My daughter has atopic dermatitis. Are biologics helpful at 28?

Question

Hello doctor,

My 28-year-old daughter has had atopic dermatitis since childhood. The itching and dryness have worsened recently, especially around her neck and wrists. We use moisturizers and mild steroid creams, but flare-ups keep coming back.

Could this mean her skin barrier is getting weaker?
She also has seasonal allergies. Could that make eczema worse?
Are there any newer non-steroidal creams or biologic injections that can help severe cases?

I would like to know if dietary changes, like avoiding dairy or gluten, actually make any difference in symptom control.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I would like to know that eczema is a chronic inflammatory condition that is autoimmune in nature, which presents with itchy rashes over the skin. No, it does not make the skin barrier weak in any way.

You do not need allergy tests, as you could be allergic to materials or pollen that you may not be able to avoid. Also, generally, antihistamines and steroids control the acute attacks, but you may need to take them in a controlled manner to prevent attacks.

Lifestyle also plays an important role in preventing flare-ups. This includes:

Having a sleep schedule.
Exercise routine.
Stress management.
Avoiding hormonal disturbances.
You need to eat a healthy, nutritious diet.
Drink plenty of fluids orally.
Take enough vitamin D through diet, as well as minimal sunlight exposure.

Continue to use a moisturizer that contains 10 percent urea and ceramides for continued hydration. You may avoid certain foods (as you mentioned that you are allergic to them) and fabrics, animal dander, and others, if you feel they cause flare-ups. Increase consumption of anti-inflammatory foods in your diet.

Yes, biologic drugs are available, like Dupilumab, which is quite effective. These biologics do not have many side effects and are widely used for controlling intense symptoms. You can talk to your primary treating physician about biologic treatment options they can safely prescribe under their supervision.

However, there may still be recurrence after use of biologics. So symptoms can be controlled, but the condition has no cure. Use mild fragrance and chemical-free soaps and lotions as much as possible.

Kindly send images so that I can see the severity of symptoms and prescribe accordingly.

I hope this helps.

Thank you.