Doctor komarovskiy atopic dermatitis treatment. Treatment of atopic dermatitis in children: what does Dr. Komarovsky recommend? Alena Ukraine, Kiev

29.05.2020

Surely every mom knows firsthand about such a disease as atopic dermatitis. Almost all children face it, starting from the earliest years.

This is a common chronic pathology that affects the skin; without timely treatment, it is actively progressing. Dr. Komarovsky believes that coping with such a disease is easy, you just need to adhere to some recommendations.

Who is Doctor Komarovsky

Evgeny Olegovich Komarovsky is a Ukrainian TV presenter, pediatrician, who is the author of the program "School of Doctor Komarovsky". He has written many books on children's health. In 2010 he won the title of the most handsome man in Ukraine.

Komarovsky tells parents in simple language about issues of concern to them regarding the health of the child. He is the founder of the consulting center "Clinic", kindergartens "Komarik" are also becoming popular today, which are completely organized according to the recommendations of Evgeny Olegovich.

Symptoms of atopic dermatitis in children

Atopic dermatitis in children under one year old and after manifests itself in the form of a rash. Pink, red spots form on the body, with or without watery blisters. Often, the disease affects the face, arms and legs, less often a rash occurs in the abdomen and chest.

A hallmark of this pathology is intense itching, which negatively affects the quality of life of the baby. The child's appetite disappears, sleep is disturbed, and the psycho-emotional state worsens. The temperature rises extremely rarely, if this happens, most likely, the baby is suffering from another disease.

If the rash is localized in the underarm area, in the folds of the skin, it is most likely diaper dermatitis. When the rash appears on the scalp as yellow crusts, it is often seborrheic dermatitis.

Atypical dermatitis, which is very similar to atopic dermatitis and is considered a type of it, can also occur.

Atopic dermatitis is usually diagnosed in one-year-old babies. Often the disease goes away on its own, but is prone to frequent relapses.

Komarovsky about atopic dermatitis in children under one year old

Komarovsky recommends that parents correctly assess the situation and make a diagnosis, since parents often call the problem a diathesis. However, according to the doctor, there is no such disease - there is only atopic dermatitis or childhood eczema.

Itchy skin, rash, and bowel function are interrelated. According to Komarovsky, this connection is not the main cause of the disease, contrary to the generally accepted opinion of pediatricians.

Two different children may have an allergy to the same product, and one will develop it and the other will not. It all depends on the immune system, the weaker it is, the more likely the child's body will be extremely sensitive to external and internal stimuli.

Treatment according to Komarovsky

Komarovsky knows exactly how to treat atopic dermatitis in children. Quite often, doctors resort to treatment "through the intestines", but this technique does not always show good results. The manifestations of the disease disappear, but after some time a relapse occurs. The main cause of pathology is allergens that enter the body.

Treating floors with regular chlorine can cause dermatitis. Molecules in your baby's sweat react with the chemical and develop a rash.

Komarovsky says that for all his medical practice he has never come across thin children suffering from atopic dermatitis, but with excess weight all the time. Therefore, to avoid allergies, do not overfeed the child.

Children who are on artificial feeding are more likely to suffer from eczema than infants. These babies usually eat more than their body can handle - breastfeeding is more difficult than drinking from a bottle.

All the excess that the baby ate begins to rot in the intestines, partially excreted by the liver and as a result dermatitis develops. For the treatment of atopic dermatitis, Komarovsky suggests adhering to three main recommendations:

Eliminate excessive consumption of food allergens.
Reduce baby's sweating.
Eliminate contact with external irritants.

Parents should keep the house clean. Use hypoallergenic products for cleaning. Bathing with atopic dermatitis should be carried out without fail and only with the help of mild hygiene products.

Diet is a prerequisite for the treatment and prevention of disease. If it does not go away, but on the contrary is actively progressing, you should not hesitate - contact medical institution and in any case, do not pick up medicines yourself.

Atopic dermatitis is considered a common disease that will develop actively without timely treatment.

The disease is easier to prevent than to treat it, so parents should take care of preventive measures before the baby is born. This is Komarovsky's main recommendation.

Dermatitis is a composite group of skin diseases, manifested by inflammation. Its appearance can be due to the action of a number of factors: physical, chemical or biological genesis. Dermatitis is a representative of the group of allergic dermatoses: the pathogenesis of the disease is based on an allergic reaction of a delayed and immediate type.

This group of diseases is represented: allergic dermatitis, toxidermia, eczema, atopic dermatitis and urticaria. The disease affects children from infancy to adolescence. What does dermatitis look like and what to do in case of illness? We will try to figure it out with the help of Dr. Komarovsky.

Why arises

Many people call atopic dermatitis diathesis. This is not entirely true. The onset, as Dr. Komarovsky says, of atopic dermatitis occurs due to the immaturity of the immune system, liver and intestines. In an adult, allergens are completely neutralized in the liver and excreted from the body with waste products. For little child the action of the same allergens will lead to the development of a skin reaction, which will require treatment.

Atopic dermatitis in children occurs under a number of conditions:

hereditary predisposition;
violation of bowel movement;
increased sweating;
exposure to an allergen from the external environment.

There are plenty of factors that contribute to the creation of constipation in a child:

Hereditary defect of embryonic tissue (Hirschsprung's disease): part of the intestine is in constant tone, contributing to the accumulation of feces over itself, making it difficult to empty.
Ailments of other body systems: digestive (cholecystitis, pancreatitis, hemorrhoids), endocrine and other pathologies.
Unhealthy diet: restriction of liquid, fermented milk products and the predominance of carbohydrate-containing ingredients in the diet.
Stress, overwork.

Excessive sweating in most cases occurs when the temperature is violated. And this can be due to two factors: too much clothes on the child or the room temperature is more than 20 degrees Celsius. A simultaneous combination of both factors is possible. Sweating increases, notes Komarovsky, in obese children.

Allergens

Allergens are more often of a food nature, but other substrates can also cause dermatitis.

Food allergens in the genesis of dermatitis:

eggs;
proteins found in cow's milk;
cereals;
citrus;
cocoa products.

If the expectant mother used allergic food components in the third trimester, then this can also provoke the onset of dermatitis in the baby.

Other allergens that cause dermatitis:

dust;
pollen of flowers;
chemistry used in everyday life;
pet hair.

Briefly about the mechanism of allergy development

Let's talk about external factors that can cause dermatitis upon contact. At the heart of the development of dermatitis in children, Komarovsky notes allergic processes. Allergy arises to a foreign protein, which penetrates the body, combines with antibodies produced by the immune system for introduction, and triggers the development of an allergic reaction in 2 types: immediate or delayed reaction.

But protein does not always enter the body unchanged. More often, the process of dermatitis is triggered inside the body by haptens. Haptens are low molecular weight substances that do not cause allergies. They are represented by chemical compounds. However, upon contact with specific (high-molecular) blood proteins, haptens form complexes to which the body's antibodies begin to attach, thereby triggering the allergic process. Most often, in atopic dermatitis, food is a foreign protein.

What does a baby eat and why is it important to comply with the norm

A newborn in its first 28 days needs not only special care, but also a rational feeding regimen. It is preferable for a mother to breastfeed, since breast milk contains all essential vitamins, minerals, enzymes for the baby. An important point in breastfeeding is the presence of antibodies in milk that provide the newborn with passive immunity. For a baby under 6 months the immune system not completely formed and before this period it can easily be exposed to any infection.

A child receiving a formula, although it meets all the parameters recommended by WHO, will be deprived, first of all, of the mother's antibodies. Now about the length of feeding. If we conventionally assume that a child needs 100 grams for a single dose, then the differences in infants will be in the rate of saturation. A breastfed baby sucks the prescribed 95 grams in 5 minutes, then for 20-30 minutes, satisfying his sucking reflex and getting pleasure from it, sucks 5 grams of the required dosage. As for the artificial man, he does not have such an opportunity to eat food for a long time. Usually, the child quickly sucks the entire portion and requires more to satisfy the saturation center located in the hypothalamus (structure of the brain). And more often the parents or those who care for the child go to meet him. Thus, the baby is overfeeding.

Our body systems are adapted to a specific amount of food. For the breakdown of components, enzymes are present throughout the digestive tract. Enzymes are substances that help break down and digest food components. However, when creating a food load, enzymes do not cope with the task, thereby inhibiting the assimilation process. And it is also important to observe the mother's diet when breastfeeding, because with overuse fatty foods change the fat content of milk.

Thus, more often dermatitis in infants in terms of feeding is due to overfeeding or a change in the composition breast milk... Overfeeding in terms of the genesis of dermatitis is especially relevant against the background of the use of milk formula.

Symptoms noted

So, based on the above information on the genesis of dermatitis, we noted that the process of assimilation of food is disrupted against the background of overfeeding. That is, it turns out that useful and nutrients do not have time to be fully absorbed in the small intestine, but in transit enter the large intestine. Against the background of insufficient intake of liquid, fermented milk products, thickening of feces occurs. This contributes to the emergence of difficulties in the act of defecation. This is manifested by constipation, the child cannot poop for several days, even with strong pushing. However, it must be borne in mind that constipation will not be the main manifestation of dermatitis. The main skin signs of dermatitis will be: redness, diaper rash, itching, peeling.

There is a definite correlation of the symptoms of dermatitis according to age, highlighting the following types of dermatitis:

infant;
children's;
teenage adult.

According to the severity and symptoms, atopic dermatitis is divided into the following subspecies:

mild;
moderate;
severe degree.

Symptoms by severity and manifestations depending on age

Mild dermatitis: slight redness is indicated on the skin, a small number of papules and vesicles are noted. The itching that appears does not bother the child much. The intervals without exacerbations and manifestations of symptoms are quite long. For eight months, the disease may not appear again.

Moderate dermatitis: The rash affects many areas of the body. The bubbles break open, exposing an erosive surface that is prone to getting wet. In the healing stage, skin hardening occurs. The itching bothers the child a lot, almost throughout the day. Escalation periods are frequent. Outside of exacerbation, dermatitis may not appear for 3 months.

Severe dermatitis: the rash is multiple, with weeping areas, deep cracks are noted erosion. Erosive manifestations are more consistent acute manifestations and the escalation period. Dryness, desquamation and cracks are more characteristic of a chronic course. Itching is almost constant. Remission of the disease is rare, periods of escalation are frequent.

For infantile dermatitis, the topography of erythematous spots on the forehead and cheeks of the baby is inherent. And they are also noted on the arms and legs, the priest, in the groin, on the scalp. The resulting erythema swells, forming blisters with a tendency to open. Burst vesicles expose an erosive surface that tends to get wet. Infant dermatitis is indicated starting at 2 months of age.

Children's dermatitis appears between the ages of 2 and 13. In the interval of escalation, the presence of erythema and tubercles in the behind-the-ear region, in the fossa under the knees and elbow depressions, in the folds of the skin is noted. It is indicated with dermatitis skin pigmentation. Outside of escalation, the skin shrinks, showing scaly patches and cracks.

In adolescents, dermatitis occurs on the skin of the back, chest and neck. Drying of the skin is noted. Dermatitis is accompanied by severe itching. Its presence can be understood by the scratches present on the teenager's body. Sometimes with dermatitis, cracks in the hands and feet are noted.

Diagnostics

Diagnosis is made on the basis of survey data (complaints, disease development and life history). Then a dermatologist examines the skin. The manifestations of dermatitis characteristic of a child are noted: erythema and papules, vesicles, erosive surfaces with weeping areas. In the escalation stage, when the elements are located in the depressions (folds), the appearance of diaper rash is noted, against the background of moisture and insufficient processing. In the chronic stage, manifestations of a dry form are more characteristic: drying of the skin, areas of desquamation are noted, cracks and bleeding may appear (with deep cracks, the deep layers of the epidermis are affected with rupture of small blood vessels).

Additional examination methods include: examination of skin lesions in a dark room, testing (blood, urine). When signs of other diseases appear during the examination, it is necessary to give a referral for examination to a specialist of a different profile.

Healing activities

Based on the above material, it is necessary to understand how to treat dermatitis. Consider drug and non-drug intervention, diet features. And also we note the advice for the treatment of Dr. Komarovsky allergic dermatitis.

Doctor Komarovsky advises that when the first symptoms of the disease appear, immediately consult a doctor, since self-medication can only aggravate the condition.

Key points to be considered by parents:

creating an optimal temperature regime in the room: 18–20 degrees Celsius, humidity not less than 60% (put a hygrometer in the house);
eliminate or reduce the effect of the allergen;
reduce the absorption of irritating substances into the blood.

First of all, at the reception, the dermatologist clarifies the possible cause of the disease. If an allergen is suspected, an immunogram is performed with a number of possible pathogens. Then they begin to carry out local activities.

The main drug for relieving skin redness is an antihistamine: Fenistil, Gistan.

Local treatment for dermatitis is based on what stage of the dermatitis is and what its symptoms are. In the acute stage with signs of wetness, various lotions and lotions are used to help reduce the release of exudate. IN chronic stage against the background of drying of the skin, preparations of moisturizing and nourishing action are used. To relieve the manifestations of the rash, Desitin, Protopik, Elidel are used. After opening the bubbles and exposing the erosive surface, the cream Bepanten, Bepanten Plus (there is an antiseptic chlorhexidine in the composition) can accelerate healing.

If the use of drugs for dermatitis is ineffective, use Advantan cream, Mometasone (hormonal agent). Application must be carried out in accurate dosage according to the instructions.

Adjunctive therapy

Physiotherapy will help the child to speed up the healing process of dermatitis:

Paraffin.
Reflexology.
Irradiation with a quartz lamp.
Oxygen therapy
Laser.
Baths with rhodon, salt, medicinal herbs or potassium permanganate.

Home activities

You can create an optimal temperature regime (18–20 degrees Celsius) and humidity (at least 60%) in different ways:

Put regulators on batteries.
Wet cleaning frequently.
Ventilate the room.

About bathing and water procedures for dermatitis: hypoallergenic detergents must be used for washing and washing. It is important to use filtered water for both washing and bathing, since the chlorine contained in the water can cause the birth allergic reactions... Against the background of allergy to this chemical element, it is also important to exclude its exposure through household items and clothing. Chlorine can be rendered harmless by boiling. To do this, after the laundry has been washed, it must be placed in boiled water. The chlorine will evaporate and will not harm your baby's sensitive skin. You can also buy 100% cotton fabric and sew all kinds of clothes for your baby to wear at home. It is important that the processing of things is carried out in the same way, not only for the sick child, but also for all family members.

Diet and nutritional features

In order for dermatitis therapy to be effective, it is very important to adjust the diet. When breastfeeding, the mother should monitor the foods with high fat content. It is necessary to limit the intake of fatty foods, drink more fluids and consume fermented milk products. In an artificial man, it is necessary to regulate the amount of the mixture used: the dose must correspond to age.

In children and adolescents, a nursing mother with dermatitis, it is definitely necessary to exclude contact with a food allergen or reduce its amount (by reducing the dosage or diluting it). Allergies are caused by foods containing gluten, rye, wheat, oats. Since the list of foods that can cause allergies, according to Dr. Komarovsky, is huge, it is necessary to remove only those that are really capable of causing allergic manifestations.

An important aspect in the treatment of dermatitis is the presence of saliva in sufficient quantities in oral cavity... The primary breakdown of food, namely carbohydrates, occurs in the mouth.

This can be achieved by slowing down the eating process:

in infancy: the hole in the nipple should be small;
older children: meals should be in small portions, at frequent intervals. It is necessary to explain to the child the importance of a leisurely meal.

It is important to understand that the exclusion of an allergenic product from food should not affect the growth and development of the child, especially infancy.

The inflammatory process that affects the skin is called dermatitis. This problem occurs quite often, especially in children.

How does Komarovsky, a popular children's doctor, describe dermatitis?

Causes

In most cases, the disease is the result of an allergic reaction of the body. An allergy is a reaction to a foreign protein.

The immune system detects this element and neutralizes it by producing certain antibodies.

Another scenario may also take place: certain substances that enter the blood are combined with its proteins.

As a result, they are endowed with foreign characteristics that turn them into targets for the immune system.

In children, the cause of such diseases in most cases is associated with food, since they digestive system has an imperfect development.

In some cases, inflammation on the skin occurs after consuming an allergenic product, in others it is the result of an excess amount of food, for the digestion of which children's organism does not have the required amount of enzymes.

For the onset of the disease, according to Oleg Evgenievich, several conditions must be met:

the ingestion of harmful substances from the intestines into the blood;
excessive sweating;
skin contact with harmful substances.

Types and symptoms

Allergic

With the development of allergic dermatitis, the child constantly suffers from severe itching. As a result, his sleep and appetite may deteriorate.

At the same time, discomfort often occurs in the evenings.

On skin red inflamed lesions appear, which are accompanied by severe dryness and peeling.

In difficult cases, cracks appear on the baby's skin.

Often, children with allergic dermatitis have white bloom on the tongue and delayed bowel movement.

If a child has rather dry skin, on which diaper rash often appears, we can talk about a tendency to dermatitis.

Parents of such a baby need to pay special attention to moisturizing the skin.

Atopic

This form of the disease is a chronic skin lesion. Its manifestations may disappear, but over time they appear again.

In this case, periods of exacerbation of the disease are replaced by remissions, in which the condition of the skin is normalized, and the symptoms completely disappear.

The manifestations of this ailment are individual in nature.

TO general symptoms usually include:

dryness;
itching sensation;
hyperemia of the skin;
the appearance of rashes.

The increased dryness of the epithelium leads to the fact that cracks may appear on it.

In this case, eczema can affect various parts of the body:

in infants, the rash is usually localized on the face and in the scalp;
in primary school children, the rash affects the folds of the arms and legs;
children of middle and senior school age usually experience rashes on their feet and hands.

Seborrheic

The seborrheic form of dermatitis is based on a violation of proper functioning sebaceous glands.

In children this disease usually appears as crusts on the scalp.

Sometimes localization can be observed in other areas of the skin that have many sebaceous glands - between the eyebrows, behind the ears.

For children, this disease usually does not cause much concern. As a rule, it goes away on its own within a few months.

Komarovsky does not recommend treating seborrheic dermatitis.

Only in rare cases, a baby may need medical intervention in the form of prescribing special lotions or shampoos.

Video: Features of the disease

Diaper

From the name it is clear that this species is associated with diapers.

If the baby's skin is in contact with urine for a long time, which cannot evaporate, there is inflammatory process.

It is caused by exposure to certain substances that make up the urine, such as uric acid.

Diaper dermatitis is very common. According to various estimates, the number of cases of this disease is 30-60%.

However, it is typical for children. early agethat have no control over the selection functions.

The development of the disease is caused not only by skin contact with urine. Equally important is the simultaneous action of feces and urine.

In this case, the damaging effect increases significantly, since in this case the skin is affected by ammonia and enzymes present in the feces.

Contact

This form of the disease is a delayed-type hypersensitivity reaction that occurs upon contact with certain substances.

The frequency of this disease increases many times after the introduction of new chemical substances, drugs, household chemicals.

In the acute form of the contact form, the child experiences the following stages of rash development:

erythema;
papules;
vesicles;
erosion;
crust;
peeling.

If the disease has a chronic course, it goes through the following stages in development:

papules;
peeling;
lichenization;
excoriation.

In difficult cases, contact dermatitis is accompanied by manifestations of body intoxication - headaches, weakness, fever, chills.

In the case of a single contact with an irritant, symptoms of the disease can be present for several days or weeks. If the child is constantly in contact with allergens, the disease persists for months or even years.

Komarovsky's methods of treating atopic dermatitis

To make the treatment of atopic dermatitis as effective as possible, Komarovsky offers an integrated approach.

Which includes the following components:

Reducing the absorption of harmful substances into the blood.
Reducing sweating.
Elimination of skin contact with factors that increase the likelihood of developing the disease.

To reduce the ingestion of harmful substances in the blood, you need to achieve regular bowel movements.

To do this, you can use lactulose syrup, namely, agents such as duphalac or normase.

Getting rid of constipation in a nursing mother is equally important. In this case, you can also use lactulose or glycerin suppositories.

If a child has a good weight gain, it is strictly forbidden to improve his digestion with eubiotics or enzymes.

Saliva is an active participant in digestion. To increase its effect, it is necessary to slow down the digestion process.

Small bore bottles are helpful for young children. It is also very important to walk a lot and monitor the air parameters.

If the child is on breastfeeding, it is recommended to try to reduce the fat content of the milk. To do this, a nursing mother must give up fatty foods, consume low-fat dairy products and drink a lot.

To prevent the ingress of poisons from the intestines, it is recommended to give the baby sorbents - enterosgel, smecta, etc.

To reduce sweating, you need to maintain an optimal temperature in the room.

It is desirable that this figure does not exceed 20 degrees. In this case, the humidity should be 60%.

The child should wear a minimum amount of clothing. Since harmful substances leave the body with urine, the baby needs to be watered more often.

To prevent the baby's skin from coming into contact with the chlorine contained in the water, a filter must be installed.

It is imperative to use exclusively special baby powders that do not contain biosystems. After washing, rinse the clothes in chlorine-free water or immerse them in boiling water for a few seconds.

When bathing, it is permissible to use exclusively children's products. At the same time, it is permissible to wash the child with soap and shampoo no more than once a week.

The fact is that any detergents lead to the neutralization of the protective film that covers the skin.

Do not allow your baby to come into contact with low-quality toys. It is also recommended that you completely discard any stuffed animals.

As for the use of drugs, Dr. Komarovsky recommends that you consult with your doctor.

At the same time, it is important to understand that the treatment of atopic dermatitis consists in the implementation of the outlined measures, therefore, it will not be possible to completely get rid of the disease with the help of drugs.

Antihistamines are effective because they reduce sweating. Such well-known agents as Suprastin, Pipolfen, Tavegil, provoke increased dryness of the skin and mucous membranes.

Calcium deficiency in the body often leads to an increase in allergic reactions.

That is why the symptoms of atopic dermatitis often increase during active bone growth or teething.

Quite often, a lack of this element is observed with excessive consumption of vitamin D.

To replenish your body's calcium reserves, you need to add calcium gluconate to your food. With an exacerbation of atopic dermatitis, it is enough to give the baby 1 tablet per day for 1-2 weeks.

Also for this purpose, it is permissible to use antihistamines for local use - for example, fenistil gel.

The most effective means for eliminating allergic reactions include corticosteroid hormones.

The most effective drugs are Advantan and Elok, which practically do not penetrate into the body, and therefore do not have a negative effect on it.

It should be remembered that any ointment helps to cope only with the external manifestation of the disease, while the reason remains in place.

Hormonal agents are usually used only if atopic dermatitis causes severe itching.

These funds are produced in the form of ointments or creams.

If the baby has a deep skin lesion, he is prescribed an ointment.

With moderate manifestations, the cream will be enough for him.

After achieving the required result, it is not recommended to stop using the drug - it is enough to reduce the concentration of the drug.

To do this, you can squeeze out 1 cm of hormonal and mix with the same amount of baby. After 5 days, the proportion needs to be changed - for example, 1: 2. In this case, the cream should be mixed with the cream, and the ointment - only with the ointment.

Other types of therapy

To cope with seborrheic appearance in children, you can use special shampoos or lotions.

However, Dr. Komarovsky claims that in most cases the disease goes away on its own within a few months.

If diaper dermatitis develops, Komarovsky's treatment suggests the following: to provide the inflamed skin with the maximum possible contact with air.

Children's epithelium recovers very quickly. If you eliminate the damaging factor, literally in a couple of days there will be no trace of the inflammation.

If this does not help, you need to use medicines - oils, powders, creams. To choose the best drug, you should consult your doctor, since there are many products on sale.

To cope with contact dermatitis, it is necessary to exclude contact of the body with the allergen that provoked this disease.

In case of exacerbation of the disease, wet-drying dressings are used, after which topical application of corticosteroid hormones is indicated.

If the rash appears as large blisters, they are punctured to remove excess fluid. In this case, the coating of the formation is not removed.

Dressings should be changed every 2-3 hours, wetting them with Burov's liquid. In difficult cases, the use of systemic corticosteroids is indicated.

Prophylaxis

In order to prevent the development of dermatitis, Dr. Komarovsky recommends to properly establish the baby's life:

do not overfeed the child;
exclude allergenic foods from the diet of young children;
control the parameters of temperature and humidity;
buy clothes made from soft natural materials;
buy quality toys;
use baby powders and detergents;
monitor the frequency of bowel movements.

To cope with this disease, you need to follow certain rules:

Use emollients - these products prevent moisture loss. The baby's skin should be well hydrated. Therefore, emollients should be part of daily care.
Emollients must be odorless. It should be borne in mind that an ointment or cream moisturizes the skin much more effectively than a lotion.
After the bath, the skin should be gently patted with a towel, and then the emollient should be applied.
Do not allow the baby's skin to come into contact with irritating substances and tissues. If the baby is highly sensitive, it is recommended to choose clothes made from natural materials - for example, cotton.
Do not use fabric softeners often.
It is recommended to limit the baby's stay in the shower or bath for 5-10 minutes. In this case, it is important that the water is at room temperature. Swimming in hot water is not recommended.
It is very important to avoid scratching the damaged skin. To do this, it is recommended to distract the baby. When scratches appear, the condition of the skin deteriorates significantly.

In addition, the threat of infection increases significantly. It is necessary to monitor the condition of the baby's nails - they should be short enough and not have sharp edges.

Dermatitis is often the result of allergies to food, wool, dust mites. If this connection is proven, contact with the allergen should be avoided.
Exacerbation of dermatitis can be the result of overheating or severe stress. In such a situation, it is very important to avoid provoking factors.

Various types of dermatitis are quite common in children.

To cope with this disease, it is very important to determine the cause of its occurrence.

Komarovsky claims that a serious lifestyle correction will help to forget about the disease, which includes a change in the approach to nutrition, the choice of quality clothing and toys, and the control of air parameters.

In the first months of life, babies are very sensitive to everything and vulnerable to many ailments. Problems with the tummy and diaper rash are the leading ones, but can you be completely sure that the reddened and inflamed folds of your baby are just a consequence of the increased moisture under the diaper? Have you ever heard of atopic dermatitis? Do you know what it is? Not? Then we'll sort it out together now.

Atopic dermatitis is a huge discomfort for babies. The skin itches and itches all the time.

Heredity is the main factor in the development of atopic dermatitis

Atopic dermatitis in children is not uncommon. Various factors contribute to the disease, but the main cause of the manifestation diffuse neurodermatitis (this is another name for blood pressure) in babies - this is a hereditary predisposition. It is widely believed among people who are not familiar with medicine that AD is a skin disease. This is totally wrong. What appears on the skin (redness, peeling, itching, etc.) is a consequence of internal malfunctions in the baby's body, and the baby's not formed gastrointestinal tract is only a "mediator" in the process of manifestation of diffuse neurodermatitis on the skin. The body's defenders (antibodies) can obtain information about the "pests" from the genes passed on to the child by the parents. Affects the onset and development of diffuse neurodermatitis in a child and your maternal nutrition (more precisely, the abuse of common allergens) in the last trimester of pregnancy.

Any skin reactions signal a malfunction in the child's body.

Ways of occurrence of diffuse neurodermatitis

How then is the HELL triggering mechanism activated? Look: for example, you deviated from the diet of a nursing mother and allowed yourself to eat plenty of that product that your baby's intestines are not yet capable of digesting. The product, although in smaller quantities, penetrates into milk. It turns out that the child's intestines have received substances for processing that he is not yet familiar with. The molecules of these substances are absorbed into the intestinal wall and transported to the kidneys, liver and lungs. In the liver, substances that are complex and unfamiliar to a small organism are not neutralized, the kidneys and lungs do not excrete them. It turns out that there is nowhere to go to the products of the decay of the food that you inadvertently ate, alien to the baby, and they begin to transform in the body of your child. As a result of this transformation, antigens (immunoglobulins) arise - substances alien and hostile to the body. Protective cells in the baby's body recognize them and compare them with the information recorded in the genetic code. Any antigens provoke the production of antibodies. Thus, the allergy begins. When antigens and antibodies collide and fight with each other, the results of this fight appear on the skin in the form of rashes. In children on IV, the mixture for feeding is most often the provocateur of atopic dermatitis. It contains, albeit modified, but cow's milk, the molecules of which the child's gastrointestinal tract perceives as foreign.

Bottle-fed babies are most prone to skin problems.

But allergic rashes happen not only when food molecules-irritants enter the child's body.

Atopic dermatitis in infants can be triggered by airborne allergens or allergy pathogens that come in direct contact with the baby's skin. For example, the baby breathed in dust, the body gave him a "record" that it was a foreign harmful substance, antibodies were activated, a struggle began, the result of which is visible on the skin.

Any external stimulus can cause a negative reaction.

Komarovsky says

The main symptom that distinguishes blood pressure from other diseases is itching.

The most famous now children's doctor E. A. Komarovsky warns of this. He also explains that the main factor that reduces the protective properties of the skin in a child is drying out of the skin due to high sweating and lack of moisture in the air. AD, according to Komarovsky, does not have a fundamental dependence on the food consumed by a child or a nursing mother. DN occurs as one of the possible manifestations of an allergic reaction to an irritant. "You can't outgrow an allergy, but you can do atopic dermatitis" - declares the doctor.

Visible manifestations of diffuse neurodermatitis

The most obvious symptoms and signs are:

dry skin prone to flaking;
inflamed, sometimes edematous skin;
irritation and itching of inflamed skin lesions, aggravated with the onset of night.

With the coming of the evening itchy skin can increase several times.

These signs of diffuse neurodermatitis can manifest themselves in varying degrees of intensity, depending on the amount of allergen that has entered the small body. The first reaction on the skin appears about an hour after contact with an irritating substance, but the body's response to an allergen can be slower (up to 6-7 hours).

Food allergies are considered the most common. In addition to the above symptoms, when crumbs react to a food irritant, the following can be observed:

specific rash;
painful sensations in the abdomen;

Allergen can cause severe pain in a stomach.

intestinal colic;
diarrhea;
rhinitis or asthma.

I will separately dwell on the rash: it can be insignificant or pronounced. It depends on how severe the allergy is. In an acute form, small blisters, about the size of a pinhead, filled with liquid, appear on the skin at the sites of irritation, which after a while burst on their own or when scratching, and then a painful weeping rash occurs. The skin itches hard enough. With intense scratching, the outer layer of the skin thickens and becomes denser, and lichen may appear. If your baby has such a situation, then try by all possible means not to let him scratch you, as it can increase the period of exacerbation and bring additional infection to the wounds and microcracks.

To avoid aggravation, do not let the baby scratch the sores.

There are also indirect signs of diffuse neurodermatitis:

geographic language;
conjunctivitis;
frequent ARVI with the addition of obstructive syndrome (difficulty breathing) or false croup (inflammation of the larynx);
frequent constipation or diarrhea;
uneven weight gain;

When a baby gets fat, by leaps and bounds - this is a reason to think.

dysbiosis is often expressed;
various diseases of the gallbladder, pancreas or liver.

The degree of development of the disease

The intensity of rashes and their spread across the skin fluctuate depending on the severity of blood pressure:

Easy- characterized by slight hyperemia and mild rashes, manifested in peeling of the skin and single weeping vesicles. The baby may feel a slight itching. Aggravation of blood pressure with easy form happens no more than 2 times a year. Remission lasts 6-8 months.
Medium - multiple lesions, focal. Hyperemia - severe. A wet rash is accompanied by induration of certain areas of the skin. The itching is troublesome for the child. The active phases of the disease occur up to 4 times a year. The remission stages usually do not exceed 3 months.
Heavy - these are large areas of the skin, affected by weeping rashes, on which the latter becomes dense. Oozing cracks and erosion can form in compacted areas. The itching lasts continuously and is very disturbing and frustrating for the baby. The exacerbation stages are repeated up to 5 times a year. Remission lasts no more than 1.5 months. In especially difficult cases, remission may be absent altogether.

Geography of rashes on the body

In infants, the first manifestation of diffuse neurodermatitis becomes noticeable on the cheeks. They turn red, dry and start to peel off. The redness may diminish or disappear completely when walking in the cold, but then it comes back again. Generally, every child prone to manifestations of atopic dermatitis is characterized by atopic skin - that is, the outer skin looks atypically dry and has an increased, often painful reaction to any irritation due to weakened defense mechanisms.

Dry skin is typical of atopic dermatitis.

After a short period of time, the inguinal and gluteal folds can join the cheeks. First, in places of friction of the skin, diaper rash that does not pass for a long time are formed, on which later a blistering rash can protrude and gradually spread throughout the body, especially on the neck, back and limbs. Simultaneously with the appearance of diaper rash in the folds, gneiss on the head (its scalp) may be observed. Atopic rashes in infants are often called thrush. The latter can manifest itself in a slightly different (seborrheic) form, expressed in the appearance of yellowish crusts on the head, elbow, wrist, popliteal and other flexion joints. The latter gradually spread out in volume and cover more and more areas of the body.

Crusts can appear not only on the head, but also on the elbow and leg folds.

BP and age of the child

The first signs of blood pressure in infants may appear at 2-6 months, but not earlier than 2. This is the most common age. Much less often, DN declares itself after the first year of life, in the interval from a year to one and a half or two. Boys are more likely to develop AD. When proper care after the baby, by 3-4 years of age, the manifestations of DN usually disappear. If you do not help your little one in time, then later he may acquire bronchial asthma or allergic rhinitis... Food allergies in children usually subside by early school age, but the disease can accompany a child throughout his life.

Boys suffer from AD much more often than girls.

Treatment of the disease

After reading all of the above, do not try to draw independent conclusions. The final conclusion about the disease can only be made by a doctor, based on the clinical manifestations of blood pressure, special analyzes and hereditary factors.

Treatment depends on the severity of the disease and the type of allergen identified. In severe cases, experts prescribe pills or intramuscular injectionscontaining antihistamines, corticosteroid ointment, which suppresses inflammation and itching. Sometimes treatment is done with ultraviolet rays. They help reduce inflammation in the skin.

In particularly severe cases, injections are indispensable.

Non-hormonal drugs that a doctor may prescribe:

"Gistan";
"Skin-Cap";
"Fenistil".

With a pronounced rash:

"Desitin";
Elidel;
Wundehil;
"Protopic".

Healing and eliminating dry skin:

La Cree;
"Bepanten";
Mustela Selatopia.

Hormonal:

"Advantin";
Elokom;
"Mometasone".

Some parents are afraid to use hormonal agents.

Anna, 22 years old, first baby:

“Hormones are such a fear. They were prescribed to us because the rash was terrible. I refused, and the pediatrician said that without them it would be very difficult to cope with our situation. I was indignant and went to the manager. Only she explained to me that hormonal drugs will bring my child much more usethan harm. Now we smear with "Elok", then we moisturize. Its price is about 400 rubles, but the effect is great. "

There are 2 types of diet:

Hypoallergenic diet. Everyday food completely excludes all foods that can provoke the onset of AD symptoms:

cow's milk and most of its derivatives;
chicken eggs;
meat, river and sea fish containing an increased amount of fat;
seafood;
vegetables, fruits and berries that are red or orange, juices from these fruits;

Fruits and many berries are a strong allergen.

chocolate, nuts, honey, other sweets, mushrooms;
all citrus fruits, kiwi;
most cereals;
smoked, spicy and fried foods.

With this diet, a baby up to one year old can be entered into the menu:

only low-fat kefir and cottage cheese;
buckwheat or oatmeal in vegetable or fruit broths;

Buckwheat porridge is considered hypoallergenic, it can be safely given to children.

apple (only from green fruits), pear and currant juices;
vegetable puree from cabbage, potatoes (be sure to soak it in advance), zucchini;
beef or rabbit meat (be sure to boil it 2 times);
weak tea and / or compote.

Elimination diet. From the diet of a child or mother, specific foods are removed that provoke acute stage allergic disease.

We treat blood pressure with proven grandmother's methods

Folk remedies for combating blood pressure are very diverse. Some of the recipes passed down from ancestors have good effect... Alternative treatment for blood pressure involves the use of only natural preparationsthat help relieve itching, reduce inflammation.

Night compress of raw potatoes: peel the potatoes, wash them and three on a plastic grater. Collect the resulting mass in cheesecloth and squeeze. We make compresses from squeezed potato juice and apply them overnight on the affected areas of the child's skin.

The grated potato compress relieves itching and redness.

You can treat blood pressure with lotion: take 1 tablespoon of herb "Veronica officinalis" and a glass of boiling water. Boil the herb with boiling water in a glass or enamel bowl. Cover and wrap for a couple of hours. Then strain the infusion and wash the places where the rash appears up to 6 times a day.
Bath: take 250 gr. oak bark, one and a half liters of water and oatmeal (grind oats with a mixer or blender). Place the bark in an enamel container and cover with cold water. Put the future broth on the fire and make it boil, then cover and boil for another 10 minutes. Cool the broth, strain it. Pour the prepared broth into the bathroom before bathing the child and add another one and a half glasses of oatmeal there. The baby should do this bath 2 times a week.

To relieve symptoms, oak bark baths should be taken 2 times a week.

Remedy for itching: Take dry crushed basil (2 tablespoons) and ½ liter of boiling water. Pour boiling water over the herb and let it brew for 3 hours. Strain the infusion and let the child drink it up to 4 times a day, half an hour before meals. You need to drink the broth for a month.

The broth may not like the taste of babies, but it has an excellent therapeutic effect.

Parents' comments on folk ways varied.

Veronica, 34 years old, 2 children:

“The first child did not have anything like that, but the second child suffered for a long time. The potato compress did not help - it only clogged the wounds with starch, but the basil in combination with the hormonal cream gave an excellent result! Try it, girls!

How to care for your skin during acute periods of the disease

A dermatologist or pediatrician usually talks about this, but suddenly he missed something or you forgot his recommendations. Here's a guide to what to do strictly and what to avoid if your child has ND:

Try to prevent your baby from experiencing stress - they provoke increased irritation and sensitivity of the skin.
During an exacerbation, be sure to wash (but do not wipe) the child's skin 1-2 times daily. You can add a decoction of linden or chamomile to the bath if the rash is moderate to mild. Doctors insist on using pH-neutral products containing tar or zinc. Consult your pediatrician on this matter.

Chamomile has anti-inflammatory properties.

The water should be warm, but not hot. Do not keep the child in it for a long time.
After the bath, be sure to apply a cream specially selected by the doctor on the skin. If your doctor has prescribed corticosteroids, first apply them to the damaged skin, and then use moisturizers.
Put thin mittens on your baby's hands so that he does not comb the rashes and injure the inflamed skin once again.
If possible, apply dry bandages to the rash.
Breastfeed him if possible and remember to diet.

Breast-feeding - best prevention HELL.

Humidify the air in your home.
Dress your baby only in loose clothing made from natural fabrics and do not entangle him. Avoid wool.

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Causes

In most cases, the disease is the result of an allergic reaction of the body. An allergy is a reaction to a foreign protein.

The immune system detects this element and neutralizes it by producing certain antibodies.

Another scenario may also take place: certain substances that enter the blood are combined with its proteins.

As a result, they are endowed with foreign characteristics that turn them into targets for the immune system.

In children, the cause of such diseases in most cases is associated with food, since their digestive system has an imperfect development.

In some cases, inflammation on the skin occurs after consuming an allergenic product, in others it is the result of an excess amount of food, for the digestion of which the child's body does not have the required amount of enzymes.

For the onset of the disease, according to Oleg Evgenievich, several conditions must be met:

the ingestion of harmful substances from the intestines into the blood;
excessive sweating;
skin contact with harmful substances.

Types and symptoms

Allergic

With the development of allergic dermatitis, the child constantly suffers from severe itching. As a result, his sleep and appetite may deteriorate.

At the same time, discomfort often occurs in the evenings.

Red inflamed foci appear on the skin, which are accompanied by severe dryness and peeling.

In difficult cases, cracks appear on the baby's skin.

Often, children with allergic dermatitis have a white coating on the tongue and delayed bowel movements.

If a child has rather dry skin, on which diaper rash often appears, we can talk about a tendency to dermatitis.

Parents of such a baby need to pay special attention to moisturizing the skin.

Atopic

This form of the disease is a chronic skin lesion. Its manifestations may disappear, but over time they appear again.

In this case, periods of exacerbation of the disease are replaced by remissions, in which the condition of the skin is normalized, and the symptoms completely disappear.

The manifestations of this ailment are individual in nature.

Common symptoms usually include:

dryness;
itching sensation;
hyperemia of the skin;
the appearance of rashes.

The increased dryness of the epithelium leads to the fact that cracks may appear on it.

In this case, eczema can affect various parts of the body:

in infants, the rash is usually localized on the face and in the scalp;
in primary school children, the rash affects the folds of the arms and legs;
children of middle and senior school age usually experience rashes on their feet and hands.

Seborrheic

The seborrheic form of dermatitis is based on a violation of the proper functioning of the sebaceous glands.

In children, this disease usually manifests itself in the form of crusts on the scalp.

Sometimes localization can be observed in other areas of the skin that have many sebaceous glands - between the eyebrows, behind the ears.

For children, this disease usually does not cause much concern. As a rule, it goes away on its own within a few months.

Komarovsky does not recommend treating seborrheic dermatitis.

Only in rare cases, a baby may need medical intervention in the form of prescribing special lotions or shampoos.

Video: Features of the disease

Diaper

From the name it is clear that this species is associated with diapers.

If the baby's skin is in contact with urine for a long time, which cannot evaporate, an inflammatory process occurs.

It is caused by exposure to certain substances that make up the urine, such as uric acid.

Diaper dermatitis is very common. According to various estimates, the number of cases of this disease is 30-60%.

Moreover, it is typical for young children who cannot control the work of the excretion functions.

The development of the disease is caused not only by skin contact with urine. Equally important is the simultaneous action of feces and urine.

In this case, the damaging effect increases significantly, since in this case the skin is affected by ammonia and enzymes present in the feces.

Contact

This form of the disease is a delayed-type hypersensitivity reaction that occurs upon contact with certain substances.

The frequency of this disease increases many times after the introduction of new chemicals, medicines, household chemicals.

In the acute form of the contact form, the child experiences the following stages of rash development:

erythema;
papules;
vesicles;
erosion;
crust;
peeling.

If the disease has a chronic course, it goes through the following stages in development:

papules;
peeling;
lichenization;
excoriation.

In difficult cases, contact dermatitis is accompanied by manifestations of body intoxication - headaches, weakness, fever, chills.

Komarovsky's methods of treating atopic dermatitis

To make the treatment of atopic dermatitis as effective as possible, Komarovsky offers an integrated approach.

Which includes the following components:

Reducing the absorption of harmful substances into the blood.
Reducing sweating.
Elimination of skin contact with factors that increase the likelihood of developing the disease.

To reduce the ingestion of harmful substances in the blood, you need to achieve regular bowel movements.

To do this, you can use lactulose syrup, namely, agents such as duphalac or normase.

Getting rid of constipation in a nursing mother is equally important. In this case, you can also use lactulose or glycerin suppositories.

If a child has a good weight gain, it is strictly forbidden to improve his digestion with eubiotics or enzymes.

Saliva is an active participant in digestion. To increase its effect, it is necessary to slow down the digestion process.

Small bore bottles are helpful for young children. It is also very important to walk a lot and monitor the air parameters.

If the baby is breastfed, it is recommended that you try to reduce the fat content of the milk. To do this, a nursing mother must give up fatty foods, consume low-fat dairy products and drink a lot.