A baby boy in Tokyo started exhibiting redness and rough skin on his cheeks when he was 2 months old. The condition eventually spread to his shoulders.

His mother, a company employee, took him to a dermatologist in November 2011. The physician prescribed vitamins and a mild cream to reduce the inflammation. However, after continuing treatment for over a month, the boy’s rough skin went through cycles of improving and deteriorating, until the condition finally spread to his whole body.

At a childcare consultation held by the local government, the woman had her son looked at by a pediatrician who indicated the possibility of atopic dermatitis. He introduced the woman to the National Center for Child Health and Development in Tokyo.

She took the boy to the Center’s Allergy Division to be examined in late December 2011. The boy was diagnosed with severe atopic dermatitis and had to stay at the centre’s hospital. Blood tests also indicated a possibility the boy was allergic to milk.

Atopic dermatitis is a chronic recurrence of rashes accompanied by itchiness. It is thought to be triggered by stress or a decline in barrier functions that protect the skin from a variety of irritants, and it is very common in people with allergies. Treatment generally consists of reducing skin inflammation through the use of a steroid cream.

A team at the centre studied newborn infants from families with atopic dermatitis patients for 32 weeks, beginning at the age of a week or less. They divided the infants into two groups. One group had moisturizer applied over their whole body every day; the other group had petroleum jelly applied only to areas with dry skin. The results showed that the occurrence of atopic dermatitis in the group using moisturizer every day was more than 30 per cent less than in the group that did not apply moisturizer.

The children who developed atopic dermatitis were also more likely to develop egg allergies than the children who did not.

Sufferers of atopic dermatitis have a degraded skin barrier function, and are therefore vulnerable to absorbing allergens through the skin. It is thought that this sets off abnormal behaviour in their immune cells, inducing the onset of food allergies.

“The skin’s barrier function is also crucial in the prevention of food allergies,” said Yukihiro Oya, the allergy division’s head.

It was decided that a moderate steroid cream should be applied to the boy’s body and scalp three times a day, and a mild steroid to his face as the skin in this area is relatively thin. After about a week, the rashes cleared up. In the second week of the boy’s hospitalisation, the number of daily applications of medication was reduced. The boy returned home in May 2012.

The boy, now 4, continues to have his entire body moisturized every day and uses the steroid medication once a week. His dermatitis is under control, and his milk allergies have also ceased.

“I was worried about food allergies. I feel really relieved,” his mother said.

His primary doctor, Motoki Yomase, who currently works at the Japanese Red Cross Medical Center, said, “I would like to see people treat atopic dermatitis at an early stage to help lower the risk of food allergies.”

Returning symptoms

In Osaka Prefecture, another baby boy was diagnosed with atopic dermatitis at 4 months old. It naturally improved when he was about 2, but came back again when he was around 5, plaguing the boy with persistent rashes.

At the boy’s dermatological clinic, he was prescribed a moderate steroid cream which he applied twice daily, but the rashes on his neck, his legs, the insides of his elbows and other areas did not improve. The primary physician advised that the boy avoid sweating as much as possible, and that the boy refrain from playing outside.

Conventionally, perspiration was looked upon as a typical factor in aggravating the symptoms of atopic dermatitis, and many physicians advise patients to avoid sweating.

However, sweat — which contains antibacterial and moisturizing components — is helpful in preventing infections and dry skin, and it has come to be understood that perspiration holds the key to improving the symptoms of atopic dermatitis.

Atopic dermatitis patients perspire much less than healthy individuals. Studies show that atopic dermatitis patients sweat only half as much as healthy people, and when they do sweat the process takes twice as long.

According to Hiroyuki Murota, an associate professor at Osaka University’s Dermatology Department, histamines that trigger skin inflammation and allergies play a role in curbing perspiration. The lack of perspiration opens the door to skin dryness and infections, leading to a relentless cycle that complicates atopic dermatitis.

In 2013, together with Shimane University, Murota studied the relationship between atopic dermatitis and perspiration in 44 patients ranging from children to adults, from July to September.

The patients were advised to sweat within reasonable levels by such means as commuting to school or work by bike or doing light workouts for one month without altering their existing treatment method.

The patients did not let sweat accumulate, but would rinse it off with tap water or wipe it off using wet towels. One month later, about 80 per cent, or 34 patients, saw improvements in their symptoms. However, eight patients experienced slight deterioration in their symptoms, such as increased itchiness.

The Osaka boy also participated in this study. He sweated during such activities as playing tag during break times and in gym class at school, and right after that he tried to wash his knees and elbows with tap water and wipe around his neck with a wet towel.

One month later, the redness in his face had almost entirely subsided, while the scratch marks and redness around his elbows and knees were also gone. The boy expressed his joy, saying, “I did sweat, but my skin became clean.”

Since this study, the boy, who is now 10, no longer hesitates to break a sweat, and with his moisturizer applied after bathing, his symptoms have more or less settled down.

“Even for those with atopic dermatitis, sweating is not a bad thing. I want patients to take the proper steps after sweating to cope more effectively with it,” Murota said.Speech