Treatment of atopic dermatitis at 1–5 years of age. The main causes and signs of dermatitis in a child, which are important to know about. Causes of allergic dermatitis

Atopic dermatitis at the reception - a breakthrough. In the last couple of weeks, almost every third child has had this problem.

The problem is widespread, doctors are often guided by outdated recommendations, prescribe what they should not (bacteriophages, probiotics, strict elimination diets, etc.), do not prescribe what they should (emollients are rare and weak, they are afraid of steroids, etc.), and deal with obvious sabotage (they put the mother on such a terrible diet that she can’t stand it and gives up breastfeeding; or they directly prohibit breastfeeding in favor of hydrolysate), etc.

Patients continue to bathe children in a row, wash tar soap, change formulas every four days, cover the rash with rich baby cream, be afraid of hormones and talk children into “grandmother’s” (no, this is not a metaphor).

But there is good news: more and more patients and doctors are reading international guides and memorandums on AD, and adhering to adequate treatment and care regimens for such children. This means that all is not lost. So, what is the most basic thing you need to know about the treatment of atopic dermatitis in children?

Constantly, for many months, until stable remission occurs, we use emollients (they are also lubricants, they are also moisturizing creams/ointments), from twice a day to at least every two hours, depending on the severity. It is especially important after bathing the baby. This is the basis of AD treatment.

My top prescriptions for drugs from this group (I don’t pretend to be complete and objective, I have no conflict of interest): Locobase Ripea, Mustela Stelatopia, Emolium special cream, Lipikar AR+, Lipobase.

Emollients should not be skimped; a 250 ml tube of cream should be used up in 1-2 weeks, depending on the severity and area of ​​the lesions.

Emollients are selected individually, by trial and error. Some, even more expensive ones, are not suitable (ineffective) for a particular child, and some even worsen the skin condition. Therefore, do not buy half a bucket at once, it will be a shame if it doesn’t fit. Ideally: collect samples and experiment, choose the best one.

Important: baby cream is not an emollient! In general, from the word “absolutely”.

What to feed a child with atopic dermatitis and what a nursing mother can eat

Only a third of AD cases are associated with food allergies, so the issue of an elimination diet (excluding certain foods) for a child is very controversial, and a breastfeeding mother needs a diet very rarely (only if there is a clear connection between food products and rashes).

Sometimes AD is combined with streaks of blood in the stool. This combination almost always indicates an allergy to proteins. cow's milk(and this is where an elimination diet can be quite justified).

Goat milk formulas (Nanny, Cabrita, etc.) are not a way to treat AD. If a child has an intolerance to cow's milk, he almost certainly has an intolerance to goat's milk; their protein composition is almost identical.

Mixtures containing soy protein (Frisosoy, Similak, Izomil, etc.) should be used with caution for AD, since soy itself is a strong allergen. But sometimes soy mixture for AD brings clinical relief.

Mixtures with partial hydrolysis of protein (Nutrilon Comfort, Nan GA, etc.) are not a treatment for AD, they are a prevention of food allergies; are used before the onset of symptoms, if there are prerequisites (primarily a family history).

Mixtures with complete protein hydrolysis (Nutrilon Pepti Allergy, Frisopep AS, etc.) are indicated only for that part of children in whom AD is associated with food allergies. This is determined individually: by blood in the stool, by eosinophilia in a blood test, by the level of total IgE, and, most importantly, by a positive clinical response to these mixtures.

Amino acid mixtures (Neocate, Alfare Amino, etc.) are used when there is a severe food allergy, with an insufficient clinical response to full-hydrolysis mixtures.

Local (topical) glucocorticosteroid creams or, in common parlance, "hormonal ointments" indicated only in cases of severe exacerbation, only in a short course, only after discussing the rules for their use with a doctor.

Topical calcineurin inhibitors (pimecrolimus and tacrolimus) are similar in effect and indications to topical steroids, but do not contain hormones(for some fearful parents this is critical) and are the second line of therapy in cases where steroids have not worked.

Antihistamines first (Suprastin, Fenistil, etc.) and second (Zirtec, Claritin, etc.) generation they do not cure AD, they only reduce itching. Useful only at the peak of itching, to relieve well-being.

Analyzes for general IgE, specific IgE, eosinophilic cationic protein, Fadiatope Immunocap, skin prick tests, prick tests and other allergological examinations are expensive and are not indicated for all patients. And for those who are still indicated, treatment tactics often do not help at all. Therefore, you do not need to take all this until your doctor directly recommends it.

Vaccinations a child with AD is shown even more than a healthy one. Because if he gets sick, for example, with whooping cough, then the risk of allergic reactions and exacerbations of AD from the disease and medications is several orders of magnitude higher than the risk of exacerbations and allergic reactions to the whooping cough vaccine. Therefore, here we choose the lesser of two evils.

But vaccination should be done when the manifestation of AD is minimal: for some it is velvety skin, but for others it is dryness, lichenification and a few scratches and scratches - everything is individual. And be prepared for the fact that vaccination may cause a temporary exacerbation of AD, which is then relieved by adequate therapy.

Modern treatment of atopic dermatitis in children

AD flows in waves. It gets worse and then goes away. Sometimes these exacerbations are provoked by something, sometimes they are not provoked by anything. And you will certainly consider what you gave before the exacerbation as the reason. And what you used before the start of remission will be considered effective treatment. And in both cases, there is a very high probability of making a mistake, stumbling upon a coincidence, and wishful thinking. Be careful with the findings, check them several times and discuss them with your doctor.

Over time (around school), AD goes away without a trace in 9 out of 10 children. The basis of treatment: emollients constantly and topical steroids briefly and locally, during exacerbation. The essence of treatment is to moisturize the skin, prevent exacerbations, treat any exacerbations that occur, and treat their complications.

There is no connection between dysbiosis or intestines in general and AD, these are myths.

Identifying and eliminating the allergen to cure AD is a very tempting idea, but it almost never works. Firstly, because only a third of patients have this connection (see above), and secondly, even if it is possible to identify a food allergen, eliminating it is not as easy as it seems. Especially when there are a lot of allergens.

However, sometimes a doctor may prescribe a switch to a hydrolyzate or diet. If the results are questionable, he will prescribe a provocative test (return to formula milk or reintroduce the product) and if this provokes an exacerbation, an elimination diet will be justified. But certainly not all atopics.

These are the very basics. AD is a large, multi-layered and long-term problem; it, like any other chronic disease, should be treated by the same (for consistency of prescriptions) competent doctor.

– a complex of inflammatory and allergic skin reactions that occur in response to exposure to various irritants. Dermatitis in children is manifested by erythema of various areas of the skin, itching, the presence of rashes or scales, changes in the sensitivity of inflamed areas of the skin, and deterioration in general well-being. Diagnosis of dermatitis in children and its form is based on data from a visual examination, analysis of scrapings from the affected surface of the skin, immunological and biochemical examination. Treatment of dermatitis in children involves eliminating contact with the irritant that caused the reaction, treating the affected areas of the skin, taking antihistamines, immunomodulators, and sedatives.

General information

Dermatitis in children is a local or widespread inflammation of the skin of a child, developing as a result of direct or indirect exposure to factors of a biological, physical or chemical nature. In pediatric dermatology and pediatrics, dermatitis accounts for 25-57% of cases of all skin diseases. In children, atopic, seborrheic, contact and diaper dermatitis are most common. As a rule, dermatitis in children manifests itself in the first year of life, and in preschool and school age it develops for the first time relatively rarely. Having begun in early childhood, dermatitis can acquire a recurrent course and lead to a decrease in the child’s social adaptation.

Causes of dermatitis

Symptoms of dermatitis in children

Symptoms of atopic dermatitis

Usually manifests in the first half of life; less often develops in preschool, school or adolescence. Skin rashes with atopic dermatitis in children can be represented by persistent hyperemia or transient erythema, dryness and flaking of the skin, or a weeping papular-vesicular rash on an erythematous background. Characteristic signs of atopic dermatitis in children include symmetry of skin lesions on the face, limbs, and flexor surfaces of joints; itching of varying intensity. Quite often, with atopic dermatitis in children, folding (hyperlinearity) of the palms and soles is detected; follicular hyperkeratosis of the elbows, forearms, shoulders; white dermographism, skin scratching, pyoderma, hyperpigmentation of the eyelids (“allergic radiance”), cheilitis, urticaria, keratoconus, recurrent conjunctivitis, etc.

The natural progression of atopic dermatitis in children in the absence of proper treatment can become the so-called “atopic march” or atopic disease, characterized by the addition of other allergic diseases: allergic conjunctivitis, allergic rhinitis, bronchial asthma.

Symptoms of seborrheic dermatitis

This type of dermatitis occurs in approximately 10% of children in the first 3 months of life and completely stops by 2-4 years. The first manifestations of seborrheic dermatitis in a child may appear as early as 2-3 weeks of life. At the same time, grayish scalp-like scales (gneiss) are formed on the scalp, which, merging, turn into a continuous greasy crust. Gneiss can spread to the skin of the forehead, eyebrows, and behind the ear; sometimes maculopapular rashes, covered with scales on the periphery, are found in the natural folds of the torso and limbs.

Distinctive features of seborrheic dermatitis in children are minimal itching and absence of exudation (scales are greasy, but dry). When the crusts are forcibly removed, brightly hyperemic skin is exposed; in this case, it can become wet and easily become infected.

Symptoms of diaper dermatitis

Diaper dermatitis is characterized by irritation of the skin of the buttock area, inner thighs, perineum, lower back, abdomen, i.e., areas of the skin in contact with wet and soiled diapers, diapers, and onesies. Diaper dermatitis occurs in 35-50% of infants, most often developing in girls aged 6 to 12 months.

By severity clinical manifestations There are 3 degrees of diaper dermatitis. With mild manifestations of dermatitis in children, moderate skin hyperemia, a mild rash and maceration of the skin in areas of typical localization occur. Moderate diaper dermatitis is characterized by the formation of papules, pustules and infiltrates on irritated areas of the skin. Severe diaper dermatitis in children occurs with the opening of blisters, the formation of areas of weeping and erosion, and extensive drainage infiltrates.

The development of diaper dermatitis affects general health children: they become restless, cry often, sleep poorly, because the inflamed areas of the skin are very itchy, and touching them causes discomfort and pain. In girls, diaper dermatitis can lead to the development of vulvitis.

Symptoms of contact dermatitis in children

Manifestations occur directly on the area of ​​the skin that came into contact with any irritant. The main signs of contact dermatitis in children include edematous hyperemia of the skin with sharp boundaries, severe itching, burning, soreness, and the formation of blisters, the opening of which leads to the formation of weeping erosive areas.

Contact dermatitis in children can take an acute or chronic course. The acute phase begins immediately after contact with the irritant and ends shortly after the end of exposure. Chronic course Dermatitis in children acquires after frequent repeated exposure to an aggressive factor.

Diagnostics

The appearance of any rash on a child’s skin requires a careful assessment by a pediatrician, pediatric dermatologist, pediatric allergist-immunologist, and sometimes a pediatric infectious disease specialist. If dermatitis is suspected in children, a thorough history taking, examination of the skin, and clinical and laboratory examination are carried out.

In the diagnosis of atopic dermatitis in children, the detection of eosinophilia in the blood plays an important role, higher level total IgE, allergen-specific IgE and IgG by ELISA, RAST, RIST, MAST; the presence of positive skin or provocative tests with allergens.

In the presence of a secondary infection, a bacteriological examination of smears is carried out; To detect pathogenic fungi, scrapings from smooth skin are studied. As part of the examination of children with dermatitis, it is important to examine the coprogram, feces for dysbacteriosis and helminth eggs, and conduct an ultrasound of the organs abdominal cavity. Sometimes with a purpose differential diagnosis A skin biopsy is performed.

During the examination, it is important to clarify the causes and form of dermatitis in children, as well as to exclude the presence of immunodeficiency diseases (Wiskott-Aldrich syndrome, hyperimmunoglobulinemia E), pityriasis rosea, microbial eczema, scabies, ichthyosis, psoriasis, skin lymphoma.

Treatment of dermatitis in children

The implementation of an integrated approach to the treatment of atopic dermatitis in children includes reducing or eliminating contact with the allergen, correct selection of diet, drug therapy, and allergen-specific immunotherapy. Systemic pharmacotherapy involves taking antihistamines, NSAIDs, enterosorbents, enzymes, vitamin preparations; for severe dermatitis in children - glucocorticoids. To relieve exacerbations of atopic dermatitis in children, hemosorption is used.

Topical therapy is aimed at eliminating inflammation and dry skin, restoring the barrier properties of the skin and preventing secondary infection. It includes external use of corticosteroid ointments, non-steroidal hydrolipidic creams, disinfectant liquids, lotions, and wet-dry dressings. For atopic dermatitis in children, non-pharmacological treatment methods have proven themselves well: reflexology, hyperbaric oxygenation, inductothermy, magnetotherapy, light therapy. For forms of atopic dermatitis in children that are resistant to traditional therapy, PUVA therapy can be used.

The basis for the treatment of seborrheic dermatitis is the correct organization of care for the affected skin using special antifungal shampoos and creams. Children are prescribed to wash their hair with dermatological shampoos with ketoconazole, ciclopirox, tar, etc.), which have fungistatic, fungicidal, keratoregulating and anti-inflammatory effects. After this, mineral or olive oil. To cleanse areas of seborrhea on smooth skin, special gels are used, after which the skin is lubricated with dermatological cream. On average, the course of treatment for seborrheic dermatitis in children lasts about 6 weeks.

In the treatment of diaper dermatitis in children, the main role is given to the organization of correct hygiene care: frequent changing of diapers and diapers, washing the child after each act of urination and defecation, taking air and herbal baths. The affected areas of the child's skin should be thoroughly dried, treated with powders and medicinal products hygiene products containing panthenol, dexpanthenol, piroctone olamine, etc.). Topical corticosteroids should be avoided when treating diaper dermatitis in children. Therapy for contact dermatitis involves avoiding exposure to aggressive substances on the skin. To relieve inflammation, zinc-based pastes, lanolin-based ointments, powders, and herbal decoctions are used.

Prevention

For any forms of dermatitis in children, general measures are important: hardening procedures, proper care take care of children's skin, use high-quality children's cosmetics and hypoallergenic hygiene products, wear clothes made from natural materials, etc. It is necessary to change diapers every 4 hours (or immediately after defecation), and avoid prolonged contact of the skin with secretions. Correction of the diet and normalization of the gastrointestinal tract are important.

For atopic dermatitis in children, contact with household and food allergens should be avoided. Long courses contribute to prolongation of remission

Behind last years The number of people suffering from allergies is growing steadily. Such a response of the body to irritants acquires alarming proportions.Children often develop allergic dermatitis, which over time can become chronic. Many parents do not know what can trigger the onset of the disease.

For any manifestations of allergies, you should contact medical care. Allergic dermatitis does not go away on its own; the patient needs proper treatment.

• indigestion due to gastrointestinal diseases, dysbacteriosis;
• poor nutrition (early introduction of complementary foods, inclusion of highly allergenic foods, citrus fruits in the diet);
• use of low-quality children's cosmetics and hygiene products;
• wearing clothes made from synthetic fabrics with added dyes;
• taking medications;
• infections of bacterial etiology;
• reaction to chemically active substances (alkali, acid);
• influence of radiation, temperature changes, mechanical effects;

Allergic dermatitis in children develops according to the standard pattern. A person is in constant contact with an allergen, which has a negative effect on the skin. The rash gradually begins to appear; it can be localized on any part of the body.

Several factors increase the risk of developing allergic dermatitis. Many of the sick are constantly faced with potential allergens:

• cosmetics;
• chemicals;
• medicines;
• toxicodendron plants;
• animal fur.

Types and symptoms of allergic dermatitis

Skin rashes may be accompanied by slight swelling in the affected area. Quite often, pimples fill with clear liquid and then burst, causing the wound to become wet. After some time, a dense crust forms on this area of ​​the skin, as can be seen in the photo below.

Often allergic reaction accompanied by characteristic symptoms, this helps doctors make a diagnosis and begin treatment without delay. If parents do not pay attention to the child’s complaints, the allergy will become chronic, leading to the formation of eczema on the skin.

Experts conditionally divide allergic dermatitis into 3 types - infant, child and adolescent:

• The first occurs in newborns. Dermatitis appears immediately after birth and accompanies the child until the age of 3. In this case, the rash affects the folds of the arms, legs and face. Often the allergy spreads throughout the body; this condition is caused by the stage of acquaintance with new food or the eruption of baby teeth.

• The childhood type of dermatitis is observed in children aged 3 to 12 years. Irritation affects the facial area, neck, and can be localized in the bends of the arms and legs. Often the rashes itch, small swelling and cracks appear. After scratching, the wounds heal and become crusty.
• During adolescence distinctive feature Allergic dermatitis is the spread of rashes throughout the body. There is no specific localization; acne can appear on any part of the skin and disappear on its own.

Quite often, allergies become chronic. Over a long period of life, dermatitis can be in remission, but the disease will return periodically.

Typical localization of childhood eczema

TO general symptoms The disease includes the appearance of small red pimples. Irritation is accompanied by itching; cracks and often weeping ulcers form on the affected area. With exacerbation of the disease, the symptoms intensify, itching forces the patient to scratch the skin.

Allergic dermatitis in a child does not always appear in those places where there is constant contact with the allergen. Most often in children and adults, rashes are localized in the groin, buttocks, arms, face and neck.

Allergic dermatitis can become chronic

Rashes on the face

In some patients, the rash is accompanied by coughing, watery eyes, and nasal congestion. Sometimes allergies do not interfere with the child at all, but sometimes the baby’s condition worsens and he needs help.

In most cases, diathesis is caused by foods that a child prone to allergic reactions is introduced to for the first time. Fragrances, dyes, and some fruits and vegetables can trigger skin rashes. It is not uncommon for children to develop a rash after contact with plants or animals. Allergy symptoms usually appear within half an hour.

Parents at home can use emollient creams, which, after application, reduce itching and bring some relief. Often, allergies to the face provoke swelling of the larynx (we recommend reading:). If a child's airway is blocked, he or she may suffocate. It is important to identify the allergen as soon as possible and try to protect the child from contact with it.

Cheek diathesis caused by food allergens

Stains on hands

Hands are the most common location for allergic dermatitis. When contacting an allergen, be it household chemicals or cosmetics, redness appears on the palms. The child experiences discomfort, hands itch, skin becomes tight and peels.

Often, hand allergies occur due to insect bites. Unbearable itching forces the child to scratch the inflamed area, which only aggravates his condition. Often, redness and rash on the hands appear due to eating sweets, coffee or cocoa, as well as after taking medications. Usually the rashes are localized on the back of the hands.

Changes in weather can also affect your baby's health. The skin of the hands, unprotected from wind and frost, reacts to external irritants with redness, swelling and itching. Special hand creams and warm gloves or mittens that can protect the skin from the vagaries of the weather will help correct the situation.

Allergies on the legs

Mostly irritation appears in the thighs, calves and legs. Often the rashes are localized under the knees. Allergic reactions can occur on the feet. In this place, irregularly shaped pimples and pustules appear, and the inflamed skin swells.

Allergic rash on the legs leads to terrible discomfort and limited mobility

Red itchy spots and blisters cause a lot of discomfort and lead to limited mobility. If a rash appears on a child’s legs, you should try to alleviate the child’s condition as quickly as possible.

Stages of dermatitis

When assessing the condition of a patient suffering from allergies, a doctor first tries to determine the stage of the disease. Based on the conclusions made, the issue of choosing treatment tactics is decided. There are 4 stages of allergic dermatitis:

1. The initial stage is accompanied by hyperemia, swelling of the skin, and peeling. If you start treating diathesis in children in time, you can soon forget about all the unpleasant symptoms forever. At the same time, improper treatment or its absence leads to the development of the next stage.
2. The pronounced stage of the disease occurs in chronic and acute forms. Rashes lead to the formation of crusts and scales at the site of inflammation.
3. The remission stage leads to a decrease or disappearance of all unpleasant allergy symptoms. This period can last for weeks and sometimes years.
4. At the stage of clinical recovery, all manifestations of atopic dermatitis completely disappear for several years.

Diagnosis of the disease

The doctor will not prescribe treatment until he identifies the nature of the rash, its location and the period of exacerbation. Laboratory tests help diagnose the disease:

• clinical blood and urine analysis;
• immunological and serological analysis;
• histological analysis of tissues;
• biopsy;
• interpretation of allergen tests.

The results obtained make it possible to identify the cause of the development of an allergic reaction in the patient. The doctor prescribes appropriate therapy. If you follow all medical recommendations, the specialist will be able to predict the timing of remission.

How to treat allergic dermatitis at home?

Knowing which allergen leads to rashes, you need to try to protect your child from contact with it. If allergies are caused certain products nutrition, they should not be on the baby’s menu.

The child must be protected from sources of allergies: create the most comfortable conditions, excluding any external irritants

Allergies often occur in children when exposed to external irritants. The main task Parents of sensitive children need to maintain cleanliness in the house and a certain level of air humidity. Pets should be given into good hands, and carpets and feather pillows should be disposed of forever.

Features of therapy for babies up to one year old

A mild form of allergy does not require hospitalization. Infants prone to allergies should be switched to a hypoallergenic diet. It is recommended to use gentle antihistamines prescribed from birth - Fenistil gel and drops, or from six months - Zyrtec drops.

With age, diathesis recedes, but not all children are so lucky (we recommend reading:). Sometimes a persistent allergy develops, leading to asthma. If the treatment does not give the desired results, there is no positive dynamics, and other diseases develop against the background of an allergic reaction, then the attending physician will suggest that the mother and child go to the hospital.

The advanced form of the disease is treated with glucocorticoids. Antibiotics will help get rid of pustules on the skin. Vitamin and mineral complexes will help improve the health of children under one year old.

Medicines for oral administration

Many medications can improve the patient's condition. They relieve allergy symptoms by reducing inflammation and itching. Antihistamines are often prescribed to treat allergic dermatitis. First generation drugs have a sedative effect.

Experts prefer modern medicines, such as:

• Cetrin;
• Zyrtec;
• Erius;
• Zodak.

Antihistamines 2 and 3 generations do not cause drowsiness or addiction. To achieve a clinical effect, such drugs must be taken for a long period of time. The dosage and course of treatment are determined by the doctor on an individual basis.

Often, irritation and itching force children to scratch their wounds - this is an open gateway to infection. Antiseptics help fight microorganisms. There are several effective drugs in the form of a solution for external use that can cope with staphylococci and streptococci:

• Chlorhexidine;
• Miramistin;
• Fucaseptol;
• Fukortsin.

Immunomodulators have proven their effectiveness in the fight against allergies. They are prescribed after consultation with an allergist when the disease is severe. Allergies should be treated with such drugs with caution, especially for those who have someone close to them in the family who suffers from autoimmune diseases. Interference with the immune processes occurring in a child’s body can lead to serious consequences.

Use of topical medications

• If the rashes are minor and mildly expressed, it is more advisable to use non-hormonal drugs: Fenistil, Keratolan, Radevit, etc.
• If the allergy is in a severe stage, irritation affects large areas of the body, the doctor may recommend hormonal ointments (Sinaflan, Akriderm, etc. (more details in the article:).
• In some cases, glucocorticosteroid drugs help relieve an allergic reaction on the skin. This group of drugs includes Advantan, Afloderm and Lokoid.

To make the affected areas heal faster, you can use ointments that accelerate tissue regeneration:

• Dexpanthenol;
• Bepanten;
• Actovegin.

Physiotherapy

Physiotherapy can help a child with allergic dermatitis recover faster. As a rule, physiotherapeutic methods are applied to patients in a hospital setting. The following physiotherapy procedures are considered the most effective:

• laser therapy;
• electrosleep;
• PUVA therapy;
• hydrotherapy;
• mud therapy;
• reflexology;
• ultraviolet irradiation.

Treatment with folk remedies

The list of medicinal herbs allowed for allergies is small. Suitable for therapy are string, periwinkle, celandine, hops, etc. To prepare a herbal decoction, you will need 3 tablespoons of dried and crushed plants and 1 liter of boiling water. The grass is being flooded hot water and leave for 4 hours. The resulting decoction is used to lubricate inflamed areas of the skin or make lotions.

However, you need to be careful: the body of children prone to allergic reactions may respond to treatment with folk remedies by increasing symptoms.

For a soda bath you will need 1 liter of boiling water and 1 tablespoon of soda. The soda must be completely dissolved in water. It is necessary to strictly observe the dosage, otherwise after the procedure there will be a feeling of dry skin.

Diet features

Atopic dermatitis requires a special diet. The child's menu should include hypoallergenic products. The baby's diet should be balanced. Serious restrictions in food will lead to disruption of its growth and development.

If a baby has an intolerance to cow's milk protein, then he is transferred to special formulas developed taking into account the individual characteristics of children suffering from allergies. If the child is breastfed, the mother must also take care of her nutrition. If possible, you should limit yourself to eating sweets, flour and salty foods. It is advisable to avoid foods such as honey, nuts, citrus fruits, strawberries, chocolate and spices.

With the introduction of complementary foods, many babies suffer from food allergic dermatitis, so new products must be introduced very carefully.

The source of the allergy may be oat or semolina, as well as products containing gluten. As a first complementary food, it is better to use zucchini or cauliflower. Then you can introduce your baby to dairy-free cereals. When the child is 7-8 months old, you can offer him turkey or rabbit meat.

Compliance with certain household rules

Allergic dermatitis is accompanied by damage to the skin, so parents should know how to properly care for their child's skin. Experts recommend adhering to the following household rules:

• In the children's room the air should be humid.
• Contact with animals and plants should be avoided whenever possible.
• It is necessary to keep the house clean. Wet cleaning should be carried out on a regular basis. No chemicals are allowed.
• It is necessary to select hypoallergenic hygiene products.
• It is necessary to choose clothes made from natural materials. Woolen products should not come into contact with the skin.

How dangerous is allergic dermatitis?

Allergies cannot be ignored. Without starting treatment for allergic dermatitis, parents increase the chances of their child developing bronchial asthma. The number of skin rashes is gradually decreasing, but this does not indicate victory over allergies, but the transformation of the disease into a new form.

Atopic dermatitis is an inflammatory allergic skin disease that is caused by allergens and toxins, another name is childhood eczema. Atopic dermatitis in children of the first years of life is more likely a congenital disease than an acquired one, since the determining factor in the mechanism of its occurrence is a hereditary factor and often children, in addition to dermatitis, suffer from other allergic manifestations - food allergies, bronchial asthma. Taking into account age, doctors distinguish 3 forms of the disease:

• Infant from 0 to 3 years;
• Children's from 3-7 years;
• Teenage

In babies under 6 months, the disease appears in 45% of cases. In the first year of life, 60% of children suffer from allergies, after 5 years - 20% of children. Treatment of atopic dermatitis in children presents serious difficulties for doctors, since it is chronic, recurrent and combined with other concomitant diseases.

Causes of atopic dermatitis in a child

The main cause of atopic dermatitis in children is a combination of genetic predisposition to allergic manifestations in combination with unfavorable factors environment. If both parents show signs of hypersensitivity to any irritants, then their children have an 80% risk of atopic dermatitis; if one of the parents has atopic dermatitis, the child may suffer from atopy in 40% of cases.

Food allergies

The manifestation of atopic dermatitis in the first days (months) of a child’s life is primarily due to food allergies. It may be provoked poor nutrition women during pregnancy and during breastfeeding(abuse of highly allergenic foods), overfeeding the baby, a woman’s refusal to breastfeed, early introduction of complementary foods. And also appear when the function of the baby’s digestive system is impaired, or with viral infectious diseases.

Difficult pregnancy

Health problems in a woman while carrying a child (threat of miscarriage, exacerbation of chronic diseases, infectious diseases, fetal hypoxia) can also influence the child’s tendency to allergies and atopy.

Accompanying illnesses

Most often, atopic dermatitis occurs in children with concomitant gastrointestinal diseases:

• gastritis,
• helminthic infestations (see,).

Other allergens

Except food products, other household allergens, such as inhalant irritants (pollen, dust, house mites, household chemicals, especially washing powders, fabric softeners, chlorine-containing cleaners, air fresheners), contact allergens (baby care products, some creams), medications , act as provocateurs of atopic dermatitis.

What other factors influence the development of the disease or its exacerbation?

• Relapse of childhood atopic dermatitis is caused by stress, psycho-emotional stress, nervous overexcitation
• Passive smoking affects general state child's health and skin condition, including
• General unfavorable environmental situation - high content of toxic substances in the air emitted by transport and industrial facilities, abundance of chemicalized food products, increased background radiation in some areas, intense electromagnetic field in large cities
• Seasonal weather changes that increase the risk of infectious diseases and immune system stress
• Physical activity accompanied by excessive sweating

Atopic forms of dermatitis arise due to any of the reasons mentioned above or in combination with one another, the more combinations, the more more complex form manifestations.

With the development of atopic dermatitis in children, treatment must be comprehensive, so consultation with several specialists is required - a dermatologist, an allergist, a nutritionist, a gastroenterologist, an ENT doctor, a neuropsychiatrist.

What are the signs of atopic dermatitis?

Signs of the disease in children under one year of age include: eczema of the skin, affecting many areas of the body, mainly the face, neck, scalp heads, extensor surfaces, buttocks. In older children and adolescents, the disease manifests itself as skin lesions in the groin area, armpits, on the surface of the folds of the legs and arms, as well as around the mouth, eyes, and neck - the disease worsens in the cold season.

Symptoms of atopic dermatitis in a child from the onset of the disease can manifest as seborrheic scales, accompanied by increased sebum secretion, the appearance of yellow crusts and peeling in the eyebrows, ears, fontanel, on the head, redness on the face, mainly on the cheeks with the appearance of keratinized skin and cracks with constant itching , burning, scratching.

All symptoms are accompanied by weight loss, restless sleep baby. Often the disease makes itself felt in the first weeks of a child’s life. Sometimes atopic dermatitis is accompanied by pyoderma (pustular skin lesions). The main symptoms of the disease are as follows:

For the chronic form of atopic dermatitis, characteristic manifestations are increased skin pattern, thickening of the skin, the appearance of cracks, scratching, and pigmentation of the skin of the eyelids. With chronic atopic dermatitis, its typical symptoms develop:

• Redness and puffiness of the foot, peeling and cracking of the skin are a symptom of winter foot
• Deep wrinkles in large quantities on lower eyelids in children this is Morgan's sign
• Thinning hair on the back of the head is a symptom of a fur hat

It is necessary to take into account and analyze the occurrence of the disease, its course, the degree of damage to the skin, as well as heredity. Usually identified with, sometimes it can also be observed in children. Clinical picture depends on the age category of the child, and is characterized in each period of life by its own peculiarity.

For children under one year old, dermatitis can occur in the form of:

• Seborrheic type - manifested by the appearance of scales on the baby’s head in the first weeks of his life (see).
• Nummular type - characterized by the appearance of spots covered with crusts, appears at the age of 2-6 months. This type is localized on the child’s limbs, buttocks and cheeks.

By 2 years, in 50% of children, manifestations disappear. In the remaining half of children, skin lesions are localized in folds. A separate form of damage to the soles (juvenile palmoplantar dermatosis) and palms is noted. With this form, seasonality plays an important role - complete absence symptoms of the disease in the summer, and exacerbation in the winter.

Atopic dermatitis in infants and older children should be distinguished from other skin diseases, such as psoriasis (see), scabies (see symptoms and treatment of scabies), seborrheic dermatitis, microbial eczema, pityriasis rosea(see), contact allergic dermatitis, immunodeficiency state.

Stages of development of atopic dermatitis

Determining the stage, phase and period of onset of the disease is important in deciding questions about treatment tactics for a short-term or long-term program. There are 4 stages of the disease:

• Initial stage - develops in children with exudative-catarrhal type of constitution. This stage is characterized by hyperemia, swelling of the skin of the cheeks, and peeling. This stage, with timely treatment and a hypoallergenic diet, is reversible. With inadequate and untimely treatment, it can progress to the next (severe) stage.
• Expressed stage – goes through a chronic and acute phase of development. The chronic phase is characterized by a sequence of skin rashes. The acute phase manifests itself as microvesiculation with the subsequent development of scales and crusts.
• Remission stage - during the remission period, symptoms decrease or disappear altogether. This stage can last from several weeks to several years.
• Clinical recovery stage – at this stage there are no symptoms for 3-7 years, which depends on the severity of the disease.

Treatment of atopic dermatitis

In severe cases of atopic dermatitis in children, treatment requires the use of local corticosteroid drugs, together with emollients. This will serve to quickly eliminate symptoms. Moisturizers and emollients are used during any period of the disease. The goal of treatment is to:

• Change in the course of the disease
• Reducing the severity of exacerbation
• Long-term disease control

An indication for hospitalization of a child may be an exacerbation of the disease, as a result of which the general condition is disrupted, recurrent infections, or the ineffectiveness of the therapy.

Non-drug treatment consists of measures aimed at minimizing or eliminating the effects of factors that provoked an exacerbation of the disease: contact, food, inhalation, chemical irritants, increased sweating, stress, environmental factors, infections and microbial contamination, disruption of the epidermis (hydrolipid layer).

Drug treatment atopic dermatitis in children is prescribed taking into account the period, stage and form of the disease. The age of the child, the area of ​​affected skin and the involvement of other organs during the course of the disease are also important. There are means for external use and systemic action. Pharmacological drugs systemic action, used in combination or as motor therapy, including the following groups of medications:

Antihistamines

There is currently insufficient evidence of the effectiveness of antihistamines for the treatment of atopic dermatitis in children. Drugs with a sedative effect (suprastin, tavegil) are prescribed for significant sleep problems due to constant itching, as well as when combined with urticaria (see) or concomitant allergic rhinoconjunctivitis.

Among antihistamines for allergies today, the most preferred are 2nd and 3rd generation drugs, such as Eodac, Zyrtec, Erius - these drugs have a prolonged effect, do not cause drowsiness, addiction and are considered the most effective and safe, available both in the form of tablets and in the form of syrups, solutions, drops (see). Clinical effect the effects of using these drugs are felt after a month, so the course of treatment should be at least 3-4 months.

However, for the treatment of atopic dermatitis, the effectiveness of antihistamines without sedation has not yet been proven and the need for their use is determined by the doctor in each clinical case. Also, the effectiveness of oral administration of cromoglycic acid and ketotifen for atopic dermatitis has not been proven.

Antibiotics

The use of systemic antibiotics is justified only if bacterial infection of the skin is confirmed; long-term use antibacterial drugs not acceptable. Antibiotics and antiseptics are prescribed externally for skin infections with streptococci and staphylococci:

• Antiseptic solutions - Chlorhexidine, Fucaseptol, hydrogen peroxide, brilliant green alcohol solution 1-2%, fucorcin
• Antibiotics - Bactroban ointment (mupirocin), Fucidin (fusidic acid), Levosin (levomycetin, sulfadimethoxin, methyluracil), neomycin, gentamicin, erythromycin, lincomycin ointments, Levomikol (levomycin + methyluracil)
• Xeroform, dermatol, furatsilin ointments
• Argosulfan, Sulfargin, Dermazin
• Dioxidine ointment

They need to be used 1-2 times a day. In case of severe pyoderma, additional systemic antibiotics are prescribed (see). Before treatment with antibiotics, it is recommended to first determine the sensitivity of the microflora to most known drugs.

Systemic immunomodulatory therapy

Uncomplicated atopic dermatitis does not require the use of immunomodulators. Only after a thorough diagnosis can an allegrologist-immunologist prescribe immunomodulators in combination with standard therapy local means in case the symptoms of dermatitis are combined with signs of immune deficiency.

The danger of using immunostimulants and immunomodulators in children is that if close relatives have any autoimmune diseases (insulin-dependent diabetes mellitus, rheumatoid arthritis, Sjögren's syndrome, diffuse toxic goiter, multiple sclerosis, vitiligo, myasthenia gravis, systemic lupus erythematosus, etc.) even a one-time use of immunomodulators can cause the onset of an autoimmune disease in a child. Therefore, if there is a hereditary disposition of the child to autoimmune diseases, you should not interfere with immune processes, as this may result in hyperactivation of the immune system, triggering immune aggression on healthy organs and tissues.

Vitamins and herbal medicines

Vitamins B15, B6 help to increase the effectiveness of treatment, thereby accelerating the process of restoration of functions of the liver cortex and adrenal glands and accelerating repair processes in the skin. Increases the resistance of membranes to toxic substances, regulates lipid oxidation, stimulates the immune system. However, in a child with a tendency to allergies, some vitamin complexes or certain vitamins, as well as herbal medicines (medicinal herbs, decoctions, infusions) can cause a violent allergic reaction, so the use of vitamins and herbal medicines should be treated with great caution.

Medicines that restore the functioning of the gastrointestinal tract

Drugs that restore or improve the activity of the gastrointestinal tract are indicated in subacute and acute period s diseases, taking into account the identification of changes in the functioning of the digestive system. They are used to improve digestion, correct impaired functions, these are Panzinorm, Pancreatin, Creon, Digestal, Enzistal, Festal, as well as choleretic drugs and hepatoprotectors: Gepabene, Allohol, corn silk extract, Hofitol, Leaf 52, . Duration of treatment is 2 weeks.

Antifungal and antiviral drugs

When the skin is affected by fungal infections, external antifungal agents are prescribed in the form of creams: clotrimazole (Candide), natamycin (Pimafucin, Pimafucort), ketoconazole (Mikozoral, Nizoral), isoconazole (Travocort, Travogen). Upon joining herpetic infection shown antiviral drugs(see list).

Sanitation of foci of infection

One should remember about the treatment of concomitant diseases, the purpose of which is to sanitize foci of infection - in genitourinary system, biliary tract, intestines, ENT organs, oral cavity. Depending on the phase of the disease, antibacterial, keratoplasty, anti-inflammatory, and keratolytic skin care preparations are used.

Anti-inflammatory drugs for external use are divided into 2 groups: those containing glucocorticoids and non-hormonal drugs.

Glucocorticoids– effective for chronic and acute forms manifestations of the disease in children. Such creams are not used as prophylaxis; moreover, glucocorticosteroid ointments and creams should be used strictly as prescribed by a doctor, in short courses, followed by gradual withdrawal of the drug (see the list of all hormonal ointments in the article).

The danger of prolonged and uncontrolled use of such drugs is the development of systemic side effects, inhibition of the function of the adrenal cortex, decreased local and general immunity, the development of skin atrophy, thinning, dry skin, the appearance of secondary infectious skin lesions, etc. If without such strong means However, you can’t do without it, you should know the rules for their use:

• These remedies are divided into: strong, moderate and weak activity. To treat atopic dermatitis in children, you should start with the weakest concentrated hormonal drugs. It is possible to increase the concentration only if the previous remedy is ineffective and only as prescribed by a doctor.
• Any hormonal ointments are used in short courses, then take a break and reduce the dose of the drug.
• Abrupt cessation of use worsens the condition and causes relapse of the disease.
• At first, pure cream is used, and when it is gradually withdrawn, the required volume of cream or ointment is mixed 1/1 with baby cream, after 2 days of such use the concentration is further reduced, already 2 parts of baby with 1 part of hormonal cream, after 2 days 3 parts of baby 1 part of the hormonal one.
• If you have to use local hormonal agents for a long time, a change in the drug, which contains another hormone, is required.
• To eliminate puffiness, use the cream at night; to eliminate plaques, use it in the morning.

Non-hormonal - For minor manifestations of dermatitis, antihistamines are prescribed (Finistil gel 0.1%, Gistan, see). Creams are also prescribed - Vitamin F 99, Elidel, Radevit (see).

• Burov's fluid - aluminum acetate
• Videstim, Radevit - fat-soluble vitamins
• ASD paste and ointment
• Zinc ointments and pastes - Tsindol, Desitin
• Birch tar
• Ichthyol ointment
• Naftaderm - liniment of Naftalan oil
• Fenistil gel
• Keratolan ointment - urea
• NSAIDs (see)

Treatment with creams and ointments with healing properties is also effective for atopic dermatitis; they enhance tissue regeneration and trophism:

• Dexpanthenol - creams and sprays Panthenol, Bepanten
• Gel Curiosin (Zinc hyaluronate)
• Solcoseryl - ointments and creams, gels with calf blood hemoderivat
• Methyluracil ointment (also an immunostimulant)
• Radevit, Videstim (retinol palmitate, that is, vitamin A)
• Cream "Forest Power" with Floralizin is a very effective cream for any skin diseases - eczema, dermatitis, psoriasis, herpes, for dry and cracking skin. Contains Floralizin - a complex of natural biologically active substances- this is an extract from mushroom mycelium, contains enzymes with collagenase activity, vitamins, minerals, phospholipids. Ingredients: floralisin, petroleum jelly, pentol, fragrance, sorbic acid.

Among the immunomodulators, cream-gel can be distinguished Thymogen, its use is possible only as prescribed by a doctor.

Diet for the treatment of atopic dermatitis in children

Diet during treatment plays an important role, especially in infants. Based on the prognosis of the disease, it is necessary to exclude products containing the allergen. In the first year of life, children may be sensitive to cow's milk proteins, eggs, gluten, cereals, nuts, and citrus fruits (see). In case of allergy to cow's milk, you can use soy mixtures: Frisosoy, Nutrilak soya, Alsooy.

For allergic reactions to soy proteins and severe forms food allergies, you need to use hypoallergenic mixtures: Pregestimil, Nutramigen, Alfare (Nestlé).

The introduction of each new product into food must be agreed with a doctor, no more than 1 product per day and in small portions. It is necessary to exclude foods that cause allergies in children if their intolerance is confirmed (you can take a blood test for a specific allergen).

Physiotherapy

It is indicated in acute and remission periods of the disease and includes:

• In the acute period - electrosleep, use magnetic field, carbon baths;
• During remission - balneotherapy.

Full recovery, based on clinical data, occurs in 17-30% of patients; the rest of the children suffer from this disease throughout their lives.

How do modern dermatologists diagnose and treat atopic dermatitis in children? Is it possible to prevent the development of the disease? How can traditional medicine and other alternative methods help?

The article was written based on materials kindly provided by the chief pediatric dermatologist of Yekaterinburg I.G. Lavrik, as well as taking into account information from forums and personal experience author on treatment of this disease with my eldest child.

Atopic dermatitis is considered one of the most common allergic diseases today. According to studies conducted in Russia and abroad, 30-40% of children suffer from atopic dermatitis. It usually begins in the first year of life and tends to become chronic or progress with frequent exacerbations.

Atopic dermatitis is a disease that brings a lot of trouble not only to the sick child, but also to his entire family. First of all, it is itching of the skin, which makes the child nervous and disrupts normal sleep, and skin rashes on open areas of the body (face, hands). Irrational and untimely treatment significantly aggravates the course of the disease – this is the position modern medicine. Even with minimal manifestations of this disease, it is necessary to ensure proper care of the child’s skin, as well as environmental control.

Parents and the entire family as a whole must understand that the basis of the disease is complex mechanisms development. It doesn’t matter which method you choose to help your child - treatment by a dermatologist in a local clinic, consultations with eminent professors and doctors of science, working with a psychotherapist or using homeopathy. First of all, you need to find a professional who will look for deep causes, and not be content with just eliminating itching and weeping areas on the baby’s body. Secondly, parents and even the child himself should prepare to work seriously with such a professional and not expect instant treatment results. Only understanding, patience and cooperation with doctors are the key to success in overcoming this disease.

What is atopic dermatitis and how to recognize it?

According to modern (European) medicine, atopic dermatitis is based on allergic inflammation and increased skin reactivity. It is believed that the disease occurs more often in children with a hereditary predisposition to allergic diseases:

If both parents suffer in a family allergic diseases(any), then the risk of atopic dermatitis in a child is 60-70% ,

If this is one of the parents, this risk is equal to 40-50% ,

If there are no patients with allergic diseases in the family, then the risk of developing atopic dermatitis in the child is significantly less - 13-15% .

Depending on the age of the child, atopic dermatitis manifests itself in various skin changes. Therefore, there are several forms (stages) of the disease: infant, childhood and adolescence.

Infant form

atopic dermatitis observed in a child in the first year of life and is called diathesis (exudative-catarrhal diathesis). The skin of these children is red, swollen, and covered with tiny blisters (vesicles). The bubbles “burst” and a bloody liquid is released from them, which, when dried, turns into a yellowish-brown crust. This form is characterized by itching of the skin of varying intensity, intensifying at night, with the formation of scratch marks and cracks. The infantile form of atopic dermatitis most often affects the face, with the exception of the nasolabial triangle. Skin rashes can be observed on the arms and legs (usually in the popliteal folds), and on the buttocks. These children are more prone to developing so-called diaper dermatitis, as well as severe intolerance to wool.

Children's uniform

atopic dermatitis is observed in children aged from 1.5 to 12 years. They experience redness and swelling, nodules, crusts, the integrity of the skin is disrupted, the skin thickens and its pattern intensifies.

Teenage form

registered in children over 12 years old and is characterized by the presence of bluish-red plaques with blurry boundaries, severe dry skin, many cracks, accompanied by severe itching. Favorite localization is the flexor surfaces of the arms and legs, wrists, dorsum of the feet and hands.

Dermatologists say: the earlier treatment is started, the higher the likelihood of success, - and they advise starting to treat the child at the first manifestations of the disease, because by the time it goes into its teenage form, it may no longer be possible to completely get rid of it. Position traditional medicine is less categorical in this regard, but even here it is believed that the body of a small child is much more plastic and receptive to therapy than the body of a teenager. Another thing is that some traditional methods(for example, hirudotherapy or reflexology) due to their pain and some other factors, there is no point in using them in very young children.

Causes of atopic dermatitis

The development of atopic dermatitis is closely related to exposure to various allergens, that is, substances that cause an allergic reaction.

In children of the first year of life, one of the first allergens that causes the development of atopic dermatitis is cow's milk. This is facilitated by early transfer to mixed or artificial feeding using formula milk.

Allergic reactions in most cases are caused by products such as:

- eggs

- fish and seafood

- nuts, honey, chocolate

- strawberries, citrus, grapes

- tomatoes, carrots, beets, mushrooms

In recent years, allergies to foods have become more common in children. bananas, kiwi, avocado, persimmon, pomegranates. Use celery, parsley, raw onions, sauerkraut, spices, meat and chicken broths enhances the manifestations of atopic dermatitis.

It is necessary to understand that this is a standard list of products that provoke allergies, but each case is individual. An individual child may have absolutely clear skin after eating oranges and chocolate, but at the same time have a sharp allergic reaction to a green apple or, it would seem, very low-allergenic buckwheat.

You can often hear this opinion, especially from “experienced” grandmothers: “Let him eat everything, he will be stronger, and the diathesis will grow away.” Relying on such advice is fraught. If specialists from traditional medicine can still, with some reservations, accept this position, then dermatologists will definitely challenge it with one voice. The fact is that with age, the role of food allergies decreases, and allergens present in the air begin to predominate. These include, first of all, microscopic mites that live in house dust, plant pollen, allergens of domestic animals, as well as birds (feather and down). Therefore, it may feel like the child has “grown out” of the skin rashes: yes, the skin has been clean for a long time, but, for example, it came from “somewhere” severe runny nose during the spring flowering period. The original problem has not gone away, it has simply transformed.

In older children it is possible cross allergic reactions. For example, intolerance to apples in people allergic to birch pollen. Cross-reactions may occur between fungal allergens and products containing fungi. Such products include kefir, confectionery products from yeast dough, fizzy drinks(for example, kvass). In recent years great importance given to hidden allergens. For example, sausages and other products may contain proteins from cow's milk and chicken eggs, and fungal allergens may be found in cheese and fruit juices.

Increased skin allergies can be caused by dyes used in the textile industry. In this regard, patients with atopic dermatitis should wear undyed products made from natural fibers. In addition, skin contact with leather products should be avoided.

The effect of allergens is enhanced by:

Climatic, geographical factors,

Errors in diet (family values ​​in nutrition),

Failure to follow skin care rules

Household risk factors (indoor air temperature above +23, air humidity less than 60%, presence of pets, smoking indoors),

Psychological stress,

Acute viral infections.

There are a huge number of reasons for a child’s increased susceptibility to allergens, in addition to the already mentioned hereditary factor. That's the point the art of a doctor, to find the key that will open the way to treatment for a particular child. It could be state gastrointestinal tract , And neurological problems, and, more deeply, a psychologically unfavorable situation in the family or psychological problems in the mother, reflected on the child, as in a mirror. Plays by no means the least role ecology (and sometimes this factor is put in one of the first places). IN oriental medicine skin problems symbolize fear, which is constantly present in the child or his mother. In homeopathy, skin rashes are good signal, meaning that the disease is at the most superficial level, and the body effectively fights it. In the absence of obvious concern for the patient, some homeopaths try not to “touch” the skin rash in order to give the body the opportunity to cope with its own problem without the use of drugs.

Prevention of atopic dermatitis

Prevention of atopic dermatitis should begin as early as before the baby is born, especially if the mother has a predisposition to this disease. Experts have developed a hypoallergenic diet specifically for this purpose. for pregnant and nursing mothers.

Patients predisposed to diseases of an allergic nature are excluded from the diet. products that have high allergenic properties and provoke the development of disease (the entire list or part of it, depending on the complexity of the mother’s illness) :

It is forbidden

fish, caviar, seafood;

fatty meat and poultry products, fatty dairy products;

eggs, mushrooms, nuts, honey;

pickled foods, hot seasonings, vinegar, sauces, hot and processed cheeses;

cocoa, chocolate, coffee, tea (other products containing caffeine);

vegetables: tomatoes, eggplants, radishes, radishes, horseradish, beets, carrots, celery;

fruits and berries: citrus fruits, pineapples, melon, persimmons, pomegranates, grapes, strawberries, raspberries, blackcurrants, blackberries, sea buckthorn, dried apricots, raisins;

foods high in carbohydrates (cakes, pastries, sweets);

strong alcoholic drinks, red wine, carbonated drinks, kvass.

You can (hypoallergenic diet according to A.D. Ado):

soups (cereal, vegetable, secondary beef broth),

boiled meat (beef, lamb, rabbit, turkey),

one-day fermented milk products (kefir, cottage cheese, yogurt),

compotes (from apples, dried fruits, currants, cherries),

fresh vegetables (cucumbers, dill, parsley),

boiled vegetables (cabbage, potatoes, zucchini, pumpkin),

porridge (rice, pearl barley, buckwheat, wheat, oatmeal, corn),

light apples (baked), watermelon, pears, plums,

inconvenient baked goods,

oil (olive, sunflower, corn).

It is very important to exclude expectant mother other nonspecific factors, contributing to the development of the disease:

stop smoking;

avoid stressful situations;

limit contact with household chemical products (washing powders, varnishes, paints, solvents, etc.);

use only hypoallergenic detergents and skin care products;

wear underwear made of cotton fabrics.

But diet and others like it are just the tip of the iceberg. Preparing for pregnancy and pregnancy itself is a good opportunity to understand the underlying causes the expectant mother's inclinations to allergies, ranging from intestinal conditions to psychotherapeutic consultations and work on a spiritual level.

Very important preventive measure for a newborn baby environmental control measures are:

Eliminate smoking in the house,

Maintain indoor relative humidity above 60%,

Change bed linen 1-2 times a week,

Dry clothes outside

Avoid clothing based on fur and animal hair,

Avoid contact with plant pollen, refuse treatment with plant extracts,

Bathing a child in non-hot water

Do not rub, but blot the baby’s skin with a towel,

Immediately after bathing, apply softening and moisturizing creams.

In the second part of the article - approaches to the problem of atopic dermatitis and various types his treatment.