Allergic Dermatitis – Causes, Symptoms, Diet and Treatment

Atopic dermatitis, alternatively referred to as atopic eczema or—following Besnier’s classification—Besnier’s prurigo, represents a multifaceted, genetically predisposed dermatological condition characterized by a recurrent and chronic course. Initial clinical manifestations typically emerge during infancy or early childhood, presenting as distinctive eczematous skin lesions accompanied by severe, persistent pruritus. The intensity of itching may become so pronounced that it disrupts sleep patterns, thereby exacerbating the patient’s overall health status. Furthermore, visible cutaneous alterations—including erythema, scaling, and fissuring—exert a substantial psychosocial burden, diminishing self-esteem, inducing feelings of shame, and impeding the formation and maintenance of interpersonal relationships, ultimately compromising the quality of life for affected individuals.

The development of atopic dermatitis (AD) arises from the interplay of numerous interdependent factors, prominently featuring genetic predispositions, environmental exposures, psychological influences, and immunological dysregulation. Individuals diagnosed with AD exhibit impaired filaggrin function—a critical structural protein essential for maintaining epidermal barrier integrity. Upon exposure to allergens (including detergents, house dust mites, animal dander, or dietary components), the skin’s protective layer becomes compromised, thereby facilitating the penetration of additional external irritants and pathogens. This process exacerbates inflammatory responses and clinical manifestations of the condition.

Atopic dermatitis primarily presents with persistent erythema and excessive dryness of the epidermis, accompanied by intense, often uncontrollable pruritus and visible desquamation of the stratum corneum. Cutaneous lesions may extend across vast areas of the body; however, their characteristic localization predominantly includes flexural regions—such as the popliteal fossae, antecubital creases—as well as the cervical area and facial zone. It is noteworthy that the clinical presentation and distribution of eruptions undergo modifications depending on the patient’s developmental stage, yet unremitting, burdensome itching remains an invariant and predominant symptom across all phases of the disease. Flare-ups may occur cyclically, with severity ranging from mild to severe. Additional insights: Phytotherapeutic interventions in atopic dermatitis In patients diagnosed with AD, systematic use of preparations containing evening primrose oil (*Oenothera biennis*) and borage oil (*Borago officinalis*)—both rich sources of alpha-linolenic acid (ALA, an omega-3 fatty acid)—may yield certain benefits. Scientific investigations suggest that regular supplementation with these compounds can contribute to reduced inflammation, alleviation of pruritic symptoms, and improved skin hydration. Caution is advised, however, as omega-3 fatty acids exhibit antiplatelet activity, which may prolong bleeding time and elevate hemorrhage risk, particularly in individuals concurrently taking anticoagulant medications.

Individuals diagnosed with atopic dermatitis (AD) may benefit from dietary incorporation or supplementation with botanical oils—particularly evening primrose oil (*Oenothera biennis*) and borage oil (*Borago officinalis*)—both of which are abundant in alpha-linolenic acid (ALA), a precursor to anti-inflammatory omega-3 metabolites. Systematic reviews of clinical evidence indicate that consistent use of these supplements may alleviate key symptomatic manifestations, including attenuation of epidermal inflammatory responses, mitigation of pruritic discomfort, and enhancement of skin hydration via reinforced barrier integrity. Nevertheless, it is critical to note that ALA’s potential antiplatelet activity may prolong bleeding times, constituting a significant contraindication for patients on anticoagulant therapy or those scheduled for surgical procedures.

The treatment process for patients with atopic dermatitis can be divided into actions in the area of direct causes of the disease as well as symptomatic treatment. Causal treatment can be introduced if an allergen is known to be eliminated from the environment or food.

The development and exacerbation of atopic dermatitis (AD) symptoms are influenced by a multitude of environmental and genetic factors, among which dietary habits play a pivotal role. Particularly in infants and young children, AD is frequently associated with food allergies, making nutrition one of the first elements to be thoroughly evaluated in the diagnostic and therapeutic process. The most common allergens triggering reactions in children include cow’s milk proteins, hen’s eggs, fish, gluten-containing grains (such as wheat and rice), peanuts, and cocoa. As children mature and their digestive systems develop, many outgrow these hypersensitivity reactions; however, in some individuals, allergies may persist or evolve. In adults, the allergen profile shifts, with reactions most commonly occurring in response to wheat, certain fruits (apples, cherries, kiwi), vegetables (celery, carrots), nuts, shellfish, and soy. The primary nutritional intervention is an elimination diet, the implementation of which should be preceded by detailed allergy testing (e.g., skin prick tests, specific IgE measurements) to accurately identify triggering factors. Conversely, certain nutrients exhibit protective and symptom-allevating effects in AD. Of particular significance are omega-3 fatty acids, especially docosahexaenoic acid (DHA), whose regular intake—whether through fatty marine fish (salmon, mackerel, sardines), cod liver oil, or supplements—may contribute to reduced inflammation and improved skin hydration. This effect is linked to the optimization of the omega-3 to omega-6 fatty acid ratio. Probiotics, defined as live bacterial cultures with documented benefits for gut microbiota and immune function, are equally important. Natural sources of probiotics include fermented dairy products (kefir, plain yogurt, buttermilk) and fermented vegetables (pickles, sauerkraut). In the context of supplementation, vitamin D3 also warrants attention, as its deficiency in early childhood is associated with an increased risk of developing AD. Given the profound impact of atopic dermatitis on patients’ psychological and physical well-being, a holistic therapeutic approach should encompass not only pharmacotherapy but also lifestyle modifications, including a balanced elimination diet and targeted supplementation, which can significantly enhance the quality of life for individuals affected by this chronic condition.