Dr. Komarovsky on the treatment of atopic dermatitis in children

Every mother wants to see her baby in the same smiling and rosy-cheeked way, like in beautiful pictures in advertisements, in magazines and on the Internet. In reality, everything looks a little different - at the karapuz, with enviable constancy, red spots are poured on the cheeks, then an incomprehensible rash appears on the pope. Diathesis, grandmothers sigh together. And the whole family begins to think how to treat this condition. There is no advertising beauty here.

About why atopic dermatitis appears in babies and how to deal with it, the well-known children's doctor Yevgeny Komarovsky repeatedly told in his TV programs, books and articles. We tried to summarize the information in one article.

But actually the release of Dr. Komarovsky dedicated to atopic dermatitis in children.

Atopic dermatitis is a fairly common disease. According to medical statistics, every third infant under six months suffers from this disease. This disease is very insidious, as it has the tendency to change. Over the past 10 years, children began to be diagnosed with this diagnosis 5 times more often, since the disease itself has become more difficult.

Most often the disease occurs in children who have a genetic predisposition to react to an allergen.. In the genome of the child at birth laid the information on which antigen how to react.

Genetics brought an interesting pattern: in families where mom and dad are not allergic, only 10% of children at birth have a tendency to allergic dermatitis. If one of the parents suffers from some kind of allergies, then the probability of having a baby with the same problem is 40-50%, and if both parents sneeze in the spring and eat antihistamines in batches and don’t tolerate oranges and cats, then with 80% probability they will have offspring that will suffer atopic dermatitis and most likely some other types of allergies.

The main symptom of atopic dermatitis is a rash. It is red, pink, with and without watery heads, solid and rare. Most often, the disease manifests itself on the baby’s face, neck, arms and legs, and in rare cases on the stomach and chest. Such allergic eczema is distinguished from others, including skin diseases, by a strong, sometimes unbearable itch that prevents a child from sleeping, eating, and waking. The temperature rises rarely. If you notice a high jump in body temperature (up to 38.0), then it is likely that in your case it is a completely different diagnosis.

So, if the rash is concentrated under the armpits, in the folds of the skin, then most likely it is diaper dermatitis. And if a baby has a rash with a white bloom on the head (as an option, yellow crusts on the hair part of the head) or the body in areas where the sebaceous glands are particularly active, then you will have to treat seborrheic dermatitis. In some cases, doctors diagnose atypical dermatitis in children, it is very similar to atopic and, in fact, is a type of this disease.

Evgeny Komarovsky, speaking of atopic dermatitis, always starts by teaching parents to correctly name the diagnosis. Moms and dads say "diathesis." There is no such disease, the doctor corrects. There is atopic dermatitis or childhood eczema.

There is a definite correlation between the appearance of reddening of the skin and itching and the work of the intestines, Komarovsky says, but it is not the main cause of the disease, as many district pediatricians like to imagine. If two children are given the same product, one will be allergic and the other will not. The whole thing in a state of immunity. The weaker it is, the higher the genetic predisposition to an unhealthy reaction, the more likely the allergy.

A common practice - to treat atopic dermatitis "through the intestines" - is not quite true, says the doctor. That is why often the treatment does not bring the desired result. Dermatitis subsides, and after a while flashes with a new force.

To approach the treatment of the disease Komarovsky advises from the standpoint of knowledge, namely from understanding what is happening with the child’s body. Alien antigens, getting to the baby with food, pollen, with irritating substances from household chemicals, cosmetics, can get out of it only in three ways - through the skin (sweat), through the kidneys (urine) and through the lungs. In case of dermatitis, the allergen that leaves the child reacts to the skin. But again, this sweat is not toxic in itself, but only in combination with some allergen outside.

And in this issue you will find interesting information about the treatment of atopic dermatitis.

Although completely abandon the view that atopic eczema is associated with disorders in digestion is impossible. Komarovsky assures that for his practice I have not yet seen a single thin child who would have suffered from this ailment. But the plump and loose children with a red rash up to a scab on the cheeks and bottom are as many as you like. Therefore, in order to reduce the likelihood of an allergic reaction to a particular antigen protein, it is better not to overfeed the child, Komarovsky said.

Artificialists often suffer from childhood eczema than infants. This is due to the fact that the kids always eat more from the bottle than they are able to digest and assimilate. After all, breastfeeding is more difficult, and the feeling of fullness, as you know, always comes after eating in 10 minutes.

All that is eaten in excess of the norm, poorly digested, rotting in the intestine, and partially excreted by the liver. However, this organ, according to Komarovsky, is the most vulnerable in babies. Hence the reaction on the skin. This also explains why atopic dermatitis can pass on its own over time - after all, as it grows, the liver improves, becomes more mature and is able to neutralize more harmful compounds.

To treat atopic dermatitis Komarovsky offers in three stages:

• Reducing the number of antigens "inside" (with food, liquid, drugs, etc.).
• Reduced perspiration.
• Elimination of external antigens (which are in the environment surrounding the child).

The “internal” stage should include intestinal monitoring. The child should regularly go to the toilet "in a big way". In case of constipation, mild laxatives can be given. If the child is on breastfeedingMom, too, need to ensure that her chair was regular.

It is desirable that the baby ate slowly. Artificial artist should give a nipple with a small hole, you can also make the mixture less saturated concentration, pour it less than indicated in the instructions. And you should always follow the rule “It’s better not to eat than to eat”.

Reduce sweating is quite simple, says Eugene Olegovich. To do this, you should not re-entangle the baby, and also monitor the air temperature in the room - it should not exceed 18-19 degrees. A kid with atopic dermatitis needs to be paid for several times a day with warm water, while remembering that the chlorine contained in tap water acts very aggressively.

Therefore, the water that you plan to rinse the baby after the bath is better to boil beforehand and cool to a warm state so that the chlorine that disinfects it at the station evaporates.

"External" stimuli should be minimized resolutely and without doubt. First of all, in the apartment where the kid with atopic dermatitis lives, it is necessary to air, make sure that dust does not accumulate, there should not be furry pets in the house - cats and dogs. Mom should abandon household chemicals with chlorine, and all cosmetics should be hypoallergenic, devoid of perfume.

For bathing, you must use baby equipment, and wash the baby’s laundry with a special powder. If the family practices joint sleep, the bedding of the parents must also be washed with baby powder. For guests who like to cuddle your allergic toddler, you must have special dressing gowns washed by children's means to prevent any contact of the child with possible antigens on the clothing of strangers.

Often not needed, says Komarovsky. There is no universal pill for this disease. Treatment is not a specific drug, but a set of measures that parents must take.

However, in some situations, the attending physician may recommend certain medications, and you should not neglect such prescriptions, Komarovsky says, because The doctor most likely has good reasons for this:

• In case of severe atopic dermatitis, medicine advises to start taking antihistamines, which are "Suprastin", "Tavegil" other. These drugs, like Komarovsky, dry mucous membranes. With sweating, they help to cope, but have a number of significant drawbacks. Therefore, they should be resorted to in extreme cases.
• All children with atopic dermatitis known pediatrician recommends taking calcium supplements. Its deficiency increases the symptoms of the disease.
• Rash does not need to cauterize or squeeze. But if a dry crust has already formed (scab), Yevgeny Komarovsky advises to process it several times a day.Bepantenom". In some cases, it is permissible to smear such places with local antihistamines - “Fenistil-gel”, for example.
• If the rash worries the baby a lot, it itches, cries, almost cannot sleep because of the constant itch, hormonal preparations (corticosteroids) will help. As the least harmful and effective Komarovsky notes "Elokom"And"Advantan».

• Treatment will be faster and more effective if you accompany it with a hypoallergenic diet. From the diet should be eliminated or minimized cow's milk, chicken eggs, the nuts, especially peanuts, sweets factory production. Sugar is better to replace with fructose. For babies it is important to reduce the fat content of mother’s milk, for this woman needs to consume less fat (sour cream, lard, butter). Babies who are on bottle feedingIt is better to give hypoallergenic mixtures during treatment. They cost more than usual, but the result will not be long in coming.
• The baby will sweat less if the house is maintained at a normal level of humidity.Komarovsky advises to start an aquarium, place basins of water in the corners, hang wet towels. All these measures are good if there is no special device - a humidifier. If present, there is no need for additional moisture.
• When bathing a child with child eczema, you should be aware that the places with the greatest accumulation of rash should not be thoroughly and thoroughly washed. It is better to avoid this, and after bathing, wipe it separately with wet wipes (naturally, without aromatic additives).
• Do not buy the kid bright clothes of unknown manufacturers. It is better to take white things, as the sweaty baby can become covered with a rash due to the contact of sweat with fabric dyes. Ideal if things crumbs are made from linen or cotton.
• The same ban applies to cheap toys made in the unknown history of the Chinese underground factory. Stuffed toys, even good and good ones, it is better to keep away or give to neighbors. They are a real "piggy bank" of various antigens from the outside, and therefore dangerous for the crumbs with atopic dermatitis.