Children’s eczema: An itch that persists into adulthood?

Children with itchy, dry skin caused by atopic dermatitis are likely to have these symptoms persist on and off throughout their life, according to a study in JAMA Dermatology.

Atopic dermatitis (a type of eczema) is a common skin disease that often begins before age 2 and is believed to disappear by about age 12, according to background information in the study.

But after analyzing the records of thousands of children with atopic dermatitis and following them for up to five years, researchers with the University of Pennsylvania concluded that the disease “is a lifelong illness with periods of waxing and waning skin problems.”

About the study

Researchers used data from the Pediatric Eczema Elective Registry (PEER). PEER was started in 2004 by companies that manufactured creams to treat atopic dermatitis as part of the U.S. Food and Drug Administration’s drug approval process.

A total of 7,157 children with dermatitis were involved in the study. Most of them had been diagnosed with dermatitis before age 2. Their ages at the start of the study ranged from 2 to 17 years old.

Every six months, caregivers or physicians filled out surveys about the children’s symptoms and treatment.

Information was collected for at least two years for 4,248 children; the rest of the children were followed for at least five years.

Researchers found that most of the children reported needing medication to treat their dermatitis symptoms well into their 20s. By age 20, only half of study participants experienced at least one month in which they were both symptom-free and not using medication. But in most cases, this was only a temporary lull.

“Based on our findings, it is probable that [atopic dermatitis] does not fully resolve in most children with mild to moderate symptoms,” the study authors wrote.

The authors acknowledged that their findings conflicted with those of previous studies. One possible reason for the discrepancy, they theorized, was that the children enrolled in PEER had more severe, and so more persistent, atopic dermatitis.

“It is possible that our results do not generalize to all children with [the disease”],” they wrote.

The take-home message
Conventional wisdom that most cases of atopic dermatitis resolve within about 10 years of diagnosis may be incorrect, especially in children with severe cases of the skin disease. The study’s authors suggest that physicians and parents let children know that the disease may persist for decades, if not throughout their life.

Atopic dermatitis can’t be cured, but parents can do many things to help their children feel better. Find out how with this guide to childhood eczema.

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