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Title: ATOPIC DERMATITIS


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ATOPIC DERMATITIS
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Definition
  • Atopic dermatitis is a very common, often chronic
    (long-lasting) skin disease that affects a large
    percentage of the world's population. It is also
    called eczema, dermatitis, or atopy. Most
    commonly, it may be thought of as a type of skin
    allergy or sensitivity.

9
  • The atopic dermatitis triad includes asthma,
    allergies (hay fever), and eczema. There is a
    known hereditary component of the disease, and it
    is seen more in some families. The hallmarks of
    the disease include skin rashes and itching.

10
ATOPIC DERMATITIS
  • The skin of a patient with atopic dermatitis
    reacts abnormally and easily to irritants, food,
    and environmental allergens and becomes red,
    flaky and very itchy. It also becomes vulnerable
    to surface infections caused by bacteria. The
    skin on the flexural surfaces of the joints (for
    example inner sides of elbows and knees) are the
    most commonly affected regions in people.

11
  • The word "dermatitis" means inflammation of the
    skin. "Atopic" refers to diseases that are
    hereditary, tend to run in families, and often
    occur together. In atopic dermatitis, the skin
    becomes extremely itchy and inflamed, causing
    redness, swelling, cracking, weeping, crusting,
    and scaling. Dry skin is a very common complaint
    and an underlying cause of some of the typical
    rash symptoms.

12
  • Although atopic dermatitis can occur in any age,
    most often it affects infants and young children.
    In some instances, it may persist into adulthood
    or actually first show up later in life. A large
    number of patients tend to have a long-term
    course with various ups and downs. In most cases,
    there are periods of time when the disease is
    worse, called exacerbations or flares, which are
    followed by periods when the skin improves or
    clears up entirely, called remissions. Many
    children with atopic dermatitis enter into a
    permanent remission of the disease when they get
    older, although their skin may remain somewhat
    dry and easily irritated.

13
Triggers
  • Multiple factors can trigger or worsen atopic
    dermatitis, including dry skin, seasonal
    allergies, exposure to harsh soaps and
    detergents, new skin products or creams, and cold
    weather. Environmental factors can activate
    symptoms of atopic dermatitis at any time in the
    lives of individuals who have inherited the
    atopic disease trait.

14
  • Scientists estimate that 65 of patients develop
    symptoms in the first year of life, and 90
    develop symptoms before the age of 5. Onset after
    age 30 is less common and often occurs after
    exposure of the skin to harsh conditions. People
    who live in urban areas and in climates with low
    humidity seem to be at an increased risk for
    developing atopic dermatitis.

15
  • About 10 of all infants and young children
    experience symptoms of the disease. Roughly 60
    of these infants continue to have one or more
    symptoms of atopic dermatitis even after they
    reach adulthood.

16
  • The itchy feeling is an important factor in
    atopic dermatitis, because scratching and rubbing
    in response to itching worsen the skin
    inflammation that is characteristic of this
    disease. People with atopic dermatitis seem to be
    more sensitive to itching and feel the need to
    scratch longer in response. They develop what is
    referred to as the "itch-scratch" cycle. The
    extreme itchiness of the skin causes the person
    to scratch, which in turn worsens the itch, and
    so on.

17
  • Itching is particularly a problem during sleep,
    when conscious control of scratching decreases
    and the absence of other outside stimuli makes
    the itchiness more noticeable. Many patients also
    notice worsening of their itch in the early
    evening when they get home from work or school
    when there are less external stimuli to keep them
    occupied. When things at home sort of quiet down,
    the itching seems to become more noticeable.

18
Major and minor features of atopic dermatitis
  • Major features
  • Itching
  • Characteristic rash in locations typical of the
    disease (arm folds and behind knees)
  • Chronic or repeatedly occurring symptoms
  • Personal or family history of atopic disorders
    (eczema, hay fever, asthma)

19
Some minor features
  • Early age of onset
  • Dry, rough skin
  • High levels of immunoglobulin E (IgE), an
    antibody, in the blood
  • Ichthyosis
  • Hyper linear palms
  • Keratosis pilaris
  • Hand or foot dermatitis
  • Cheilitis (dry or irritated lips)
  • Nipple eczema
  • Susceptibility to skin infection
  • Positive allergy skin tests

20
Conditions aggravating AD
  • Many factors or conditions can intensify the
    symptoms of atopic dermatitis, including dry
    skin, winter or cold weather, wool cloths, and
    other irritating skin conditions. These factors
    may further trigger the itch-scratch cycle,
    further stimulating the many times already
    overactive immune system in the skin. Repeated
    aggravation and activation of the itch-scratch
    cycle may cause further skin damage and barrier
    breakdown. These exacerbating elements can be
    broken down into two main categories irritants
    and allergens. Emotional factors and some
    infections can also influence atopic dermatitis.

21
Management
  • Although there is no cure for atopic eczema, and
    its cause is not well understood, it can be
    treated very effectively in the short term
    through a combination of prevention (learning
    what triggers the allergic reactions) and drug
    therapy.

22
Management
  • Most patients can be successfully managed with
    proper skin care and lifestyle changes and do not
    require the more intensive treatments discussed.
    Much of the improvement comes from homework,
    including lubricating generously especially right
    after showers or baths.

23
Management
  • The doctor should have three main goals in
    treating atopic dermatitis
  • healing the skin and keeping it healthy
  • preventing flares, and
  • treating symptoms when they do occur.
  • Much of caring for the skin involves developing
    skin-care routines, identifying exacerbating
    factors, and avoiding circumstances that
    stimulate the skin's immune system and the
    itch-scratch cycle. It is important for the
    patient and family members to note any changes in
    skin condition in response to treatment and to be
    persistent in identifying the most effective
    treatment strategy.

24
Management
  • A simple and basic regimen is key. Staying with
    one recommended soap and one moisturizer is very
    important. Using multiple soaps, lotions,
    fragrances, and mixes of products may cause
    further issues and skin sensitivity.

25
  • Healing the skin and keeping it healthy are of
    primary importance both in preventing further
    damage and enhancing the patient's quality of
    life. Developing and following a daily skin care
    routine is critical to preventing recurrent
    episodes of symptoms. Key factors are proper
    bathing and the application of lubricants, such
    as creams or ointments, within three minutes of
    bathing.

26
Management
  • People with atopic dermatitis should avoid hot or
    long (more than 10 to 15 minutes) baths and
    showers. A lukewarm bath helps to cleanse and
    moisturize the skin without drying it
    excessively. Bath oils are not usually helpful.

27
Management
  • Once the bath is finished, the patient should
    air-dry the skin or pat it dry gently (avoiding
    rubbing or brisk drying) and apply a lubricant
    immediately. Lubrication restores the skin's
    moisture, increases the rate of healing, and
    establishes a barrier against further drying and
    irritation. Several kinds of lubricants can be
    used. Lotions generally are not the best choice
    because they have a high water or alcohol content
    and evaporate quickly. Creams and ointments work
    better at healing the skin. Tar preparations can
    be very helpful in healing very dry, lichenified
    areas. Whatever preparation is chosen, it should
    be as free of fragrances and chemicals as
    possible.

28
Management
  • Another key to protecting and restoring the skin
    is taking steps to avoid repeated skin
    infections. Although it may not be possible to
    avoid infections altogether, the effects of an
    infection may be minimized if they are identified
    and treated early. Patients and their families
    should learn to recognize the signs of skin
    infections, including tiny pustules (pus-filled
    bumps) on the arms and legs, appearance of oozing
    areas, or crusty yellow blisters. If symptoms of
    a skin infection develop, the doctor should be
    consulted to begin treatment as soon as possible.

29
Treating atopic dermatitis in infants and children
  • Give brief, lukewarm baths.
  • Apply lubricant immediately following the bath.
  • Keep a child's fingernails filed short.
  • Select soft cotton fabrics when choosing
    clothing.
  • Consider using antihistamines to reduce
    scratching at night.
  • Keep the child cool avoid situations where
    overheating occurs.
  • Learn to recognize skin infections and seek
    treatment promptly.
  • Attempt to distract the child with activities to
    keep him or her from scratching.

30
Controlling atopic dermatitis
  • Lubricate the skin frequently.
  • Avoid harsh soaps and cleansers.
  • Prevent scratching or rubbing whenever possible.
  • Protect skin from excessive moisture, irritants,
    and rough clothing.
  • Maintain a cool, stable temperature and
    consistent humidity levels.
  • Limit exposure to dust, cigarette smoke, pollens,
    and animal dander.
  • Recognize and limit emotional stress.

31
Prevention
  • Since there is no cure for atopic eczema,
    treatment should mainly involve discovering the
    triggers of allergic reactions and learning to
    avoid them.
  • Diet Originally controversial, the association
    of food allergy with atopic dermatitis has now
    been clearly demonstrated. Many common food
    allergens can trigger an allergic reaction such
    as milk, nuts, cheese, tomatoes, wheat, yeast,
    soy, and corn. Many of these allergens are common
    ingredients in grocery store products (especially
    corn syrup, which is a sugar substitute).

32
Prevention
  • Specialty health food stores often carry products
    that do not contain common allergens. If a child
    avoids these allergens early on, the frequency of
    reactions to these later in life is decreased
    significantly. Breastfeeding is the best way to
    avoid these problems, but if that is unavailable,
    then hydrolyzed formulas are preferred to cow's
    milk.

33
Prevention
  • Environment and Lifestyle Since dust is a very
    common allergen and irritant, adults with atopic
    eczema should likely avoid smoking, as well as
    the inhalation of dust in general. The dander
    from the fur of dogs and cats may also trigger an
    inflammatory response. It is a common
    misconception that simply removing an animal from
    a room will prevent an allergic reaction from
    occurring.

34
Prevention
  • A room must be completely free of animal dander
    in order to prevent an allergic reaction. Anger,
    stress, and lack of sleep are also factors that
    are known to aggravate eczema. Excessive heat
    (especially with humidity) and coldness are known
    to provoke outbreaks, as well as sudden and
    extreme temperature swings.

35
  • The Scratch Test An allergy skin-patch or
    "scratch" test, given by an allergist, can often
    pinpoint the triggers of allergic reactions. Once
    the causes of the allergic reactions are
    discovered, the allergens should be eliminated
    from the diet, lifestyle, and/or environment. If
    the eczema is severe, it may take some time (days
    to weeks depending on the severity) for the
    body's immune system to begin to settle down
    after the irritants are withdrawn.

36
  • The primary treatment involves prevention,
    includes avoiding or minimizing contact with (or
    intake of) known allergens. Once that has been
    established, topical treatments can be used.
    Topical treatments focus on reducing both the
    dryness and inflammation of the skin.

37
  • To combat the severe dryness associated with
    eczema, a high-quality, dermatologist approved
    moisturizer should be used daily. Moisturizers
    should not have any ingredients that may further
    aggravate the condition. Moisturizers are
    especially effective if applied within 510
    minutes after bathing. A doctor might also
    prescribe lotion containing sodium hyaluronate to
    improve skin dryness

38
  • Most commercial soaps wash away all the oils
    produced by the skin that normally serve to
    prevent drying. Using a soap substitute such as
    aqueous cream helps keep the skin moisturized. A
    non-soap cleanser can be purchased usually at a
    local drug store. Showers should be kept short
    and at a lukewarm/moderate temperature.

39
  • If moisturizers on their own don't help and the
    eczema is severe, a doctor may prescribe topical
    corticosteroid ointments, creams, or injections.
    Corticosteroids have traditionally been
    considered the most effective method of treating
    severe eczema.

40
  • Disadvantages of using steroid creams include
    stretch marks and thinning of the skin.
    Higher-potency steroid creams must not be used on
    the face or other areas where the skin is
    naturally thin usually a lower-potency steroid
    is prescribed for sensitive areas. If the eczema
    is especially severe, a doctor may prescribe
    prednisone or administer a shot of cortisone or
    triamcinolone If complications include infections
    (often of Staphylococcus aureus), antibiotics may
    be employed.

41
  • A more novel form of treatment involves exposure
    to broad or narrow-band ultraviolet light. UV
    radiation exposure has been found to have a
    localized immunomodulatory effect on affected
    tissues, and may be used to decrease the severity
    and frequency of flares. The usage of UVA1 is
    more effective in treating acute flares, whereas
    narrow-band UVB is more effective in long-term
    management scenarios.However, UV radiation has
    also been implicated in various types of skin
    cancer,and thus UV treatment is not without risk.

42
Lifestyle and home remedies
  • To help reduce itching and soothe inflamed skin,
    try these self-care measures
  • Try to identify and avoid triggers that worsen
    the inflammation. Rapid changes of temperature,
    sweating and stress can worsen the condition.
    Avoid direct contact with wool products, such as
    rugs, bedding and clothes, as well as harsh soaps
    and detergents.

43
Lifestyle and home remedies
  • Apply an anti-itch cream or calamine lotion to
    the affected area. A nonprescription
    hydrocortisone cream, containing at least 1
    percent hydrocortisone, can temporarily relieve
    the itch. A nonprescription oral antihistamine,
    such as diphenhydramine (Benadryl, others), may
    be helpful if itching is severe.
  • Avoid scratching whenever possible. Cover the
    itchy area if you can't keep from scratching it.
    Trim nails and wear gloves at night.

44
Lifestyle and home remedies
  • Apply cool, wet compresses. Covering the affected
    area with bandages and dressings can help protect
    the skin and prevent scratching.
  • Take a warm bath. Sprinkle the bath water with
    baking soda, uncooked oatmeal or colloidal
    oatmeal a finely ground oatmeal that is made
    for the bathtub (Aveeno, others). Or, add 1/2 cup
    (118 milliliters) of bleach to a 40 gallon (151
    liter) bathtub filled with warm water. The
    diluted bleach bath is thought to kill bacteria
    that grow on the skin.

45
Lifestyle and home remedies
  • Choose mild soaps without dyes or perfumes. Be
    sure to rinse the soap completely off your body.
  • Moisturize your skin. Use an oil or cream to seal
    in moisture while your skin is still damp from a
    bath or shower. Pay special attention to your
    legs, arms, back and the sides of your body. If
    your skin is already dry, consider using a
    lubricating cream.
  • Wear cool, smooth-textured cotton clothing. Avoid
    clothing that's rough, tight, scratchy or made
    from wool. This will help you avoid irritation.
    Also, wear appropriate clothing in hot weather or
    during exercise to prevent excessive sweating.

46
Factors that worsen atopic dermatitis
  • Long, hot baths or showersDry
    skinStressSweatingRapid changes in
    temperatureLow humiditySolvents, cleaners,
    soaps or detergentsWool or man-made fabrics or
    clothingDust or sand

47
Atopic Dermatitis At A Glance
  • Atopic dermatitis is a type of eczema.
  • The skin sensitivity of this disease may be
    inherited and genetically determined.
  • The patient's skin may be "super sensitive" to
    many irritants.
  • Dry scaly patches develop in a characteristic
    distribution.
  • Itching varies but may be intense and scratching
    hard to resist.
  • Scratching can cause skin thickening and
    darkening and lead to further complications,
    including bacterial infection.

48
Atopic Dermatitis At A Glance
  • Extremely dry skin can break down and ooze or
    weep.
  • If the itch can be controlled, the rash (which is
    aggravated by vigorous scratching) may be more
    readily contained.
  • Treatment of atopic dermatitis is centered around
    rehydrating the skin with rich moisturizers like
    Vaseline and cautious use of topical steroids to
    reduce inflammation and itching.
  • Oral antihistamines are often necessary to break
    the "itch-scratch" cycle.
  • Since secondary infections can aggravate the
    rash, topical or oral antibiotics may also be
    occasionally indicated.

49
  • Researchers have discovered a very effective and
    low-tech means of managing eczema.  Its called
    household bleach. The bleach study, published
    in the journal Pediatrics, found that giving
    diluted bleach baths to children with moderate or
    severe eczema (atopic dermatitis) reduced signs
    of infection and reduced the severity and extent
    of the eczema on their bodies.
  • Dr. Amy Paller and researchers treated 31
    patients (6 months to 17 years old) who had
    eczema and a bacterial staph infection for 14
    days with oral antibiotics. Half of the patients
    received bleach in their bath water (half a cup
    per full standard tub), while the other half
    received a look-alike placebo. All were
    instructed to bathe in the bleach twice a week,
    and soak for five to 10 minutes for three
    months.

50
  • The research team saw such rapid improvement in
    the kids taking the real bleach baths that they
    terminated the study early because they wanted
    the children getting the placebo to get the same
    relief. "The eczema kept getting better and
    better with the bleach baths and these baths
    prevented it from flaring again," Paller said.
    "We presume the bleach has antibacterial
    properties and decreased the number of bacteria
    on the skin, which is one of the drivers of
    flares."

51
Myths and Facts
  • Myth Keep Bathing to a Minimum It is a common
    misconception that bathing dries the skin and
    should be kept to a bare minimum.What
    dermatologists recommend People with atopic
    dermatitis tend to have excessively dry skin. To
    hydrate the skin, take a short, daily bath(s) in
    warm not hot water. A mild, non-irritating
    soap should be used only when needed. The
    facts Daily bathing as recommended by a
    dermatologist helps to hydrate the skin, which
    can reduce flare-ups and relieve discomfort when
    moisturizers also are used as directed.For
    severe atopic dermatitis, a dermatologist may
    recommend up to 3 short baths a day. Even
    patients who avoid water because getting wet can
    be painful tend to get relief after some initial
    discomfort.

52
  • Myth Moisturizers Add Moisture to the SkinThe
    word moisturizer causes a great deal of
    confusion. People often think that a moisturizer
    adds moisture to the skin and can be applied any
    time.What dermatologists recommend Apply
    moisturizer within 3 minutes of bathing. This
    will trap moisture in the skin. Continue to apply
    moisturizer throughout the day to very dry
    areas.The facts A moisturizer cannot add
    moisture to the skin. Moisturizer seals in the
    water from the bath, preventing water from
    evaporating. This is why moisturizer is most
    effective when applied within 3 minutes of
    bathing.

53
  • To apply a moisturizer after bathing
  • Gently pat the skin partially dry.
  • Apply medication directly on the lesions.
  • Apply moisturizer on top of the medication and to
    the rest of the skin. For best results,
    dermatologists recommend using a thick, oily
    moisturizer and applying it in the same way that
    you would apply icing to a cake.
  • Applying moisturizer within 3 minutes of bathing
    and frequently throughout the day will help the
    skin to retain moisture from bathing. This, in
    turn, helps prevent dryness and cracking, which
    is especially important when the air is dry. With
    regular use, moisturizer can help to reduce
    discomfort and flare-ups as well as decrease the
    need for medication.

54
  • Myth Identify and Avoid Allergens to Prevent
    Flare-upsDermatologists often hear their
    patients and caregivers say that if only a
    patients allergies could be identified, then the
    patient could avoid these and prevent atopic
    dermatitis flares.What dermatologists
    recommend No one thing not even allergen
    (substance to which the patient is allergic)
    avoidance can control atopic dermatitis.
    Successfully managing this complex condition
    requires a multi-faceted approach. Proper skin
    care, using medication as directed, and avoiding
    ones personal triggers all play a role. A
    trigger is anything that irritates the skin. A
    trigger need not be an allergen. The facts
    Laundry detergents, soaps, smoke, skin care
    products that contain alcohol or fragrance, and
    rough-textured clothing such as wool are common
    triggers that cause atopic dermatitis to flare.
    Triggers vary from person to person though, so it
    is important to learn what irritates the skin and
    avoid contact with individual triggers.

55
Preventing Flare-Ups
  • Lifestyle modifications are the first line of
    defense in controlling eczema, regardless of
    whether the eczema is mild, moderate, or severe.
    Recommended by dermatologists, the following
    guidelines can help reduce the severity and
    frequency of flare-ups, which also may decrease
    the need for anti-inflammatory medicine.
    Continuing to follow these guidelines once the
    signs and symptoms clear can help prevent further
    outbreaks

56
Preventing Flare-Ups
  • 1. Moisturize, moisturize, moisturize. Eczema is
    usually dry and itchy, so applying moisturizers
    as needed to keep the skin moist is part of an
    effective treatment plan. Frequent moisturizing
    locks in the skins own moisture to prevent
    dryness and cracking.
  • One of the best ways to lock in moisture is to
    apply moisturizer after bathing. When bathing,
    care must be taken to avoid irritating the skin.
    For tips on how to bathe and moisturize to help
    alleviate eczema,

57
Preventing Flare-Ups
  • 2. Limit contact with anything that irritates the
    skin. Soaps, bubble bath, perfumes, cosmetics,
    laundry detergents, household cleaners, too much
    time spent in water, finger paints, gasoline,
    turpentine, wool, a pets fur, juices from meats
    and fruits, plants, jewelry, and even lotions can
    irritate sensitive skin. Know what irritates your
    skin and limit contact with all that does.
    Avoiding personal-care products that contain
    alcohol and not washing hands too frequently also
    will help reduce irritation.  3. Avoid sweating
    and overheating. The most common triggers of the
    scratch/itch cycle are sweating and overheating.
    It is essential to prevent these situations
    whenever possible.

58
Preventing Flare-Ups
  • 4. Avoid sudden changes in temperature and
    humidity. A sudden rise in temperature can cause
    overheating and sweating. A drop in humidity can
    dry skin and lead to a flare-up. 5. Grab a cold
    compress to curb the itch. Scratching makes the
    condition worse and may puncture skin allowing
    bacteria to enter and cause an infection. Gently
    applying a cold compress to the area that itches
    can reduce inflammation and lessen the desire to
    scratch. 6. Keep fingernails short. Short nails
    decrease the likelihood that scratching will
    puncture the skin. Keeping nails short and
    wearing cotton gloves at night may help prevent
    scratching that punctures the skin while asleep.

59
Preventing Flare-Ups
  • 7. Dress in loose-fitting cotton clothes.
    Synthetic fabrics, wool, and other materials that
    feel rough to the touch often irritate the skin
    and trigger a flare-up. Cotton and cotton-blend
    clothes usually make skin feel better.8. Double
    rinse clothes, and wash new clothes before
    wearing. Laundry detergents can trigger
    flare-ups. Using a fragrance-free, neutral pH
    detergent and double rinsing clothes can help
    prevent flare-ups caused by laundry detergent. It
    also may be helpful to wash new clothes before
    they are worn as washing removes excess dyes and
    fabric finishers, which can irritate the skin.
    Tags should be removed, too, as these can rub the
    skin, causing irritation.

60
Preventing Flare-Ups
  • 9. Reduce stress. Stress reduction plays a key
    role in preventing eczema flares. In todays
    fast-paced world, reducing stress can be
    challenging however, there are ways to
    effectively reduce stress.
  • 10. Follow a prescribed treatment regimen.
    Moisturizing and using medications as directed by
    a dermatologist go a long way toward keeping
    flare-ups at bay.

61
Stress Reduction Techniques
  • Reducing stress makes controlling eczema much
    easier. In fact, studies show that keeping calm
    and having a positive outlook may be the best
    ways to keep eczema under control. However, in
    todays fast-paced world, managing stress can be
    a challenge even for children. Here are some
    time-tested techniques that can help effectively
    manage the stress of everyday life
  • Maintain your treatment regimen. When life
    becomes especially hectic, it is important to
    comply with your treatment regimen to help avoid
    a flare-up. 
  • Dont skimp on sleep. Adequate sleep reduces
    stress and gives skin time to rejuvenate.  
  • Pace yourself.  
  • Think calm. Take a minute or two to think calming
    thoughts when under stress.  

62
Stress Reduction Techniques
  • Free your mind with a relaxation technique. Deep
    breathing, progressive relaxation, visualization,
    yoga, meditation, or listening to a relaxation CD
    can help.  
  • Write away your worries. Research shows that
    taking 15 minutes each day to write down your
    concerns is an effective stress management
    technique. Ripping up the paper after you finish
    writing also helps relieve stress.  
  • Participate in a hobby. Doing something you enjoy
    can enhance your mental, emotional, and physical
    well-being.  
  • Get a pet. Pets reduce stress for many.  
  • Make time for yourself everyday. Create a list of
    things you enjoy. Maybe a walk, catching a
    favorite TV show, or curling up with a book are
    on your list. Find time everyday to do something
    you enjoy.  
  • Join a support group. Some find comfort and a
    feeling of well being when they talk with others
    who have eczema.

63
Around the Home
  • Indoor allergens and irritants can trigger the
    signs and symptoms of atopic dermatitis, a type
    of eczema that occurs when there is a genetic
    predisposition to atopic conditions, such as
    asthma and hay fever. Taking some precautions
    around the home can help prevent flare-ups
  • 1. Control Dust Mites. Some studies suggest that
    reducing dust mites can reduce symptoms other
    studies show no effect. For the most part, only
    children have shown improvement when dust mites
    were controlled. This is what can be done to
    control dust mites in a childs room
  • Eliminate carpeting, rugs and blinds.
  • Limit upholstered furniture. The only upholstered
    item in the bedroom should be the bed.
  • Cover box spring and mattress in plastic zippered
    covers and wipe off covers weekly.
  • Keep furnishings to a minimum. Only items made of
    wood, rubber, metal, or plastic should be used.
    That goes for toys, too.

64
Around the Home
  • Use a pillow and mattress pad made of Dacron.
  • Clean the room thoroughly each week. This should
    include wiping the floor, furniture, tops of
    doors, window frames, and sills with a damp cloth
    or oil mop.
  • Wash all bed clothes and curtains at least once a
    week in water that is 130 F or hotter.
  • Air the room thoroughly after cleaning.
  • Keep all animals with fur or feathers out.

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Around the Home
  • 2. Keep homes humidity level between 45 and
    55. Dehumidifiers and humidifiers can keep
    humidity levels between 45 and 55. Use a
    hygrometer, a device that measures humidity, to
    monitor the amount of moisture in the air.
    Hygrometers are available in places where
    thermometers are sold, such as a local hardware
    store. 3. Avoid contact with pets that have fur
    or feathers. When fur and feathers come into
    contact with skin, they can cause a flare-up. Pet
    dander is another common trigger. Be sure to keep
    pets with fur or feathers out of the bedroom.4.
    Avoid contact with harsh dish-washing products
    and household cleaners.  Look for natural
    alternatives to bleaches and other cleaners that
    contain harsh chemicals.  If you must use such
    cleansers, wear protective gloves.  Wearing
    cotton gloves under rubber gloves can help
    prevent a flare-up if you have an allergy to
    latex.5. Cover up in the yard. If plants or
    other things in the yard trigger a flare-up,
    wearing gloves and long pants and sleeves may
    help prevent a flare-up.

66
Homeopathic treatment
  • Duration of treatmentThe total length of
    treatment varies form case to case, depending of
    the following factorsDuration of Atopic
    DermatitisAreas affectedExtent of
    spreadPrevious medication (Extensive use of
    oral or local cortisone)One may expect a
    definite change in about three to five months,
    depending on the extent. The total length of
    medication may be anything between six months to
    two years or longer.

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  • Mothers History during pregnancy
  • The babys constitution
  • Activity status
  • Thermal status of the baby
  • Sleep position of the baby
  • Fears of the baby- approaching people, downward
    motion

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Common remedies coming up
  • Belladonna
  • Calc carb
  • Stramonium
  • Sulphur
  • Chamomilla
  • Rheum
  • Calc Phos
  • Tub
  • Cup met

69
Common constitutional symptoms of babies
  • Desire to be carried
  • Biting
  • Spitting
  • Pulling hair
  • Restlessness
  • Violent
  • Fear of dark
  • Clinging
  • Aversion to be touched or looked at
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