Dr. Dawn Davis, a dermatologist at Mayo Clinic and co-chair of the American Academy of Dermatology Atopic Dermatitis Guidelines Committee, is an author of the newly released and updated guidelines for managing atopic dermatitis.

She says understanding potential triggers for atopic dermatitis is a start.

Watch: The Mayo Clinic Minute

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Triggers for atopic dermatitis or eczema can be internal and external.

"Any sort of stressor to the mind, to the nerves, to the skin or to the immune system can cause a flare of eczema," says Dr. Davis.

It could be daily stress, a food allergy or the jewelry you are wearing.

"Some people with eczema are sensitive to nickel, they may be sensitive to a preservative and a medication that they're using," she says.

Learning how to decrease your sensitivity or stress can help.

Dr. Davis encourages patients to: 

• Practice mind-body exercises.
• Get plenty of rest.
• Stay hydrated.
• Avoid smoking. 
• Practice a sensitive skincare routine.

This includes daily baths or showers with mild soaps, and frequent moisturizing with a fragrance-free, dye-free and chemical-free lotion.

"They may need may need prescription medicines. Those can be available topically by a cream or an ointment or systemically by a pill or a shot. And then we may choose to do advanced therapy beyond that, such as patch testing," Dr. Davis says.

Related posts:

• Mayo Clinic Q and A: Childhood eczema
• Mayo Clinic Minute: Eczema occurs in people of all ages

The post Mayo Clinic Minute: Atopic dermatitis triggers and treatment appeared first on Mayo Clinic News Network.

Mayo Clinic has developed its first 3D prototype of human skin bioprinted to model inflammatory skin disease. 3D bioprinting is a technology that mixes bioinks with living cells to print natural tissue-like structures in three dimensions. This new technology provides the most human-like skin model for studying inflammatory conditions such as atopic dermatitis — more commonly known as eczema — a chronic inflammatory skin condition that causes dry, itchy and inflamed skin. The 3D bioprinting skin procedure, applications and limitations are described in a review article in Regenerative Biomaterials.

"3D bioprinting is a burgeoning field in tissue engineering and regenerative medicine that has the potential to transform clinical and laboratory practice. In this article, we discuss the process of 3D bioprinting skin, including cell selection, scaffold selection, and advantages and disadvantages of certain skin bioinks," says Saranya Wyles, M.D., Ph.D., a dermatologist and senior author of the article. "This 3D model more accurately recreates disease, creates surgical grafts and provides the ability to test new therapies."

A dry, itchy disease with few options

Eczema affects 30 million Americans, mostly children and adolescents, according to the National Institutes of Health. This painful condition causes dry, itchy skin that can trigger an immune response and can in turn cause inflamed skin. Eczema can weaken the skin's ability to retain moisture and protect against bacterial, viral or fungal infections. People with this disease are often at risk of conditions such as asthma and food allergies. The few treatments that exist can ease the symptoms but are not a cure.

Research to increase understanding of eczema and advance new therapies for this condition has been limited by a lack of preclinical models that accurately simulate human disease.

"That's where 3D bioprinting brings new options. It can create human equivalents that are truer and more representative of the disease, unlike the animal models we have worked with in the past," says Dr. Wyles. "Inflammatory skin diseases and rare diseases can be modeled (through bioprinting) for better understanding of the underlying pathology and drug testing and how that might affect the patient."

Dr. Wyles' team, including collaborator Alexander Revzin, Ph.D., hopes to replicate inflammatory skin conditions using cells of people with eczema to 3D bioprint skin. The research team will test topical and injectable regenerative therapies such as exosome technology on bioprinted skin in hopes of identifying new therapies. Exosomes are cell-free substances that act like a delivery service, moving cargo from one cell to another with instructions for targeting exact tissues that need repair.

Dr. Wyles' research is supported by Mayo Clinic's Center for Regenerative Biotherapeutics and funded by the Skoll Foundation. Her work advances the center's objective of delivering new cellular therapies for complex conditions with few therapeutic options.

Bioprinting a complex organ

Skin is the body's largest organ, and it regenerates monthly. The 3D bioprinting model seeks to replicate the complexity of skin layers, but has yet to incorporate the sweat glands, blood vessels, skin follicles and nerves found in native human tissue.

"The 3D bioprinter uses human cells as inks called bioinks, which act similar to ink from a printer ink cartridge. We can print the skin from cells of patients with atopic dermatitis or eczema," says Dr. Wyles. "Our system allows us to use up to six different cell types to model and recreate human skin tissue."

The research team uses many types of cells including melanocytes, which form skin pigment; keratinocytes, which allow for skin renewal; and fibroblasts, which form a connective tissue. These cells are printed in layers that stratify and mature into full layers of skin.

"The printing process is sort of like creating layers of a tiered cake with different cell types," says Dr. Wyles. "You start at the bottom (the dermis), then you add the next layer (the epidermis), and the scaffold material acts as the frosting to connect the layers. The printed skin is put into an incubator where the cells can communicate with each other, expand and form bioprinted skin."

Research using 3D bioprinted skin goes beyond inflammatory disease. Dr. Wyles also uses the prototype 3D models to better understand, on a molecular level, the role of senescent cells in age-related skin conditions. Also called zombie cells, senescent cells no longer divide and multiply, and therefore are not able to heal and repair tissue. Her goal is to better develop new therapies to address skin aging.

More research is needed to bioprint an exact replica of human skin with atopic dermatitis. Future studies will explore 3D bioprinting of full skin thickness with an emphasis on attaining the full features of patient-specific skin.

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Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:13) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

Atopic dermatitis is a sensitivity disease of the skin, similar to asthma in the lungs, hay fever in the sinuses and food allergies in the gut.

"It's a multisystem disorder. Inflammation affects the skin, and the skin is more sensitive than usual," says Dr. Dawn Davis, a Mayo Clinic dermatologist.

It's a chronic condition and tends to flare periodically. The symptoms vary.

"Atopic dermatitis tends to be red, weepy, crusty, itchy, flaky patches, like oval or circular-shaped areas on the skin," says Dr. Davis.

The darker your skin tone is, the more the inflammation can be disguised.

"Our skin is like a brick wall. And over time as we age, or genetically if we are predisposed to sensitive skin, it can look like a wicker basket more than a brick wall. And that makes it more vulnerable to inflammation and to environmental triggers," says Dr. Davis.

Adult eczema often occurs in patches on areas of the body prone to friction or sweat.

"It might be where your waistband would sit or where your socks or shoes would rub. If you have a watch, (it might occur) where you would wear your watch, or if you have a headband or certain things that you wear along your neck, like a necklace or a tie," she says.

The first basic component of eczema treatment is taking care of sensitive skin.

"It's important to bathe regularly. It's important to hydrate the skin with a moisturizer that is hypoallergenic. It's important to monitor for infection," says Dr. Davis.

If those self-care steps don't help, your dermatologist may prescribe topical or oral medications, or other therapies.

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, and other safety protocols were followed.

The post Mayo Clinic Minute: Eczema occurs in people of all ages appeared first on Mayo Clinic News Network.

When it comes to itchy, red skin, it’s possible that psoriasis or atopic dermatitis, also known as eczema, could be the cause. 

"Psoriasis and eczema are both skin reactions to the inflammation or immune system coming to the skin and causing a reaction," says Dr. Dawn Davis, a Mayo Clinic dermatologist.

Psoriasis is thought to be an immune system problem that causes the skin to regenerate at faster-than-normal rates. This rapid turnover of cells results in scales and red patches.

Eczema results from irritants or allergens. It's common in children, but can occur at any age. And people with eczema often have other sensitivities, including asthma, hay fever or food allergies.

Both are long-term chronic conditions that don’t have a cure but can be treated. It is important for people with psoriasis or eczema to seek care to control flares-ups and improve their quality of life.

"Anticipate a lifelong relationship with your dermatologist or primary care provider so that we can take care of your skin over time and keep track of the treatment and management of your condition," explains Dr. Davis.

On the Mayo Clinic Q&A podcast, Dr. Davis helps explain the similarities, differences and treatments for psoriasis and eczema.

Watch: Dr. Davis discuss psoriasis and eczema.

Read the full transcript.

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.

For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

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Today's parents face an almost constant bombardment of guidance, warnings, advice, anecdotal information and suppositions regarding their child's health and wellbeing. Even the most well-read parents may struggle to find the facts among the fiction — or to figure out which facts are true for their child.

This constant barrage of often conflicting information can cause unnecessary fear, as is the case for parents experiencing corticophobia — an irrational fear of corticosteroids. Recent research from Mayo Clinic may alleviate some of that fear for parents whose children are suffering from atopic dermatitis.

Atopic dermatitis, also known as eczema, is common among children. It causes the skin to become red and itchy. The most common treatment is a corticosteroid cream that helps control the itching and repair the skin.

"While there are risks with every medication, when we prescribe corticosteroid cream for our patients, we know that the relief for the itching and inflammation will be almost immediate," says Reese Imhof, M.D., an internal medicine resident at Mayo Clinic, and the first author of the study.

One common fear parents express is that this medication will cause their child's bones to break more easily.

"We conducted this study because we hoped to lay some fears to rest," Dr. Imhof says. "The Rochester Epidemiology Project is a great resource for this type of research. It basically contains an entire community's health history for more than two generations."

The researchers used the Rochester Epidemiology Project to identify patients who received their first diagnosis of atopic dermatitis before age 4, during the years 2004 – 2017. They conducted a landmark analysis — a methodology intended to hone in on any predictive, or causal, relationship between corticosteroids and broken bones — on 2,499 children who met additional inclusion criteria. The team found no association.

"Unfortunately, children do sometimes break bones, but we didn't find any reason to believe that using corticosteroid cream for eczema could make that more common.," says Dr. Imhof.

The authors mention some limitations for their findings, including that their study population was predominantly Caucasian, and that they were unable to evaluate cumulative exposure to corticosteroids. They also expressed interest in further research to address this latter concern and other possible variables.

The Rochester Epidemiology Project is a medical records linkage system containing nearly 2 million medical records from multiple health care systems providing a full picture of risks for an entire geographical region. The multidisciplinary team that conducted this study received additional support from Mayo Clinic's Department of Medicine, Division of Biomedical Statistics and Informatics, Division of Epidemiology, Department of Health Sciences Research, Department of Dermatology, Department of Pediatric and Adolescent Medicine, Department of Clinical  Genomics and the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

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ROCHESTER, Minn. — In a retrospective case study, Mayo Clinic researchers have found that antibiotics administered to children younger than 2 are associated with several ongoing illnesses or conditions, ranging from allergies to obesity. The findings appear in Mayo Clinic Proceedings.

Using health record data from the Rochester Epidemiology Project, a population-based research collaboration in Minnesota and Wisconsin, researchers analyzed data from over 14,500 children. About 70% of the children had received at least one treatment with antibiotics for illness before age 2. Children receiving multiple antibiotic treatments were more likely to have multiple illnesses or conditions later in childhood.

Types and frequency of illness varied depending on age, type of medication, dose and number of doses. There also were some differences between boys and girls. Conditions associated with early use of antibiotics included asthma, allergic rhinitis, weight issues and obesity, food allergies, attention deficit hyperactivity disorder, celiac disease, and atopic dermatitis. The authors speculate that even though antibiotics may only transiently affect the microbiome, the collection of microbes in the body, this may have long-term health consequences.

"We want to emphasize that this study shows association ― not causation ― of these conditions," says Nathan LeBrasseur, Ph.D., a researcher at Mayo Clinic's Robert and Arlene Kogod Center on Aging and the study's senior author. "These findings offer the opportunity to target future research to determine more reliable and safer approaches to timing, dosing and types of antibiotics for children in this age group."

While recent data show an increase in some of the childhood conditions involved in the study, experts are not sure why. Other than the issue of multidrug resistance, antibiotics have been presumed safe by most pediatricians.

Researchers also say the ultimate goal is to provide practical guidelines for physicians on the safest way to use antibiotics early in life.

Other coauthors of the study are Zaira Aversa, M.D., Ph.D., first author; Elizabeth Atkinson; Marissa Schafer, Ph.D.; Regan Theiler, M.D., Ph.D.; and Walter Rocca, M.D. ― all of Mayo Clinic ― and Martin Blaser, M.D., of Rutgers University.

The study was supported by the Pritzker Foundation, Leonard and Mary Lou Hoeft Fund in Healthy Aging and Independent Living Research, Rochester Epidemiology Project, C&D Fund, and Transatlantic Networks of Excellence of the Leducq Foundation.

The Rochester Epidemiology Project has been supported by the National Institutes of Health since its inception more than 50 years ago.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and Mayo Clinic Facts for more information about Mayo.

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. The journal has been published for more than 90 years and has a circulation of 127,000. Visit the Mayo Clinic Proceedings website to view articles.

Media contact:

• Bob Nellis, Mayo Clinic Public Affairs, newsbureau@mayo.edu

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Need practical advice on diet and exercise? Want creative solutions for stress and other lifestyle issues? Discover more healthy lifestyle topics at mayoclinic.org.

Receive a free e-subscription to Housecall and other health newsletters.

The post Housecall: Over-the-counter weight-loss pills — know the benefits and risks appeared first on Mayo Clinic News Network.

"Dermatologists are always encouraging people to protect their skin," says Mayo Clinic pediatric dermatologist Dr. Dawn Davis, who was not part of the research. "This study emphasizes the importance of [moisturizer] for newborns in reducing the risk for the rashes and itching of eczema."

In this Mayo Clinic Radio Health Minute, Dr. Davis explains why petroleum jelly is a good defense against eczema.

To listen, click the link below.

Protecting babies from eczema risk

The post Protecting babies from eczema risk: Mayo Clinic Radio Health Minute appeared first on Mayo Clinic News Network.

No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps and other irritants, apply medicated creams or ointments, and moisturize your skin.

To help reduce itching and soothe inflamed skin, try these self-care measures:

• Take an oral allergy or anti-itch medication.
  Options include nonprescription allergy medicines (antihistamines) — such as cetirizine (Zyrtec) or fexofenadine (Allegra). Also, diphenhydramine (Benadryl, others) may be helpful if itching is severe. But it can make you drowsy, so it's better for bedtime.
• Take a bleach bath.
  A diluted-bleach bath decreases bacteria on the skin and related infections. Add 1/2 cup (118 milliliters) of household bleach, not concentrated bleach, to a 40-gallon (151-liter) bathtub filled with warm water — measures are for a U.S.-standard-sized tub filled to the overflow drainage holes.Soak from the neck down or just the affected areas of skin for about 10 minutes. Do not submerge the head. Rinse, pat dry and moisturize. Take a bleach bath no more than two or three times a week.
• Apply an anti-itch cream or calamine lotion to the affected area.
  A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch. Apply it to the affected area before you moisturize. Once your reaction has improved, you may use this type of cream less often to prevent flare-ups.
• Moisturize your skin at least twice a day.
  Use a moisturizer all over while your skin is still damp from a bath or shower. Pay special attention to your legs, arms, back and the sides of your body. If your skin is already dry, consider using oil or lubricating cream.
• Avoid scratching.
  Cover the itchy area if you can't keep from scratching it. Trim nails and wear gloves at night.
• Apply cool, wet compresses.
  Covering the affected area with bandages and dressings helps protect the skin and prevent scratching.
• Take a warm bath.
  Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for the bathtub (Aveeno, others). Soak for 10 to 15 minutes, then pat dry and apply medicated lotions, moisturizers or both (use the medicated form first).
• Choose mild soaps without dyes or perfumes.
  Be sure to rinse the soap completely off your body.
• Use a humidifier.
  Hot, dry indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home. Keep your humidifier clean to prevent the growth of bacteria and fungi.
• Wear cool, smooth-textured cotton clothing.
  Reduce irritation by avoiding clothing that's rough, tight, scratchy or made from wool. Also, wear appropriate clothing in hot weather or during exercise to prevent excessive sweating.
• Treat stress and anxiety.
  Stress and other emotional disorders can worsen atopic dermatitis. Acknowledging those and trying to improve your emotional health can help.

The post How do I remedy the painful eczema irritation? appeared first on Mayo Clinic News Network.

Over-the-counter weight-loss pills
There's no magic bullet for losing weight. The most effective way to lose weight and keep it off is by eating a healthy, low-calorie diet and being more physically active. But the appeal of using over-the-counter weight-loss pills to lose weight fast is hard to resist. Do these products lighten anything but your wallet? And are they safe? Here's what you need to know.

EXPERT ANSWERS
What are the risks of vitamin D deficiency?
Vitamin D deficiency can cause your bones to become thin, brittle or misshapen. Vitamin D also may play a role in insulin production and immune function — and how this relates to chronic disease prevention and cancer. Learn more from Katherine Zeratsky, a Mayo Clinic registered dietitian nutritionist.

Can whole-grain foods lower blood pressure?
Eating more whole-grain foods regularly may reduce your chance of developing high blood pressure. If you already have high blood pressure, eating more whole-grain foods may lower your blood pressure. Learn more from Dr. Sheldon Sheps, an emeritus Mayo Clinic hypertension and peripheral vascular diseases specialist.

PLUS ADDITIONAL HIGHLIGHTS
Atopic dermatitis (eczema)
Proper walking technique
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Need practical advice on diet and exercise? Want creative solutions for stress and other lifestyle issues? Discover more healthy lifestyle topics at mayoclinic.org.

Receive a free e-subscription to Housecall and other health newsletters.

The post Housecall: Breast self-exam for breast awareness appeared first on Mayo Clinic News Network.