Hospital Universitario La Moraleja Madrid


Atopic Dermatitis Parents School Unit

Atopic dermatitis is characterised by inflammation of the skin, dryness (xerosis), and eczema (redness, flaking, and occasionally tiny blisters on the skin). These appear on different areas of the child's skin, with pruritus (itching) being the most frequent and determining symptom of the condition. It is very common in our society and something that paediatric dermatologists and paediatricians deal with extremely frequently.

There are several factors that play a part in this skin condition, the cause of which is unknown:

  • Genetics.
  • Environment.
  • Immunological factors.
  • Infection.
  • Reduced skin barrier .

Atopic dermatitis can appear at different stages of childhood, and there is also a type that exists in adults, which can be a continuation of the childhood condition or an entirely new instance. There are the following categories:

  • Atopic Dermatitis in unweaned babies: from 0-2 years. In 60% of cases it appears during a child's first year and can either then disappear or continue into the next phase.
  • Infantile Atopic Dermatitis: from 2 years to adolescence.
  • Adult Atopic Dermatitis: from adolescence onwards.

The condition is chronically relapsing, with acute flare-ups the symptoms are exacerbated, and periods of remission the common symptom is dry skin. With appropriate treatment from a dermatologist and a paediatrician, the periods of remission can be prolonged as much as possible and the flare-ups can be resolved effectively, reducing the impact of the condition on the patient and their family.

Practical workshops can be extremely useful for sufferers and their parents or immediate family. The “no scratching workshop” s a friendly clown who plays with, teaches, and entertains the children, allowing scratching prevention strategies to be developed and playing an active role in treatment and recovery. There is also a “massage workshop”, with a qualified masseur and a nursing assistant, children are taught how to apply moisturisers to ensure that their skin remains in good condition and that the flare-ups occur less and less frequently.

There are also educational talks for the parents and relatives of child sufferers, so that the condition and its triggers can be better understood and that they can learn the importance of their role in keeping the child's skin in good condition, particularly through moisturising. They can also take part in massage workshops to learn how to correctly apply the creams and actively work with their paediatrician and/or dermatologist.

  1. Use clothes made with 100% cotton or natural fabrics like linen. Wool and acrylics should be avoided, both in the child's clothing and in fabrics with which they come into contact (sheets, pushchair liners, and so on)
  2. Baths should be short and with lukewarm water, using delicate skin products like glycerins and emollient oils. It is preferable not to use a sponge.
  3. Atopic children's clothing should be washed with ordinary soap and well rinsed, without using softener. New clothes should be washed prior to use.
  4. The child's bedroom should be kept at a moderate temperature and should preferably be humidified (using a humidifier).
  5. In principle, food is not associated with flare-ups (except in specific allergy cases). For children who can tolerate solid food (over 2 years old) eating oily fish and nuts is recommended, as is organic food.
  6. Hydration forms the basis of treatment, using emollient creams twice daily if possible. Softly massaging these into the skin improves hydration and also the parent-child bond, especially in the case of babies.
  7. Atopic flare-ups often accompany common illnesses such as colds and viruses. Extra moisturising is d, as is a visit to the dermatologist, since it is important to treat flare-ups early. The first symptom is often pruritus, followed by eczema, which can be greatly helped by oral antihistamines.
  8. Since it is an organ, the skin continues to develop along with the child. It is, therefore, capable of hydrating itself more and more effectively, making flare-ups less and less frequent and severe.
  9. Atopic flare-ups can occur despite following all the recommendations and administering the treatment prescribed by a dermatologist. This should not be a cause for despair, however, since with appropriate action they can be resolved and the condition clears up in the majority of cases.
  10. It must be highlighted that, in general, children affected by this condition are very bright and intuitive, which is some compensation for all the worry.

For some time, we have been working with the parents of children affected by atopic dermatitis. This is always done on an individual basis through our dermatology service. Every day, we give explanations that are as detailed as possible, and we often find that people have obtained misleading information from sources outside the clinic.

More than 40% of the patients in our paediatric dermatology unit suffer from atopy, a large number of which have a serious case of the condition. It is, therefore, extremely important to get these families together and educate them as best as possible on understanding and treating their child's condition. This is why we d a “Parents' School" aimed specifically at them. We will try to standardise criteria, educate and, most importantly, make the day-to-day lives of our patients and their families easier. Successful treatment of atopic dermatitis lies in an appropriate understanding of the condition by parents, who can provide continuous treatment based on advice from the various specialists that come together to form this unit.

This team involves dermatologists, paediatricians and allergists, all of whom play an essential role in diagnosing, managing, and treating the condition in its acute and chronic phases. This collaboration is necessary for managing the patient and their therapeutic progression until a full remission of the symptoms is achieved.

Nursing staff also play an important role, since treatments must be applied during the acute phases and flare-ups. Our professionals are specialised in this condition and in therapeutic massage using special emollients and creams to keep the skin perfectly hydrated. The Hospital Universitario Sanitas La Moraleja management supports the project, which offers all patients and their families the best quality care and an improved quality of life. Several interactive workshops will take place for parents and patients, as well as informative talks with flexible time. The frequency of these will depend on the demand from families or adult patients.



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