ATOPIC DERMATITIS is a chronic inflammatory skin disease that itches, cracks, crusts or rashes, and becomes hypersensitive to irritants. In most cases, it occurs in children under seven years of age. In about half of those who experienced atopic dermatitis in childhood, symptoms will continue into adulthood – but in a less severe form. Often, atopic dermatitis is paired with bronchial asthma, allergic rhinitis, or food allergies.
No one really knows why atopic dermatitis, some people have, and at the other is not. So far, we can say that the development of this disease is influenced by a family history and a mutation in the FLG gene , which is responsible for the barrier function of the skin. If one of the parents had atopic dermatitis, the child’s risk of getting the same thing is two to three times higher . If he was with both parents – that in three to five times. By atopic dermatitis can not be cured, but it can improve the status and control symptoms. Journalist and entrepreneur Kristina Farberova told us about life with such a feature.
I am five years old, in Novosibirsk, winter, we are with the father go on fresh snow at UAZ in the military hospital. There, a doctor in a starched cap will use forceps to remove the bandages from my hand. Everything looks very bad. The toes are burgundy, swollen and wet. The gauze comes off with the skin. Palm in Cork. On the bends of the elbows – a red rash and cracks, because of which it is painful to bend and unbend them. My father yells at me to stop itching.
At home, my mom takes the bandages off me. I will forever remember the color of potassium permanganate, which she diluted in a three-liter glass jar to wipe me during dressings – purple-crimson. And I also remember furacilin. Yellow like that. My father makes sure that I cut my nails short and teaches me how to scratch with my fingertips.
The main scourge of people with atopic dermatitis is itching. You itch. No, not like that. You are tearing yourself apart. Itching is pain and sweetness at the same time. Some kind of fierce thrill and hellish torment. Rip the thighs to blood, leave abrasions on the ankles and swollen furrows on the shoulders or armpits. Itching eats away at the body from the inside. I toss and turn, and with difficulty falling asleep – every pellet on the sheet my enemy. I can’t take a shower properly, I am tormented in woolen sweaters and spiky tights.
What is eczema
At first, parents think that itching, rashes and open sores are an allergic reaction to sweets , because I quietly carry Blizzard chocolates from the top cabinet in the kitchen. Contrary to popular misconception, food cannot cause atopic dermatitis from scratch – there is only evidence that pre-existing food allergies can exacerbate symptoms .
I am sent to an allergist – he does a patch test and notes reactions to book dust, nicotine, starch and pets. New introductions change the way of life of our family: the father is trying to quit smoking, the potatoes are leaving the menu, and the cat Partos is sent from home to work to catch mice. At least that’s what the parents said.
The doctor also said that I have eczema – a chronic inflammatory skin disease. Finally someone gave it a definition! A little explanation: atopic dermatitis and eczema are interchangeable terms . When used alone, the term “eczema” usually refers to atopic dermatitis (atopic eczema). “Eczematous” means scaling, crusting, or oozing. The term dermatitis is used by doctors to describe a variety of skin conditions (eg, seborrheic dermatitis, contact dermatitis, or allergic dermatitis).
What does mutation have to do with it
The outer layer of human skin – the epidermis – is the first line of defense between the body and the environment. He did not give allergens and germs to penetrate into our body, it prevents the loss of moisture from the skin. In people with atopic dermatitis, the barrier function of the skin is genetically impaired . Anna Bruckner, MD, Fellow of the American Academy of Pediatrics, explains that this is due to a damaged FLG gene . This gene is responsible for instructions for the “assembly” of the protein profilaggrin, which is contained in the cells of the stratum corneum of human skin. When broken down, profilaggrin produces several copies of the protein filaggrin, which is responsible for maintaining the skin’s barrier function. In addition, filaggrin is involved in the creation of molecules of the skin’s natural moisturizing factor. With filaggrin mutations, the barrier functions of the skin are disrupted: it does not retain moisture well, becomes dry, flaky, and the risk of allergic reactions increases. Meta- analyzes confirm the association of phyllagrin mutations with atopic dermatitis.
It is a pity that in 1998 my family did not know about this . Instead, at eight I was taken to the healers, and at thirteen – to the salt lakes. My grandmother turned out to be a witch doctor on the outskirts of Novosibirsk. She sat me down on a stool, sprinkled me with water and whispered something, and then gave me candy – for patience. But on the lakes it was not bad. I went into the water, the salt corroded the wounds, and they ached – just like in Dobrynin’s song. But at least it helped.
How is it treated
In the early 2000s, my parents divorced, and this is probably one of the reasons the eczema started all over again. Stress and emotional distress due to a sudden turn of habitual life in the wrong place sharpen my skin every day. I have several lesions that are not healing well. One of them is in the palm of his right hand, the size of a five-ruble coin. The wound itches all the time, gets wet and crusts. Since the right hand is a running hand, it makes life difficult. At school you write with a pen, in physical education you do exercises on the wall bars or play volleyball with both hands. And also socialization. At some point, classmates and their parents notice this , asking what is wrong with you , is it contagious . Can you touch common utensils at a tea party in the classroom or take someone’s pencils to the picture. Eczema is not contagious. You can not “pick up” it from someone else. People inherit eczema due to a combination of factors, and it can be activated due to external triggers: food allergies, stress, environmental factors.
Mom took me to a dermatologist, and he prescribed an ointment. At first, doctors usually recommend drugs, which is composed of corticosteroids. They relieve swelling, soothe itching and heal wounds. The next step is topical calcineurin inhibitors (tacrolimus, pimecrolimus), which are used when corticosteroids do not help. Pharmacological agents are usually used for severe forms of atopic dermatitis, when large areas of the skin are affected and this causes severe discomfort.
Together with the ointment, I received a few instructions from the doctor on the non-pharmacological control of eczema. Use moisturizers with emollients to restore the skin’s barrier function. This can help, and sometimes even eliminate the need for medication. CeraVe, La Roche-Posay, Avène, Eucerin – some of these brands will do; the latter has a lot of products with important components in the composition – for example, cortisone for itching, antimicrobial decandiol, petroleum jelly, which is ideal for atopics, because it has a high occlusion and does not cause allergies. Many helpful guidelines, by the way, can be found on the website of the National Eczema Association . They make lists of cosmetic products approved for atopic, explain what ingredients in looking after cosmetics should be avoided , and are taught to impose water dressings .
I really love to lie in the bath, but I have to step on the throat of this song and follow the recommendations regarding water treatments. Bathing is generally indicated for people with atopic dermatitis, but it is important to monitor the temperature of the water: it should not be hot. In an ideal – warm water. As a means for cleaning is to use products containing no soap with neutral or low pH. It is better if they are labeled “hypoallergenic” and do not contain fragrances or dyes. The American Association of Dermatologists also recommends adding a small amount of bleach (called bleachbaths) to your bath to relieve itching and other symptoms of atopic dermatitis. But I ‘ve never tried.
What happened next
Several years of lull – until the age of twenty-eight nothing happens. Is that slight peeling on the fingers and ankles, which, if I don’t forget, I smear with corticosteroid ointment . Until one day, during a dinner at an Indian restaurant on me again attacked itching. I locked myself in the closet and began to itch somewhere between the mops and boxes of cleaning products. It was incredibly satisfying. At such moments, you think that in some ways it is similar to an orgasm – so it lets go when the attack passes. The skin instantly becomes furrowed, reddens and burns. I lean my shoulder against the cold tiles, my T-shirt up. It’s cold, good. I slap in the pockets of my tight jeans – one of them has an antihistamine. Many studies show that histamine is the main itch- causing agent . Therefore, antihistamines are prescribed for atopics. I pick out the pill from the blister, wash it down with tap water , exhale and wait. It’s over now.
Do you know which phrase I hate the most? “Chris, don’t itch.” At first I even wanted to name my Telegram channel in honor of this – “Scale from here”. I try to adhere to the rules of decency, moisturize my skin and relieve itching, follow the foolish advice “be less nervous”, and lead a cautious lifestyle. I carry pills and ointment with me , I passed the food panel for 300 allergens and now I don’t drink red wine, I don’t eat eggs, oranges, peanut butter and a dozen other things that can cause a reaction.
Sometimes I conduct a dialogue “to myself” – about how the perception of my body has changed in atopy. As a child, I felt plague and stigmatized, causing a lot of trouble and anxiety for my parents, and today I feel almost the chosen one and even think: “Hmm, a gene mutation – that sounds a little proud.” As if the dermatitis is not a problem and not a disease but a trait of which will not escape it. The kind of grumpiness. Only you are not grumpy , but your body.