When It Itches All the Time

Not a typical allergy

Very often, these patients also suffer from hay fever, asthma, or food allergies. These conditions, along with neurodermatitis, are classified as atopic diseases. Atopy refers to the body’s response to environmental factors by producing IgE antibodies. Atopic dermatitis is not an IgE-mediated reaction—that is, one in which the skin immediately worsens, for example, after eating hazelnuts. Nevertheless, some patients report that their skin condition worsens in connection with certain foods or during hay fever season. It is an inflammatory reaction in the skin that is influenced by various factors and leads to an excessive response by the immune system.

Multi-stage therapy

Thanks to its close ties to research, the University Hospital of Zurich is consistently able to offer innovative, proven therapies. Take, for example, the drug dupilumab, which is approved for certain severe forms of atopic dermatitis. It is injected under the skin every two weeks and, according to USZ specialist Peter Schmid, has proven to be a highly effective alternative. “It very selectively inhibits certain neurotransmitters and has a strong anti-inflammatory effect.” The only downside: The treatment is very expensive. However, in severe cases of atopic dermatitis, health insurance companies would generally cover the costs, at least for a certain period of time, according to Schmid.

During an acute flare-up, cortisone is often used topically. This locally inhibits the immune response and, consequently, the severe inflammatory reaction. The side effects on the body are minimal, since topical cortisone rarely enters the bloodstream. In cases of widespread atopic dermatitis, medications that temporarily suppress the immune system as a whole may also be used. For the dermatologist, however, this is not a sustainable option. “As soon as you stop taking these medications, a new flare-up may occur. Often, patients don’t tolerate the medications very well either.”

Effective, simple, and without side effects

The second treatment of choice after anti-inflammatory ointments such as cortisone is light therapy. It acts directly on the skin, has virtually no side effects, and is therefore also suitable for pregnant women. Because it filters out a specific wavelength in the UVB spectrum, it does not increase the risk of skin cancer. Above all, however, it can have a long-term, positive effect. In addition, the actual treatment is extremely short: a session lasts just a few minutes. Its only drawback is the sometimes considerable organizational effort required to hold two to three sessions a week for three to four months. Incorporating treatment into your commute: With the services offered by the USZ at the Circle at Zurich Airport, this might be easier for some people.

Learning to Live with the Disease

For Karin Grando, the most important thing is that those affected learn to cope with the disease and the constant itching. And not to give up. These are simple tips she can share with her patients. “If there’s enough time. First and foremost, after the doctor’s appointment, we go over the prescribed treatment again and explain how to use, apply, or take the medications.” What other tips would she share? “Avoid anything that puts extra strain on your skin. So take a shower with lukewarm water and a gentle stream, pat yourself dry—never rub. Or try wearing your underwear with the seams on the outside every now and then.”