Therapies for atopic dermatitis, climate change is also “bad” for the skin: cases of eczema on the rise

Therapies for atopic dermatitis, climate change is also “bad” for the skin: cases of eczema on the rise


OfVera Martinella

Overheating, fires and urbanization have direct biological effects on atopic dermatitis. This is indicated by a scientific review that analyzed various environmental risks. From March 23rd free visits in 40 Italian hospitals

It is now well known that pollution and climate change have consequences on our health and a new study, published by American scientists in «Allergy»adds a new piece regarding the Atopic dermatitis (or eczema) which affects millions of Italians, both in childhood and adulthood.

The authors of the research carried out a review of the scientific literature on climate risks linked to greenhouse gas emissions for those suffering from atopic dermatitis and the conclusions indicate their impact on the spread of the diseaseon its severity and on exacerbations, with obvious consequences on the increase in necessary therapies.

«Californian colleagues have taken this into consideration 10 climate risks – tells Maria Concetta Fargnoli, vice president of the Italian Society of Dermatology and Sexually Transmitted Diseases (SIDeMaST) —: overheating, heat waves, drought, excessive rainfall, fires, floods, storms, rising sea levels, ocean climate change and urbanization. The data evaluated came from several studies, most of which analyzed the impact of a single climate factor on dermatitiswithout however considering the complex interactions between the various climatic events and their possible “enhanced” effects”.

Too many bad bacteria on the skin

Numerous previous studies had already clarified this a direct link between eczema and air pollution. Now it emerges that overheating, fires and urbanization, in particular, also have direct biological effects. «Without considering that the pollutants in the air (particulate matter and volatile organic compounds deriving from traffic) increase with many climate changes – continues Fargnoli, head of the Dermatology Unit at the San Salvatore Hospital in L’Aquila -. All this affects thealteration of the skin barrierfavoring inflammationcausing dysbiosis (i.e. a microbial imbalance caused by a excessive growth of “bad” bacteria on the skin) and unleashing the itching. All factors that contribute to the development and exacerbation of dermatitis.”

The role of allergens

Of course, a lot depends on the geographical area in which you live and its climate. «There are numerous other factors that contribute to triggering atopic dermatitis or worsening it in those who already have it – he explains Antonio Costanzo, director of Dermatology at the Humanitas Clinical Institute in Milan —: a crucial role is played by allergens (like the pollen), which can reach the body through the defective skin barrier, through nutrition or through breathing. Also ultraviolet radiation and smoke they can interact directly with the skin barrier and immune systems in the skin to aggravate eczema. Finally there is the climate: intense heat and cold, together with too much humidity and sudden temperature variations, they are usually poorly tolerated.”

The skin of those with this pathology is dry and rough to the touch and, in the acute phase, has patches of eczema (red spots covered with fluid-filled blisters which can then evolve into crusts) in characteristic areas: mainly face, neck, décolleté, bends of elbows or knees, hands and feet. And flare-ups easily occur after stimuli such as sweat, rubbing, contact with aggressive detergents.

How to protect yourself

What can you do? «Assiduous attention is important – replies Costanzo -: it absolutely must be applied emollient creams which repair the barrier defect of the skin and avoid situations that can worsen the state of dryness such as the use of wool or synthetic clothingThe dusty or dry environments, contact with aggressive soaps and irritating substances due to the sensitivity of atopic skin. Excessive sweating is an “insidious enemy”, like bathing too frequently.” The good news is that the therapies available for atopic dermatitis today are, finally, many, effective and well tolerated.

The countryside and free visits

To help adult patients suffering from this disease first reach a diagnosis and then be treated and followed in an experienced center, SIDeMaST promotes awareness campaign “On the side of your skin»created under the patronage of ADOI (Association of Italian Hospital Dermatologists-Venereologists and Public Health) and ANDeA (National Atopic Dermatitis Association) and with the non-conditional contribution of Sanofi. The initiative includes cfree dermatological consultations from 23 March to 15 April 2024 in over 40 university centers and hospitals throughout the national territory. To access consultations there reservation is mandatory to the toll-free number 800086875 active seven days a week from 10am to 6pm. Information and a complete list of centers are also available on the website

Available therapies

The important thing is to have a clear diagnosis in order to arrive at the most suitable therapeutic strategy chosen based on various criteria. «Age, intensity of itching, extension and localization of the lesions, comorbidities, the clinical course and the impact of the disease on the patient are evaluated – concludes Fargnoli -. In less serious cases they can be used corticosteroid-based anti-inflammatory creams, while in more serious ones we opt for systemic therapy, by mouth or injection, with traditional immunosuppressive drugs or with the most recent biological drugs and “small molecules” (JAK inhibitors). The ultimate goal is to make itching and lesions on the skin disappear, achieving long-term control of the disease.”

Cases on the rise

Statistics indicate that atopic dermatitis is on the rise worldwide. In Italy it affects approximately one in 10 adults and one in 4 children, with a peak incidence between 10 and 20 years of age. It is a chronic relapsing inflammatory disease with several causes. One is common in those who suffer from it genetic predisposition to hypersensitivity to environmental allergens (around 30% of patients, sooner or later, also have asthma and allergic rhino-conjunctivitis). Generally the pathology begins during childhood (even a few months of life) and in the majority of cases goes into remission once the age of 10-12 is reached. But it can also appear in adults, rarely in the elderly. Once it appears it can last months, more often years, with phases of improvement alternating with worsening. The presence of lesions visible to all and itching are the main causes of the serious repercussions on the quality of life.

March 16, 2024



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