Modern therapies

Atopic dermatitis: conquering the agonizing itching!

Thanks to modern therapies, the itching caused by atopic dermatitis can be well controlled.

(Bild: amixstudio/stock.adobe.com)

Atopic dermatitis (neurodermatitis) is primarily associated with severe itching, which causes sufferers to despair and even deprives them of sleep. There are now effective therapies for every degree of severity of the disease, which help the long-suffering patients to regain their quality of life. 

In addition to itching, other symptoms of atopic dermatitis include red, dry and inflamed skin. However, it is not just a skin disease, but also a hypersensitivity of the body's own immune system, as OA Dr. Martin Zikeli, Department of Dermatology at the Regional Hospital Wr. Neustadt (Lower Austria) explains: "Some signal substances of the immune system cause skin inflammation (eczema), others trigger itching on sensory nerves."

The latter leads to a vicious circle. "Scratching in turn damages the skin and intensifies the inflammation and itching. This creates the so-called itch-scratch cycle," says the expert. Histamine, which is responsible for the itching in hives, plays no role in atopic dermatitis, as Dr. Zikeli explains further. On the other hand, certain factors such as contact with foreign substances, clothing, sweating or cigarette smoke can promote an increased release of inflammation-promoting messenger substances.

Scratching in turn damages the skin and increases the inflammation and itching. This results in the so-called itch-scratch cycle.

OA Dr. Martin Zikeli, Landesklinikum Wr. Neustadt

Bild: © Maria Noisternig

Therapy for every degree of severity
Although there is still no cure for atopic dermatitis, sufferers do not have to put up with the symptoms. There are now effective therapies for every degree of severity of the disease. The basis of any treatment is basic therapy with moisturizing, nourishing creams, ointments or lotions.

"Nourishing ointments improve the dryness of the skin and the itching. Further skin damage can be avoided by cooling instead of scratching. Anti-inflammatory ointments and medication are the most effective way to combat itching, reducing the signaling substances of the immune system that trigger itching," explains the dermatologist.

The doctor and patient discuss the treatment goals.

(Bild: stock.adobe.com/Siphosethu F/peopleimages.com )

Bringing the immune system under control
Dr. Zikeli continues: "For mild and moderate eczema, cortisone ointments and cortisone-free, anti-inflammatory creams, so-called topical calcineurin inhibitors, as well as light therapy are used. For moderate and severe cases that do not respond adequately to topical therapy, there are some new medications, so-called Janus kinase inhibitors in the form of tablets and biologics in the form of injections, which specifically block the signaling substances in the immune system that are involved in the development of eczema and itching."

In most cases, this can reduce itching within a few days and achieve significant and long-term disease control with an improvement in quality of life.

For example, patients with severe hand eczema can return to work without restrictions and those with facial skin inflammation can continue their social contacts. Itching-related sleep disorders are prevented, which increases the ability to concentrate during the day. Patients with eczema in the large bends of the joints are also able to do sport again without the skin cracking, as the expert explains.

Which medication is used depends on various factors, such as the patient's living conditions or accompanying illnesses. The doctor and patient therefore try to find the best solution together.