Moisturizing ointment for atopic dermatitis

Allergic diseases are a widespread pathology of childhood. Today, great strides have been made in the treatment of various allergic diseases, but the number of children, especially young children, with skin manifestations of allergies is growing rapidly. Allergic dermatitis is a fairly common skin lesion in children at an early age. It affects approximately 20% of children worldwide. Cream and ointment for skin allergies for children are now sold everywhere in pharmacies.

Allergic (atopic) dermatitis - what is it?

It is an allergic inflammation of the skin, which occurs when exposed to numerous factors and is manifested by itching, irritation and rashes in different areas of the skin. Allergic dermatitis in many cases occurs in children whose parents suffer from allergies.

In children, skin manifestations of allergies vary and depend on age, the form of atopic dermatitis and the severity of the disease. These differences determine which ointments and allergy creams for children will be used in treatment.

Forms of atopic dermatitis

1. Infant form. The first skin rashes often appear in the first 2 - 3 months of life in the form of exudative diathesis. Appearing first on the face, the rash quickly spreads to the arms, legs and buttocks. In the affected areas of the skin, redness, swelling, a spotty-blistering rash, weeping, and then crusts occur. All these are manifestations of acute inflammation. When the inflammation subsides, the patchy rash becomes dry and peeling appears. The infantile form appears before the age of three.
2. Children's uniform. These are children aged from 3 to 12 years. Mostly the skin folds of the elbows, popliteal, behind the ears, inguinal, as well as the outer side of the hands and fingers, neck, and ankles are affected. Characterized by redness, swelling of the skin, thickening and increased pattern on the skin. The skin has a dull gray tint and pityriasis-like peeling.
3. Teenage form. It manifests itself in children from the age of thirteen as a pronounced thickening. The skin is dry and flaky; the face and upper body are most affected. Characterized by a continuous course with periods of exacerbations.

Based on the nature of the skin rashes, they are divided into:

1. acute phase (skin redness, spots, blisters, erosions and peeling);
2. chronic phase (thickening of the skin, flaky patches with scratching on the skin).

The severity of the disease is divided into: mild, moderate and severe.

Stages of development of atopic dermatitis

1. Initial stage. It can develop in children prone to allergies and is manifested by a milky scab (limited redness of the skin with yellowish crusts), redness on the cheeks and swelling, and slight peeling.
2. Stage of pronounced skin changes. Skin changes depend on the phase of allergic dermatitis.
3. Remission stage. Disappearance of all manifestations on the skin. This stage can last from several days, months and many years, or may not occur at all.
4. Clinical recovery. No manifestations of the disease for 3 years or more.

Causes and factors in the formation of atopic dermatitis

1. Food allergens are products with increased allergic activity. These are cow's milk, chicken eggs, fish, seafood, cereals, citrus fruits, chocolate. Intolerance to cow's milk in newborns and children under one year of age occurs in 70 - 90% of cases.
2. Aeroallergens (contained in the air) of residential premises - house dust mites, fungi (molds, yeasts), wool and excreta products of animals and insects.
3. Chemical factors - various detergents, cosmetics, creams, powders.
4. Physical factors - trauma to the skin during combing, sweating and wearing clothes made of synthetic fabric.
5. Psychosocial factors - tense environment at school, difficulties in the family, stress.
6. Environmentally unfavorable factors.

The main factor for the occurrence of atopic dermatitis is considered to be a violation of the barrier function of the skin. This is expressed by severe dryness of the skin. Microcracks that appear on dry skin are entry points for germs, irritants and allergens.

Treatment of atopic dermatitis

Skin itching and inflammation, sleep disturbances interfere with the child so much and reduce the quality of life that they become a difficult ordeal for the baby and for all family members.

The main goal of treating atopic dermatitis is to achieve remission of the disease by influencing the child’s body with agents that eliminate and reduce inflammation and itching of the skin, thereby improving the quality of life.

Main directions in the treatment of dermatitis:

1. Removing allergens from the child’s environment.
2. General drug treatment: 2nd generation antihistamines (loratadine, cetirizine); enterosorbents for the purpose of removing allergens from the stomach and intestines. An effective drug that can be prescribed to children is Enterosgel.
3. External therapy. This is a treatment for skin manifestations.

Treatment of skin manifestations of allergies

An individual approach is used, taking into account the patient’s age, changes in the skin and drug tolerance.

Before treatment, it is necessary to clean the affected areas of the skin from crusts, scales and remnants of medications that were used before. To avoid these manifestations, it is cleaned by pre-treating it with lotion or oil. Softened crusts and scales are carefully removed with tweezers. The more acute the process, the more careful and gentle the external skin treatment should be.

First, it is recommended to use surface-acting agents (lotions, shaken mixtures), then moving on to agents that have a deeper effect (pastes, ointments, oils, creams).

1. Powder. This is a mixture of powdery substances. It is used when the activity of the process is minimal, when there are lesions with slight inflammation and itching. Not for use on wet surfaces.
2. Lotions. These are medicinal solutions with low concentrations. Used in the acute phase of the disease with weeping areas. They have a drying and anti-inflammatory effect. Not for use in children under 6 months.
3. Aerosols with anti-inflammatory and antiallergic properties. Skin-cap, Polysol, Neogelasol have antimicrobial and disinfecting effects. Aerosols with a healing effect are Olazol, Libyan.
4. Pastas. It is a mixture of powders and fatty substances. It acts deeper than an aerosol, but more superficially than an ointment. Has a drying, cooling and anti-inflammatory effect (zinc paste). Important. Do not apply to wet surfaces.
5. For a deeper effect, gel, creams and ointments are used. Gels have a dual effect - they dry out areas of weeping and moisturize dry areas of the skin. Antipruritic gels are Soventol and Fenistil. Solcoseryl and Actovegin gel have a resolving and healing effect.
6. Cream. These are fatty substances mixed with water. It has cleansing, anti-inflammatory, softening, and moisturizing effects (Skin-cap, Atopic).
7. Skin allergy ointment for children is prescribed for chronic illness.

It has a deep and long-lasting effect on the affected skin, softening and moisturizing it. Do not use on hot, wet surfaces.

For quality treatment, it is necessary to evaluate skin manifestations, the activity of the process and select the correct dosage form.

1. If there are wet areas, treatment is carried out only with lotions and aerosols.
2. In the absence of weeping areas on the skin, hormonal and non-steroidal anti-inflammatory external drugs in the form of paste, cream or ointment are prescribed to relieve inflammation and itching.
3. Hormonal external medications are prescribed only for severe dermatitis or severe exacerbation, if there is no effect from other medications. The course of treatment is 3 - 5 days.
4. To reduce inflammation, in mild to moderate cases, especially for children under one year of age, use anti-inflammatory non-hormonal agents (Elidel cream, Protopic ointment). They can be used from three months. There are no side effects from them with long-term use; they are applied to all areas of the skin without restrictions.

Ointments and creams are prescribed that eliminate itching and dry skin, exfoliate and improve metabolic processes in the skin (Iricar, Desitin).

Modern anti-allergy medications for children are highly effective, safe for long-term treatment, non-addictive, available in a variety of dosage forms (aerosols, powders, creams, ointments, oils) and act locally without affecting the baby’s body as a whole.

In the treatment of allergic manifestations on the skin today, children's medicinal cosmetics are widely used: Atoderm cream, Sicalfat, Atopic. This cosmetics is recommended for use from birth. It has a disinfecting and anti-inflammatory effect and is good at healing, soothing and moisturizing damaged skin.

Skin care for a child with atopic dermatitis

Atopic skin requires daily and proper care. Parents often make the mistake of stopping caring for their baby’s skin after the exacerbation subsides. It is important to remember that the protective function of the skin is impaired both during an exacerbation and at the time of remission.

When restoring the skin, it is necessary to constantly use special products at the time of remission and exacerbation. To moisturize, soften, and cleanse the skin, such products (creams, balms, bathing gels) are developed taking into account the characteristics of atopic skin. Constant and competent skin care helps to achieve a mild course, prolong remission and reduce exacerbations.

Rules for caring for atopic skin.

1. Cleanse and moisturize. The child's skin should be kept clean from head to toe. Daily bathing moisturizes dry, atopic skin, clearing it of impurities, germs and allergens. Daily warm baths with a temperature of 27 - 30 degrees are taken for 5 minutes. After bathing, gently dry your baby's skin with a towel and apply nourishing products with moisturizing ingredients (emollients) to the moistened skin for 3 minutes, paying special attention to areas with irritation and increased dryness.
2. Moisturizing and softening. To eliminate dryness, you need to use emollient often and in large quantities. This is a moisturizing and emollient allergy cream that can be used for infants and older children. A child’s needs for emollients are individual; they are used as many times as necessary without leaving the skin dry for even a minute. It is recommended to apply creams repeatedly, up to 10 times a day, to the entire body. When improvement occurs, the frequency of use is reduced to 2 - 3 times a day.
3. Soothing care. Severe skin itching is one of the main signs. It provokes the child to scratch the irritated areas, which leads to trauma and an even greater decrease in the protective properties of the skin. Itching at night significantly worsens the child’s sleep and well-being. Soothing agents should be applied to irritated skin (with the exception of wet areas). Their use helps eliminate itching, relieve irritation, and ensure a restful sleep for the child.

Conclusion

Strictly follow all recommendations given by your doctor. This will prevent the disease from becoming chronic, eliminate skin symptoms as much as possible and improve your well-being.

It is recommended for adults and children to use a moisturizer for atopic dermatitis. There are medicinal products that are suitable for complex treatment of the disease: they eliminate inflammation, relieve dryness and stimulate the restoration of damaged tissues.

Several effective drugs for adults

Non-hormonal creams are widely used and are sold mainly in pharmacies:

1. "Bepanten." Recommended for the treatment of dermatitis in children and adults. A moisturizer is good for atopic dermatitis in infants, as it does not cause side effects and does not smell. The composition includes dexpanthenol, which accelerates the process of skin cell restoration. Helps get rid of dryness, cracks and diaper rash.
2. "Zinocap." The product contains zinc, which best copes with itching, flaking and inflammatory processes. Suitable for therapy for children from 1 year of age and adults. Used in courses during the acute stage, but not longer than 30 days in a row.
3. «Sudocrem." A good moisturizer for atopic dermatitis, often used by adults.
4. "La-Cree." A moisturizing product consisting only of natural ingredients. Used to heal inflamed epidermis. Often used in combination with antihistamines.

For very young patients suffering from atopic dermatitis, the use of other moisturizing creams is recommended.

Skin moisturizers for children

The effect of moisturizing children's creams for atopic dermatitis is softer and safer. Any aggressive components and substances that can increase allergies are excluded:

1. Topicrem. The product consists of several moisturizing components. Used to soften rough areas without forming an unpleasant greasy film. Use on damaged areas 3-4 times a day. Suitable for treating children aged 2-3 months (as prescribed by a doctor) and older.
2. Lipikar Baume AP+. The preparations in the series are created specifically for moisturizing the skin of children with atopic dermatitis. Suitable for the treatment of complicated disease. They relieve inflammation well and get rid of infectious processes. After use, the baby’s skin becomes more tender and retains moisture better. The first effect is visible already on 3-4 days of use. Children feel better, stop itching and being capricious. The drug is produced in a very convenient bottle with a dispenser, which prevents the development of pathogenic flora in the product. Moisturizing cream for atopic dermatitis is instantly absorbed, economical and non-addictive.
3. Avene. The drugs are developed for the treatment of skin with atopic dermatitis in children prone to hypersensitivity. Can be used for several months if there are no contraindications in the instructions. The composition contains safe ingredients, no chemical flavors or preservatives. The drug does not aggravate allergies. The series includes thermal water - an antibacterial product with a slight moisturizing effect, it is good to use together with cream.
4. "Zorka" An inexpensive baby cream designed to moisturize and treat skin rashes that cause severe itching. Triggers cell regeneration, relieves inflammation, acting in all layers of the skin. The product is absorbed well, does not leave grease, and forms a thin protective film.
5. Uriage. Multifunctional moisturizing cream for children with atopic dermatitis, able to cope with discomfort during the acute stage of the disease. It can be used during remission, but the cost of the cream is quite high. But the course of treatment lasts only 2 weeks. It can be used constantly to moisturize the skin; the product cannot cause allergies or addiction.
6. "Sudocrem". The drug for babies with contact and atopic dermatitis is especially effective in treating the disease caused by diapers. It moisturizes well and restores the epidermis, creating a film that protects the skin from the effects of feces for a long time. The composition of the cream is hypoallergenic. Even with prolonged use, negative effects may not appear.
7. "Zinocap." The composition of the product, as described above, includes zinc. Its action is aimed at treating wet forms of dermatitis. Excellent for the treatment of atopic reactions. When applied to the skin, no greasy film is formed. It copes well with severe itching, improving the well-being of babies. Recommended from 2-3 months of age. To get rid of the symptoms and causes of the disease, the drug must be used for a long time. But don’t worry about addiction – the unique composition will not allow the product to become ineffective.

When choosing moisturizing creams for the treatment of atopic dermatitis, the composition of the product is taken into account. It should not contain aggressive chemicals; it is advisable to give preference to products marked “hypoallergenic”.

Moisturizers are included in the complex therapy of atopic dermatitis, but cannot be the only medicine to combat the pathology. It is important to take into account your diet - only eliminating allergens from food will help restore damaged skin.

Dermatitis is an inflammation of the skin, an organ located in the human body most superficially and fed by an extensive network of blood vessels. When the integrity of the skin is not compromised and it has an acidic pH, it performs a good barrier function and does not allow substances that reach the surface to be absorbed. Once microbial or allergic inflammation or inflammation resulting from a burn develops, the skin becomes permeable to various substances. This property is used by dermatologists when choosing an ointment for dermatitis.

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It must be said that although the general processes that occur during skin inflammation are similar, the mechanism for triggering them is different. Therefore, it is very important that the local remedy for its treatment is selected correctly, and also takes into account the changes that exist in the integumentary tissue at the moment. Let's look at what effective ointments and creams can be used for each type of dermatitis.

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Some terminology

Allergic dermatitis - occurs in response to skin contact with one of the factors (household chemicals, cosmetics, topically applied medications, metals, plant sap). In this case, in response to this contact, several immunoglobulins are released at once, and redness and blisters appear on the skin, accompanied by itching. This is allergic contact dermatitis. More often it is called simply “contact”.

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There is also allergic atopic or simply atopic dermatitis. This is a chronic disease that occurs in response to the intake of a substance that causes the release of antibodies in food, its entry into the respiratory tract or directly into the blood. Inflammation, genetic predisposition, chronic infections, pathological pregnancy, and diseases of the digestive organs contribute to the appearance of atopic dermatitis. Areas of redness and itching appear on any part of the body, most often on the face and palms, but can be located throughout the body.

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If redness of the skin, its swelling, the appearance of blisters filled with clear or bloody liquid are associated with exposure to an aggressive chemical, ultraviolet rays, hot or cold substance, this is also dermatitis. Its name will reflect the nature of the factor that caused the inflammation (for example, solar).

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When inflammation of the skin occurs against the background of increased activity of the sebaceous glands, in the product of which Malassezia bacteria greatly multiply, this is seborrheic dermatitis. His manifestations are special. These are clearly defined red lesions covered with hard-to-remove fatty yellow scales. Areas of inflammation tend to grow progressively and merge with each other. Skin rich in sebaceous glands is affected: face, scalp, chest and back; in severe cases - axillary fossae and inguinal folds.

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Principles of local treatment of allergic dermatitis

Let's consider what the doctor's choice of one or another local remedy against dermatitis is based on.

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Here, local treatment consists of applying compresses with a weak solution of potassium permanganate or an aqueous solution of boric acid. Chatterboxes prepared at the pharmacy are also used.

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After a compress or mash, anti-dermatitis gels based on an antihistamine are applied to the inflamed area. This is “Fenistil-gel” or “Psilobalm”. When the inflamed area stops getting very wet, to speed up its healing, use a dermatitis cream such as “Bepanten” (“D-panthenol”), which, when absorbed by the skin, turns into a vitamin and is included in the normal metabolism of skin cells, stimulating their division. Instead of dexpanthenol agents, you can use Actovegin or Solcoseryl gel. These non-hormonal drugs improve the nutrition of skin tissue affected by dermatitis.

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If allergic dermatitis affects large areas, or local antihistamines do not have an effect (and the person has excluded exposure to the allergen), steroid ointments are prescribed. They contain laboratory-made analogues of glucocorticosteroid hormones, the “originals” of which are produced by the adrenal glands. These local agents have pronounced antiallergic, anti-edematous and anti-inflammatory activity.

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Corticosteroid ointments used for allergic dermatitis are divided according to the severity of their effect into:

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1. Weak: hydrocortisone and prednisolone ointments.
2. Medium strength: “Afloderm”, “Dermatop”, “Flixotide”, “Lokoid”.
3. Strong: Cutivate, Flucinar, Advantan ointment and cream, Triamcinolone ointment, Elokom and Celestoderm-B ointments and creams.
4. Very strong: “Dermovate” in the form of a cream or ointment, “Chalciderm”.

These ointments must be prescribed by a doctor. He will indicate how many days the product can be used (usually a potent drug is used for no more than 3 days, while “weak” drugs are used for up to a week), and will tell you how it should be gradually discontinued so as not to harm your own skin by abruptly stopping the topical corticosteroid.

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When pus begins to ooze from the inflamed area, or the contents of the blisters become whitish, a cream for the local treatment of allergic dermatitis with an associated secondary infection should also be prescribed by a dermatologist, since there may be 3 options:

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1. A product containing only an antibiotic (erythromycin, tetracycline ointment);
2. Local combination preparation of an antibiotic or antiseptic in combination with a non-hormonal agent: “Levomekol” (antibiotic + drug that improves healing), “Oflokain” (antibiotic + anesthetic);
3. A combination of an antibiotic, an antifungal component and a hormone: Triderm, Pimafucort.

Treatment of atopic dermatitis

Since this pathology causes more concern in childhood, let’s consider which group of ointments for dermatitis is used to treat children.

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Treatment of children with exacerbations of atopic dermatitis begins with such local drugs. Initial therapy can begin with these same drugs if the disease is severe.

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The calculation for appointment is as follows:

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1. During an exacerbation of the disease, when the areas of redness are small and appear only on the torso and limbs, the list of hormonal ointments for dermatitis consists of drugs such as 1% Hydrocortisone cream, Prednisolone ointment. If there is no weeping, use Afloderm or Lokoid ointments; when the inflamed area becomes wet, it is better to use Flixotide or Afloderm in the form of a cream.
2. If exacerbations are severe (the severity is determined by a dermatologist), and the inflammation is localized on the skin of the torso, face and extremities, treatment should begin with drugs such as Advantan (if wet, in the form of an emulsion or cream, if not, in the form of an ointment ), “Celestoderm B”, “Elocom” (if wet - in the form of lotion or cream), “Triamcinolone”, “Polcortolone”, “Mometasone furoate”.

The frequency of application is selected by the doctor. Typically, Advantan can be applied to children from six months of age once a day, Afloderm - twice a day, Lokoid - up to 3 times a day. "Elocom" can be used only from 2 years of age, once a day, the course is up to 1 week.

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With a significant decrease in the severity of the rash in atopic dermatitis, rapid discontinuation of local therapy is not recommended. It is better to switch to a course, lubricating the affected areas 2 times a week for 1-2 weeks, on the remaining days using moisturizing and nourishing products.

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The preparations “Dermovate”, “Galcinonide”, “Chalciderm”, “Diflucortolone valerate”, which have a powerful, long-lasting effect and maximum depth of penetration, are ointments used for dermatitis in adults and children over 14 years of age as prescribed by a doctor.

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Hormonal ointments are contraindicated for acne, fungal and bacterial skin diseases, scabies, herpes and herpes zoster, tuberculosis. They cannot be used if allergic dermatitis appears after vaccination. For children under one year old and during pregnancy, such drugs are not prescribed. For children under 7 years of age, steroid ointments and creams should be prescribed by a doctor.

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1. if dermatitis has developed on the hands, apply a maximum of 3 units of product to each hand (1 unit is the amount placed on the phalanx of the index finger of the same person);
2. per foot – maximum 1 unit;
3. on the groin area - 1 unit on each side;
4. per body – maximum 14-15 units.

The face is not treated with hormonal ointments. There it is recommended to use only wetting agents and calcineurin inhibitors.

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If fungal or bacterial flora is suspected of being attached to areas of dermatitis, ointments containing an antibiotic and antifungal drug are prescribed: Triderm, Pimafucort.

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In children under 7 years of age, hormonal cream is not applied directly to inflamed skin, but to previously lubricated skin with emollient - a substance with sufficient fat content, which, when applied, forms a film on the skin. Good emollients include Emolium, Topicrem, La Roche-Posay, Mustela Stelatopia cream.

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The latter is a cream-emulsion made from natural ingredients, easily spread over the child's skin and dries within a few minutes. It can be used not only as a “base” for a hormonal drug, but also in the intervals between applying topical steroids, and before going outside, especially in the cold season. Mustela cream emulsion also helps eliminate skin itching that occurs with atopic dermatitis.

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Applications of Mustela Stelatopia can be replaced with the drug Physiogel AI, you can alternate them. Physiogel also consists of membrane-forming lipids, identical to those that protect intact skin from external influences. It eliminates minor manifestations of atopic dermatitis, relieves irritation and itching.

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Such emollient preparations are the best ointments for dermatitis during pregnancy. They are an excellent alternative when there are contraindications to treatment with hormonal ointments.

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You need to apply emollients at least 3 times a day, and also after bathing. It is recommended to change them every 3-4 weeks to avoid a decrease in the therapeutic effect.

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For this disease in children, adults, and pregnant women, non-hormonal ointments for dermatitis are prescribed. They can be different:

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1. "Eplan". The active ingredient is glycolan, which has wound-healing, bactericidal and analgesic effects. There are no instructions for use during pregnancy and lactation.
2. "Bepanten" ("Pantoderm", "Dexpanthenol", "D-panthenol"). Absorbed by skin cells, it turns into vitamin pantothenic acid, which accelerates skin healing. Can be used during pregnancy and lactation.
3. Ointment for dermatitis with zinc (“Zinc ointment” and “Desitin” based on zinc oxide, “Zinocap” based on zinc pyrithione) has good anti-inflammatory, antibacterial and antifungal effects. Well used when getting wet. During pregnancy and breastfeeding, use as prescribed by a dermatologist.
4. Calcineurin inhibitors (Elidel and Protopic creams). They suppress the release of substances that provoke allergic reactions on the skin and reduce the severity of inflammation. They are used to treat the neck, folds, and facial skin. "Protopic" is the optimal antipruritic ointment for dermatitis. These drugs are not used for herpetic rashes, the presence of genital warts or warts on the skin, or for treatment with ultraviolet irradiation. Not recommended during pregnancy and breastfeeding.
5. “Radevit” is an ointment based on vitamins (D2, E and A), which has an anti-inflammatory, softening effect and eliminates itching.
6. “Gistan” is a local dietary supplement based on extracts of medicinal herbs, dimethicone and betulin.
7. "Fenistil gel", which is based on the antihistamine substance dimethindene maleate. It has antipruritic and local anesthetic properties.
8. "Losterine." It is based on dexpanthenol (more about it above), urea (softens the skin), salicylic acid (softens the skin, eliminates inflammation).
9. "Naftaderm" is a liniment based on naftalan oil. Has an analgesic, softening, antiseptic effect.
10. For infected dermatitis and for its prevention, children from 3 months of age are treated with the drug "Dermazin" based on a sulfonamide antiseptic - silver sulfadiazine. It is effective against a large number of microbes and eliminates mild weeping. It is applied to a gauze pad, which is applied to the area of ​​dermatitis only after the inflamed skin has been washed with water and dried with sterile gauze.

Previously, a cream for the treatment of dermatitis such as Skin-Cap was widely recommended, positioned as a non-hormonal complex drug with anti-inflammatory, antifungal and antibacterial activity. Reliable studies have not yet been provided that it does not contain the glucocorticoid hormone - clobetasol propionate.

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Treatment of seborrheic skin lesions

The main ointment for seborrheic dermatitis is antifungal: Ketoconazole, Nizoral, Sebozol, Nizorex, Mycozoral. It is recommended to treat the affected skin with keratoregulating agents (for example, Mustela Stelaker). In special cases, Sulsena paste and hydrocortisone ointment are added, but preference in the treatment of this type of dermatitis is given to physiotherapeutic methods.

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Therapy for solar inflammation

For solar dermatitis, an ointment based on glucocorticoids is prescribed: Fluorocort, Polcortolone, Beta-Methasone. After reducing inflammation, the affected areas are treated with Bepanten cream or its analogues.