What is Atopic Dermatitis?
Atopic Dermatitis (AD) is a chronic inflammatory skin condition affecting approximately 15-20% of children and 1-3% of adults across the globe. AD can be described as dry, itchy, flakey scalp, irritated skin, and hair loss in the affected areas. The prevalence of AD has increased over the years due to a greater consumption pro-inflammatory agents, genes linked to AD, severe changes in weather, and a decline in overall health. There are three major causes of AD are significantly supported by research: malfunctions of the epithelial barrier from allergens, disruption of the microbiome, and dysfunction of the immune system (Avena-Woods, C. 2017).
AD begins to manifest through two different processes. The first potential pathway is initiated when the body is exposed to certain allergens. The skins epithelial barrier becomes weakened and left unprotected from additional irritants. This in turn leads to an on-going reaction which appears as AD. The second potential pathway occurs through a genetic disorder. A resulting malfunction is the downregulation of the filaggrin, an important protein in maintaining the skins epithelial barrier by binding keratin fibers together (Silverberg et al. 2015). Another genetic mutation that has been linked to AD is the excessive activation of specific genes on chromosome 5, which releases increased quantities of pro-inflammatory factors (Bieber, 2008). In most scenarios, these malfunctions co-exist which makes AD multi-factorial when considering the most effective approach for treatment.
The inflammation of the skin can be managed over time by treating symptoms, typically through cortisone creams and in more aggressive cases immunosuppressants, which can take a great toll on the body with excessive, repeated use. Progressive studies have been conducted that suggest certain dietary interventions can help manage AD.
Dietary Interventions with Atopic DermatitisOmega-3
Omega-3’s have been continuously researched for their anti-inflammatory effects and used in conjunction with pharmaceuticals for various autoimmune diseases. Promising research about AD that has been published suggests that omega-3’s have the potential to downregulate the pro-inflammatory pathways. One mechanism by Palmer et al. (2013) suggested that supplementing with omega-3 could potentially displace omega-6 in the body, therefore reducing inflammation. In an animal study, it was concluded that after supplementing with omega-3 for 90 days, there was an increase in cutaneous skin hydration, which implies a decrease in dryness and flakey skin (Fang et al. 2016). Additionally, in a double-blind random control trial, mothers who supplemented with omega-3 during their pregnancy had children with a lower risk of developing AD (Denburg et al. 2005). The abundance of AD and omega-3 research has been conducted mostly in animal models but demonstrates a correlation between a lower risk of AD or a decrease in severity of symptoms with regular intake of omega-3. In the years to come, it is exciting to think of the clinical trials that will stem from this!Vitamin D
Vitamin D is the most essential nutrient to supplement with as Canadians. In recent clinical trials, it has been proven that low vitamin D serum levels are linked to an increase susceptibility for infection and autoimmune disorders. Some studies have suggested that living further away from the equator leaves us more susceptible to vitamin D deficiency and potentially a higher risk for developing AD. In cases where people were already pre-diagnosed with AD, the patients with the most severe symptoms were found to have low serum vitamin D levels (Peroni et. al, 2011). Research suggests that daily vitamin D supplementation can help modulate the immune system with AD and is beneficial for overall physical and mental health. Take your vitamin D!Choose a quality supplement for Atopic Dermatitis
It is extremely important to know the quality of the omega-3 consumed when managing dermatitis. Since this condition is caused by inflammation, we do not want to add to this burden. A high-quality omega 3, without omega-6 fillers, is vital to support the body and decrease inflammation to help manage the symptoms of dermatitis.
- Avena-Woods, C. (2017). Overview of Atopic Dermatitis. Am J Manag Care., 23(8). Retrieved Jan. 23, 2021 from: https://www.ajmc.com/view/overview-of-atopic-dermatitis-article
- Balić A, Vlašić D, Žužul K, Marinović B, Bukvić Mokos Z. Omega-3 Versus Omega-6 Polyunsaturated Fatty Acids in the Prevention and Treatment of Inflammatory Skin Diseases. Int J Mol Sci. 2020;21(3):741. Published 2020 Jan 23. doi:10.3390/ijms21030741
- Bieber T.(2008) Atopic dermatitis. N Engl J Med. 358(14):1483-1494. doi: 10.1056/NEJMra074081.
- Denburg J.A., Hatfield H.M., Cyr M.M., Hayes L., Holt P.G., Sehmi R., Dunstan J.A., Prescott S.L. Fish oil supplementation in pregnancy modifies neonatal progenitors at birth in infants at risk of atopy. Pediatr. Res. 2005;57:276–281. doi: 10.1203/01.PDR.0000148279.72611.1D
- Fang, Y. P., Yang, S. H., Lee, C. H., Aljuffali, I. A., Kao, H. C., & Fang, J. Y. (2016). What is the discrepancy between drug permeation into/across intact and diseased skins? Atopic dermatitis as a model. International journal of pharmaceutics, 497(1-2), 277–286. https://doi.org/10.1016/j.ijpharm.2015.12.006
- Palmer DJ, Sullivan T, Gold MS, et al. Randomized controlled trial of fish oil supplementation in pregnancy on childhood allergies. Allergy. 2013;68(11):1370–6. doi: 10.1111/all.12233.
- Peroni, D. G., Piacentini, G. L., Cametti, E., Chinellato, I., & Boner, A. L. (2011). Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children. The British journal of dermatology, 164(5), 1078–1082. https://doi.org/10.1111/j.1365-2133.2010.10147.x
- Silverberg NB, Silverberg JI. Inside out or outside in: does atopic dermatitis disrupt barrier function or does disruption of barrier function trigger atopic dermatitis? Cutis. 2015;96(6):359-361.
My seven years old daughter in atopic eczema, please guide about treatment, competent dermatologist not available in Sahiwal.