indicator. First, in order for it to start working fully, it is necessary to fill with moisture floors, walls, doors, upholstered furniture, etc. Accordingly, the first couple of weeks he will deal mainly with this. Secondly, the humidifier is enough, on average, for one room. Accordingly, that the humidity is maintained more or less optimal, it is necessary to close the windows and doors in the room where this moisturizer is worth. Thirdly, the humidity of the cold street air does not go to the apartment, because despite the high relative humidity, in such air there is little humidity absolute (cold air can not contain a large amount of water vapor). As a result: when airing humidity in the apartment falls, despite the fact that the relative humidity in the street is high. Accordingly, at airing all our humidity leaves, and to ventilate it is necessary. Therefore, the humidifier works around the clock, and after airing-to the maximum.
For example: In our 2-room apartment There are two 24-hour humidifiers. Humidity at this winter is at the level of 20-30%. It is necessary to ventilate-falls even lower. Thus, a hygrometer in the house where Atopik lives is a necessary thing to know for sure-whether any other events are needed.
As for the walks-there are also features. Of course, fresh air for the skin is good, but it should be remembered that external aggressive factors can negatively affect the skin. Besides the fact that it is desirable to walk in places really with fresh air (and not along highways, factories, etc.), it is necessary to consider, that the skin of many children with atopic dermatitis negatively reacts to the cold and the sun. In this regard, half an hour before the walk and immediately after it should be applied to the skin jemolent.
In the hot season it is recommended to walk in the morning or in the evening when the sun is less active. The child is required to wear a cap or Panama. In sunny weather it is necessary to use sun creams, which do not cause contact skin irritation. Even if the child has weeping stains that you want to dry, do it not in the open sun, but with special local remedies that will not overdry the skin does not need to podsushivanii.
In addition, at any time of the year the child should wear the weather so that it does not sweated, because the sweat (as mentioned above)-is the loss of the body moisture, as well as a strong stimulus.
The phrase "hypoallergenic life" mother of children, prone to atopy, hear from doctors quite often. This concept includes a number of activities aimed at eliminating or minimizing the impact of factors that may provoke a worsening of the disease:
- Wet cleaning in the apartment should be carried out as often as possible, as it helps to fight the dust (one of the main irritants of the skin) and create the necessary humidity in the room. Thus for washing of floors it is necessary to use special children's means, soda or to do just clean water. And in general, when cleaning use a minimum of chemistry in a ventilated room and away from the child (ideally, when the child on a walk with his father, grandmother, grandfather, etc.).
- If possible, remove carpets from walls and floors, as these are the main dust bags, which also prevent the creation of proper humidity and temperature in the room. If you do not have carpets, you should clean them as often as possible.
- Soft toys are also dust bags. They are either cleaned or eraseed as often as possible.
- Feather and feather pillows and blankets, fleecy plaids, wool blankets, curtains and upholstered furniture should also be identified among the main dust bags. All this must be washed and cleaned as often as possible. In addition, the baby's skin can irritate feather mites, so feather and feather pillows and blankets are better to replace the synthetic. If the feather mites are too disturbing to the baby, it is also possible to think about the use of protective covers for upholstered furniture and mattresses.
- Pets and flowers are best not to be kept in an apartment where a child with atopic dermatitis lives because it is quite a strong irritant. If there is no animal at all-do not let it into a room where the baby spends most of the time and/or sleeps, as well as on the bed and other furniture.
- Maximum rid from inhaled irritants, especially from tobacco smoke. Smoking in the room where the child lives, in principle, not worth it, and where a child with atopic dermatitis-especially since tobacco smoke is also a strong irritant. Accordingly, on the street smokers also try to bypass the side.
Creating hypoallergenic life is important not to overdo it. The child will not live in a sterile world, but the basic purity must be maintained.
Remove Contact stimuli
Even if there is a food allergy or immaturity of the digestive tract, toxins and allergens that have been on the skin since then often manifest themselves only after meeting with any contact irritant, so it is very important to limit such contact. About sweat and dust was said above, but there are other common stimuli.
Bathing-is the best way to saturate the skin with moisture, so to bathe a baby, prone to atopy, you can and need. However, one of the most common contact irritants is chlorine contained in tap water, so it should be removed first, using one of the ways to soften the water.
It is also necessary to observe certain bathing rules. In particular, as rarely as possible to use soap and shampoo (and if you use, only intended for children with atopic dermatitis at a certain stage), monitor the temperature of water (start bathing from a temperature not higher than 35 °-36 °), do not rub the skin etc.
All washing-laundering during the day should also be done in water without chlorine and with a minimum amount of detergent.
Any new clothes before to put on the first time on the child, it is necessary to wash, and also to cut off from it tabs, that the last did not irritate tender skin.
For washing it is necessary to use only special children's powders, preferably without biosystems and liquid, instead of powder (because the powder is more difficult to wash out of a fabric).
Before buying the powder carefully read the composition. In particular, the maximum permissible concentration of anionic surfactants should be no more than 2-5% (and 100USD without them). The main task of surfactants to remove stains from clothing, but in large numbers they can also lead to disorders in the immune system, allergic reactions and lesions of internal organs. Often in powders are used phosphates, the purpose of which is the activation of surfactants and softening water, and in addition they can lead to such consequences as the penetration of harmful substances into the body of the baby, even in the absence of wounds on the skin (and now Imagine skin Atopika in a period of aggravation), reduction of barrier functions of the skin, degreasing of the skin, destruction of cell membranes, reduction of immunity, violation of blood properties-a real poison for the gentle skin of the baby. In most European countries and in America, these components are prohibited and replaced with harmless (sodium Disilikat (15-30 percent), zeolites), but domestic producers have only reduced the concentration of phosphates to 15-30 percent. As for bleaches contained in powders, they should be oxygen, not optical or chlorine. Flavors, fragrances, phthalates and conditioners should ideally not be, because they are not vypolaskivajutsja from the fabric. Enzymes are responsible for splitting of difficult disappearing stains and in a soap solution absolutely harmless, therefore it is quite possible to be present in a powder, however at their constant use clothes faster thinner.
Ideally, clean laundry detergents or soap nuts should be used. If powder detergent is used, it is necessary to fill it in the washing machine as carefully as possible, and after it is better to ventilate a room as its toxic dust keeps in air up to 30 minutes.
That on linen there is no detergents (they can cause irritation of a skin), it is necessary to rinse well as many times as possible (now on all washing machines there is a function of an additional rinse-for children's clothes it is obligatory ). and ideally to rinse it is necessary in hot water (50-60 degrees) as in cold anionic surfactants and phosphates practically do not vypolaskivajutsja. It was considered that the last rinse should be carried out in water without chlorine (in filtered or boiled). If a child has a strong reaction to chlorine, the ideal option is to install the appropriate filters at the entrance to the apartment, so that all the water was filtered, but it is expensive enough. It is necessary to remember, that chlorine as a volatile substance, in the process of drying and ironing also evaporates, however its vapors to breathe very harmfully, and therefore to dry linen it is recommended in a nonresidential premise (ideally-on a balcony).
It is very important to observe the above rules of washing not only in relation to baby clothes. Any tissues with which it is contacted with its tender skin, should be washed in compliance with these rules: diapers, bed linen, adult clothes, plaids, etc. It is ideal to change not only clothes, but also linens every day.
Avoid wool and synthetics
Dry Atopichnuju skin can irritate even cotton, but wool and synthetics make it much stronger, and therefore the contact with such tissues should be abandoned. We leave only 100% cotton and flax. In addition, dyes can also negatively affect the condition of the skin, so ideally the child's clothes and bedding, on which he sleeps, should be white (without dye). Before you take toddler on your hands, Mom (Dad/grandparents, etc.) should wrap around the shoulders of a diaper dedicated specifically for these purposes.
As for outerwear-here the situation is more difficult, because now even lining caps-Kombezikov often made of fleece. In this case, it is necessary to make the sleeves of the garments protrude over the sleeves of such fleece Kombeza. As for the head and neck, on sale you can find X/b hats-helmets that can be worn under a warm hat.
We buy only quality toys from quality materials. It is better to have one high-quality toy than a set of unknowable material covered with unknowable paint. If the toy comes with an unpleasant odor-it does not mean that it can be simply ventilated. In particular, this applies to soft puzzle mats.
It is also necessary to remember that any toy before you give the baby, should be washed with a special detergent to wash toys 0 + or boil. And if mine, then opolaskivaem water without chlorine.
Soft toys are better temporarily removed as a source of accumulation of dust.
Since dry skin itself has the property to itch (and in the period of strong aggravation-it itchy incredibly), the baby's nails should be short cut. Besides the fact that Karapuz will scratch itself, the skin will get bacteria, accumulated under the fingernails. In the period of aggravation it is desirable to lay a child to sleep in mittens and socks.
Elimination of dryness
The best way to saturate the skin with moisture-bathing in compliance with all the necessary rules. However, the skin of a child suffering from atopic dermatitis, in itself can not retain moisture, so in addition to the standard hydration must be constantly (including during remission) in sufficient amount to use Jemolentami (special means that help the skin to retain moisture). At the same time to apply emollient must also comply with the appropriate rules for the use of Jemolentov. The most important of them: Jemolentom should be used as dry. During remission-it is usually 2-3 times a day. In the period of aggravation-at least every hour. Touched-skin dry-uvlazhnili-inflicted jemolent.
Ensuring proper care during the period of aggravation
In the period of aggravation is necessary to connect anti-inflammatory agents. If we are dealing with an easy stage-usually enough cream with zinc (Cindol, A-Derma dermalibour, Cicaplast BAUME B5, Uriage Cu-Zn + Creme, etc.). At aggravation of light and Srednetjazhelom from 3 month age also it is possible to use cream jelidel. In severe aggravation-only corticosteroids, suitable for age or topic from 2 years of age. If the secondary infection-hormones in combination with antibiotics or antifungal preparations, or combined means is added additionally. In order to ensure maximum efficacy and safety of the use of hormonal drugs, it is also necessary to follow the rules of their application and use them only for the purpose, as well as under the supervision of a doctor.
Our treatment regimen looked similar to the following:
- On weeping Stains: 2 times a day skin-cap (ideally aerosol, but we had only cream, and stains such for all time was only 2 and then small) after treatment chlorhexidine/miramistinom. We did not use corticosteroids;
- When Moknutie passes, but redness still remains, and also on the inflamed (red) areas without Moknutij: Once a day cream skin-cap (here is already needed cream) or 2 times a day cream Jelidel after treatment chlorhexidine/miramistinom. Also at this stage connect jemolent for very dry skin (TRIAKTIVNYJ/Special cream Emolium; softening Balm Mustela stelatopia; Topicrem AD Emollient Balm; Lipikar Baume AP + from LA ROCHE-POSAY, etc.), which is used as dry. We were perfectly approached Lipikar Baume AP +, but there are complaints that he stings/burns the skin. Also liked Lokobejz Ripea, Mustela. From Emolium especially effect did not notice, from Topicrem was worsening, however all individually;
- On white Dry areas: continue to smear jemolent for very dry skin as the appearance of dryness;
- For the rest of the body: light jemolent (usually in the form of emulsions, we have milk Lipikar) as dry (during remission we smear in the evening after the bath and in the morning).
In most cases, with proper care for atopic skin signs of dermatitis are significantly reduced or disappear at all, and therefore it is one of the most important aspects of treatment.
The essence of care is reduced to the restriction of skin contact with irritants, constant use in sufficient quantity of Jemolentov and application of anti-inflammatory means (in particular, corticosteroids) in the period of aggravation. And the heavier the manifestation of dermatitis, the more careful to follow the rules to limit contact with irritants. Such care is carried out prior to the onset of a persistent remission.
My crumbs dry skin is still left (at the time of writing it 1 year and 3 months), but due to skin care exacerbation has not been observed for six months. Many children have a persistent remission coming to the year, some-by the age of 3m. To school atopic dermatitis disappears untraceably in 9 out of 10 children. Even rarer it passes only to the transitional age and very seldom remains in adult life.
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