What is Atopic Dermatitis?
Atopic Dermatitis (AD), is a multi-factorial, chronic skin condition prone to relapse – brought about by an interplay between immunological, genetic and environmental variables. It is commonly known as eczema in most cases, even though dermatitis conditions can really represent itself in different forms. Characteristics of ADi nclude chronic inflammation, broken skin or epithelial barrier, immunological abnormalities and increased serum IgE(1). Red, inflamed and pruritic rash or lesions are commonly observed on patients with AD. It is estimated that AD affects approximately 20% of children in most developed countries. However, in low income countries, the prevalence of AD has continued to rise across the years. In adults, the prevalence of AD ranges from 1% – 3%(2).
Studies have demonstrated that
- There is an increase prevalence of AD in populations living in geographic locations with higher altitudes and reduced sun exposure and hence, reduced Vitamin D production(3).
- A deficiency in Vitamin D levels increases an individual’s risk of developing AD(4).
- AD patients are usually found to have lower zinc serum levels(8).
What Causes Atopic Dermatitis?
- Skin Barrier Defect
The epidermis of AD patients exhibits abnormalities in the skin barrier function that could result in excessive fat and water loss. This increases their sensitivity to the penetration of allergens, bacteria, fungal, viral invasions and inflammations(1).
- Immune Dysregulation
When a foreign protein e.g. bacteria, virus or allergen presents itself to our body’s immune cells, a cascade of complex immunological reactions occurs as different immune cells communicate with one another via secretion of biochemical substances in an attempt to get rid of the causative agent (the ‘foreign protein’). Ironically, being a double-edged sword, these immunological reactions can cause harm to normal body cells too. AD is a result of such a scenario when the immune cells turn on the skin.
Dietary Supplements and Food Preferences:
Vitamin D, Vitamin C (5) with Quercetin as well as Vitamin A, zinc (6,7,8) as well as a good probiotics are all important supplements to restore the skin integrity and control the severity and prevalence of an attack. The dosage and as well as quality of the supplements are as important in ensuring that the vitamins and minerals as well as good bacteria are able to be absorbs and in the right quantities needed by the body.
As patients with atopic dermatitis usually have other conditions such as food allergies, it is advisable for patients to avoid the common allergens such as soy, diary, gluten and sugars. Processed foods usually contain a high amount of these and hence should be avoided. Probiotics are also encouraged to keep a healthy gut flora. Additionally, a diet rich is healthy fats e.g. fish, avocadoes, and coconut oils are also a great way to build a healthy lipids level in the skin to promote a good skin barrier function.
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1. Umar M, Sastry K, Al Ali F, Al-Khulaifi M, Wang E, Chouchane A. Vitamin D and the Pathophysiology of Inflammatory Skin Diseases. Skin Pharmacol Physiol. 2018;31(2):74-86. doi:10.1159/000485132
2. Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy. 2013;69(1):3-16.doi:10.1111/all.122702.
3. Weiland SK, Husing A, Strachan DP, Rzehak P, Pearce N; ISAAC Phase One Study Group: Climate and the prevalence ofsymptoms of asthma, allergic rhinitis, and atopic eczema in children. Occup Environ Med 2004; 61: 609–615.
4. Cheng HM, Kim S, Park GH, Chang SE,Bang S, Won CH, Lee MW, Choi JH, Moon KC: Low vitamin D levels are associated with atopic dermatitis, but not allergic rhinitis, asthma, or IgE sensitization, in the adult Korean population. J Allergy Clin Immunol 2014; 133: 1048–1055.
5. Wang K, Jiang H, Li W, Qiang M, Dong T, Li H. Role of Vitamin C in Skin Diseases. Front Physiol. 2018;9. doi:10.3389/fphys.2018.00819
6. Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients. 2017;9(8):866. Published 2017 Aug 12. doi:10.3390/nu9080866v
7. http://www.progressivehealth.com/zinc-deficiency-and-eczema.htm Accessed 26 Nov 2018
8. Kim J, Yoo S, Jeong M, Ko J, Ro Y. Hair Zinc Levels and the Efficacy of Oral Zinc Supplementation in Patients with Atopic Dermatitis. Acta Dermato Venereologica. 2014;94(5):558-562. doi:10.2340/00015555-1772