There are many common complications with AD, but there are a few that are rare. These include: eye complications, exfoliative dermatitis, hand dermatitis, and skin infections (bacterial, viral, or fungal). If you have trouble with any of these, seek medical attention.
Eye complications: Unbearable, itching eyelids which can lead to permanent eye damage and loss of vision. Symptoms: burning, inflamed eyelids, itching, mucus discharge, and watering. The inflammation may cause a cobblestone pattern to develop under the eyelid and hard rubbing of the eyes may cause the cornea to become deformed. Care of this may end up needing the expertise of an ophthalmologist.
Exfoliative Dermatitis: Can be life threatening, the surface of the skin is mostly covered by lesions.
Symptoms: bacterial or viral infection, draining and crusting pus, dehydration, fever, itching, redness, scaling, and toxicity affecting other organs.
Hand dermatitis: Chapped, dry hands that become inflamed, patchy, red, and scaly. May be worse in the winter and is aggravated by washing or wetting the hands and most cleansers.
Bacterial skin infections: Staph infections are the most common skin infections that affect AD patients. The bacteria which causes this, Staphylococcus aureus, is common on 90% of AD patients. The infection occurs through breaks in the skin from cracking or scratching.
Symptoms include: crusting (yellow colored), fatigue, fever, inflamed hair follicles, pus producing lesions, and swollen lymph nodes
Viral infections: Eczema herpeticum, which can be life threatening, is caused through contact with cold sores of fever blisters. Initial manifestation begins between 5 and 12 days of exposure. Patients do not always know that they have com into contact with the virus, so it is important to know and notice these symptoms: multiple itchy, watery blisters appearing on AD affected skin areas.
These spread and may bleed, become crusty, erode and become painful; the infection spreads over the entire body and a secondary bacterial infection may develop, further eroding the skin. Fever is always present with this eczema herpeticum as is fatigue and a general feeling of being sick.
Both hand dermatitis and exfoliative dermatitis may be treated by topical medications called corticosteroids initially. These are a steroidal cream or ointment which is applied to the skin. It is important to use these as directed since too few applications will not benefit as they should and too many applications can cause thinning of the skin.
If there is not sufficient improvement or the condition is too severe, phototherapy may be used. In phototherapy, specialized UV rays are directed on the affected area through either lasers or sunlamps. This may also be aided by a medication applied to the area before treatment. This is not to be confused with natural sunlight; although it does employ Ultraviolet
Light, it is specialized and does not contain the entire UV spectrum. Attempts at phototherapy through tanning are not recommended but moderate sunlight exposure is fine. You will not achieve the same results through personal attempts at phototherapy as those that are gained in a clinical setting.
If symptoms still do not see improvement or the case is extremely severe, systemic medications may be used. These are medications that are taken into the body either orally or injected and, in the case of eczema conditions, usually consist of steroids. Systemic medications tend to have more side effects than any other form of treatment.
Regardless of the type of medical treatment you receive, you will have to avoid your triggers. Good moisturizing is also a key to your comfort. After washing or rinsing, always apply a cream or petroleum based moisturizer to wet skin, which will help the skin retain more moisture, alleviating some of the itching.
Keep your nails cut short and wear white cotton gloves while you sleep to keep from scratching in your sleep. When bathing or washing, always use warm (not hot) water and a very mild soap that contains no fragrance or dye. Try to keep your stress level at a minimum as higher stress levels tend to make flare ups worse.
Treatment of infections is determined by the type and severity of the infection. Bacterial infections will be treated with topical or systemic antibiotics, depending on the severity.
Viral infections are treated with antiviral agents which will differ according to the specific virus and fungal infections are treated with antifungal medications. With any of these, be sure to use the medication as directed by your doctor to achieve optimal results.
