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What is the cause and treatment for atopic dermatitis?

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Practicing since : 2005
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I've been plagued by a rash for the past couple of months that is worsening in severity. It's triggered when I wear clothes that are made of nylon and spandex. I recently moved to a (rural) tropical area and notice it especially when I get hot/sweaty. It's very itchy, in a pattern of small raised red bumps that's visible in the outline of the offending clothes item that lasts several days. I saw the doctor and he said I was "atopic". He gave me clotrimiazole and betamethasone creams to apply twice a day but I need more relief. The itching keeps me up at night, so I try taking half doses of Benydryl which is very difficult, as I'm a single mother to a toddler who doesn't sleep well and the Benydryl makes me even more tired. My job is very active, so I can't not wear a bra (synthetic, itch causing fabrics). As background, I have a lot of environmental and food allergies and intolerances. I understand yeast may be a problem, and though I do drink alcohol in moderation, I don't use sugar. Please help!
Posted Mon, 17 Mar 2014 in Skin Hair and Nails
Answered by Dr. Johny Chacko 41 minutes later
Brief Answer: Atopic dermatitis / Prickly heat Detailed Answer: Hello, Welcome to healthcare magic. Atopic individuals have a very sensitive skin. As the barrier function of the skin is defective such people can become sensitive to a lot of internal and external allergens. Even extremes of temperature can trigger a rash in them. In your case it could be a flare up of atopic dermatitis or prickly heat (Miliaria) due to heat. I will advice you to wear loose cotton garments as much as possible. Take bath twice a day and avoid hot water baths. Soon after bath apply a moisturizing lotion over the body which will help to maintain the barrier function of the skin. Dusting powders or prickly heat powder application will help absorb excess sweat and will cool your body down. Benadryl is a sedative anti histamine, you may take a non sedating antihistamine like Loratadine 10 mg at night (Claritin / Alaspan ). You may continue the application of cream twice a day over the rash. Hope this helped, I will be happy to clarify any further queries you have. Take care.
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Follow-up: What is the cause and treatment for atopic dermatitis? 3 days later
This is the third time I've submitted a follow-up question, which doesn't seem to be going through for some reason... Is there any testing I can do to see why my allergies are getting worse? The reading I've done says that this is the third part of the "atopic triad", which I've just found out about. I don't understand why this is occurring now, as I've lived in tropical climates in years past without this kind of issue. I did however develop asthma from allergies during my second year in Thailand, which is one of the reasons I left. Would I be better off in a cooler climate? I'm frustrated, as I already feel limited by my food allergies and intolerances. One of the reasons I moved to a tropical climate was to help with my SAD, as I also suffer from depression. What else can I be doing? I don't use artificial fragrances, I don't wear make-up, I use perfume/dye-free detergent, very mild, fragrance free soap, etc. I'm fit/active and don't smoke. I take 10mg of Zyrtec per day, do you think Claritin would be better? I have been using Gold Bond for my rash, which seems to help a little. I ordered cotton bras and underwear... I understand that there is a maternal genetic component to this issue, can I have my daughter tested? Fingers crossed this message goes through! Thanks again.
Answered by Dr. Johny Chacko 58 minutes later
Brief Answer: Atopic dermatitis Detailed Answer: Hello, Welcome back, For atopic dermatitis there are no useful special tests. There is a test called serum IgM, but it just shows an elevated level in atopics and won't help in control of disease. Atopy can manifest as either asthma, allergic running nose or atopic eczema (Third part of triad). Atopic eczema can occur any time, when it starts in the adulthood it is adult onset atopy. Extremes of weather is bad for atopics. Even very cold climates may make it worse. Bright sunlight is better for depression and I would not recommend you to shift in view of Atopy. Zyrtec is also a non sedating anti histamine. Alaspan/ Claritin is a better non sedating anti histamine in my experience. Gold bond can be continued. Not just underwears, try using cotton garments for daily wear as well. There is no advantage in testing your daughter as even if she is atopic by doing IgM test we are not going to prevent or cure. If you can upload a close up picture of the rash, it will help me assess better. You have an option of uploading picture on the right side of your query page. Otherwise you may send the picture as an attachment to YYYY@YYYY with the subject "Attn Dr Johny Chacko". Is anybody else in the house having itching. Hope this helped. Take care.
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