Atopic dermatitis in children: Why the skin shows what the body is missing
- Nadia Licci
- Mar 25
- 8 min read
Around 20 percent of all infants and young children develop atopic dermatitis. The skin is red, dry, and intensely itchy. Parents try creams, change detergents, avoid allergens. Sometimes the skin improves. Often, the itching remains.
Atopic dermatitis is not just a skin disease. It is the expression of a system that has fallen out of balance. Skin, gut, and immune system are closely connected. When one of these systems is disturbed, it often shows up on the skin.
From a naturopathic perspective, the question is not only how to relieve symptoms. But why the body reacts this way in the first place.
What is atopic dermatitis?
The name already says a lot. Atopic dermatitis is made up of “neuro” (nerves) and “dermatitis” (inflammation of the skin). This connection is no coincidence. The skin is densely interwoven with nerves. In atopic dermatitis, these nerves react with hypersensitivity.
Stress, emotional strain, or physical stimuli cause skin nerves to release messenger substances. These intensify itching and inflammation. At the same time, chronic itching weakens the nervous system. A vicious cycle develops.
The skin is not only a protective barrier. It is a sensory organ, a communication interface, and part of the nervous system. In atopic dermatitis, this connection is out of balance.
The condition presents with dry, red, scaly skin and intense itching. Commonly affected areas are the inner elbows, backs of the knees, neck, and face. It occurs in flares. Phases of severe symptoms alternate with calmer periods.
Many children experience significant improvement as they grow older. But not all outgrow it.
Not just genetics: antibiotics as an underestimated factor
Atopic dermatitis has a genetic component. If both parents are affected, the risk for the child is 60 to 80 percent. If only one parent is affected, it is 20 to 40 percent.
But genetics is not the only factor. A massively underestimated risk is repeated antibiotic use in infancy.
Antibiotics do not only kill harmful bacteria. They also destroy beneficial gut bacteria that train the immune system. Every course of antibiotics in the first year of life leaves traces in the gut flora.
Studies show that children who receive antibiotics multiple times in the first months of life have a significantly increased risk of atopic dermatitis. The gut flora does not recover on its own. What is missing in the first year of life can have long-term consequences.
This does not mean that antibiotics should never be used. But they should only be used when truly necessary. Not for every cold, not as a precaution..
The disrupted skin barrier
In atopic dermatitis, the skin barrier is impaired. The skin loses too much moisture and dries out. At the same time, foreign substances can penetrate more easily.
An important factor is a mutation in the filaggrin gene. Filaggrin is a structural protein that holds the outermost layer of the skin together. If it is missing or not functioning properly, the barrier becomes permeable.
This permeable skin reacts hypersensitively to stimuli. Textiles, sweat, cold, heat—everything can trigger a flare. Allergens such as house dust mites or pollen can also penetrate more easily and trigger inflammation.
The immune system: overreaction instead of regulation
Atopic dermatitis belongs to the atopic spectrum. This means the immune system tends to overreact. It classifies harmless substances as dangerous and responds with inflammation.
In children with atopic dermatitis, a TH2 dominance is often observed. The immune system produces increased inflammatory substances that cause itching and redness. At the same time, the regulatory function of the immune system is weakened.
Around 30 to 40 percent of children with atopic dermatitis also have food allergies. Others develop hay fever or asthma over time. This phenomenon is known as the atopic march.
The gut: where much is decided
Around 70 to 80 percent of the immune system is located in the gut. The intestinal mucosa is where the body learns to distinguish between friend and foe.
Studies show that children with atopic dermatitis have an altered gut flora. There are fewer beneficial bacteria such as bifidobacteria and lactobacilli. Instead, there are more potentially harmful microbes such as Clostridium species or Staphylococcus aureus.
This dysbiosis, the imbalance of the gut flora, directly affects the immune system. A dysregulated gut produces inflammatory substances that also reach the skin via the bloodstream.
The connection is clear: a disturbed gut means a disturbed immune system means inflamed skin.
This is why gut health is not a side issue. It is central.
The role of birth and breastfeeding
The gut flora begins to develop at birth. During a natural birth, the mother’s vaginal bacteria are transferred to the newborn. In a cesarean section, this initial contact is missing. Instead, mainly skin bacteria colonize.
Studies show that children born by cesarean section have an increased risk of atopic dermatitis. The lack of initial colonization with vaginal microbes can have long-term effects on the immune system.
Breastfeeding supports the development of a healthy gut flora. Breast milk contains not only antibodies but also prebiotic sugar molecules that promote the growth of beneficial bacteria. Exclusive breastfeeding during the first four months of life can demonstrably reduce the risk of atopic dermatitis.
Pets: not always harmless
The question of pets in atopic dermatitis cannot be answered in general terms. Some children react allergically to animal hair, saliva, or dander. Others do not.
If a child sneezes, develops watery eyes, or the skin worsens after contact with a pet, an allergy assessment should be carried out. If an allergy is confirmed, the animal can be an additional burden.
If there is no allergy and the animal brings joy to the child, there is no reason to give it away. However, in unclear flares, it is worth checking pets as a possible trigger.
Diet: wheat, dairy, sugar as disruptive factors
Around 30 percent of children with atopic dermatitis react to certain foods. But even if there is no proven allergy, certain foods can promote inflammation.
Wheat contains gluten, which can irritate the intestinal lining in sensitive children. An irritated intestinal lining is more permeable to undigested food components. The immune system reacts with inflammation.
Dairy products contain casein and lactose. Many children with atopic dermatitis do not tolerate these proteins well. This can also place strain on the intestinal lining, which shows up on the skin.
Sugar and sweets promote the growth of harmful gut bacteria and fungi. A diet high in sugar shifts the gut flora toward dysbiosis. At the same time, sugar promotes inflammatory processes throughout the body.
This does not mean that every child with atopic dermatitis must avoid all these foods. But it is worth reducing them and observing whether the skin improves.
Important: no blanket elimination diet without guidance. Children need nutrients to grow. A one-sided diet can do more harm than good.
Skin care: the basis of every therapy
Regardless of all other measures, skin care remains essential. The dry, permeable skin needs moisture and fat.
Regularly applying cream to the entire body, even during symptom-free phases, stabilizes the skin barrier. Products with evening primrose oil can help.
Important: gentle cleansing, no alkaline soaps, no chlorinated water. Wool and synthetic fabrics can also irritate. Cotton is usually better tolerated.
Naturopathic support: addressing the causes
From a naturopathic perspective, atopic dermatitis is not an isolated skin problem. It is a signal that the system needs support.
This means in practice:
Build gut health: a stool analysis can show the composition of the gut flora. Based on this, targeted support with probiotics can be implemented. Studies show that certain bacterial strains can alleviate atopic dermatitis symptoms. Especially after antibiotic use, rebuilding the gut flora is crucial.
Adjust diet: reduce wheat, dairy products, and sugar. Instead, increase vegetables, healthy fats, and high-quality protein. Omega-3 fatty acids from fish or flaxseed oil can have anti-inflammatory effects.
Use fatty acids and micronutrients strategically: omega-3 fatty acids from fish, flaxseed oil, or algae oil have strong anti-inflammatory effects. They compete with pro-inflammatory omega-6 fatty acids and shift the balance toward regulation. Evening primrose oil contains gamma-linolenic acid, which directly supports the skin barrier and can reduce itching. Studies show improvement with regular use over several weeks.
Vitamin D plays a central role in immune regulation and skin health. Children with atopic dermatitis often have low vitamin D levels. A deficiency worsens inflammatory processes and weakens the skin barrier. Dosage should be individualized, ideally based on lab values.
Zinc is also often deficient. It is essential for wound healing, skin regeneration, and immune function. In cases of scratched, oozing skin, zinc supplementation can significantly accelerate healing. Here too, dosage should be adjusted.
Use phytotherapy specifically: pansy has anti-inflammatory and itch-relieving effects. Calendula supports wound healing. Chamomile has anti-allergic effects. These plants can be used as tea, wash, or ointment.
Do not forget stress regulation: stress has been proven to worsen atopic dermatitis. In children, it is important to give attention not only during scratching, but in general. Relaxation exercises, rituals, and emotional stability help the nervous system to calm down.
Actively manage itching: short fingernails, sleepwear with mittens, cooling compresses with quark or comfrey can relieve itching. Distraction during the day helps shift focus away from scratching.
Recognize and avoid triggers in everyday life
Many flares are triggered by everyday factors that can be avoided. Sweating strongly irritates the skin. Children should not be dressed too warmly. After sports or play, a short, lukewarm shower helps remove sweat.
Textiles play a major role. Wool scratches, synthetics prevent the skin from breathing. Cotton is usually better tolerated. New clothing should be washed before first use to remove residues of dyes or chemicals.
Chlorinated swimming pool water further dries out the skin. If possible, rinse the skin immediately after swimming and apply cream. Hard tap water can also irritate. Some families report improvement after installing a water filter..
UV light: sun in moderation
Sunlight can be beneficial in atopic dermatitis. UV radiation has anti-inflammatory effects and can reduce itching. Many children experience significant improvement in summer.
The right balance is important. Too much sun dries out the skin and can trigger flares. Short, regular sun exposure is better than hours of sunbathing.
The psyche: stress shows on the skin
Atopic dermatitis and the psyche are closely linked. Not because the condition is psychological in origin. But because stress directly affects the skin.
During emotional strain, skin nerves release messenger substances that intensify itching and inflammation. At the same time, the itching itself is stressful. Children sleep poorly, are tired during the day, and feel uncomfortable in their skin.
For families, this often means additional stress. Sleepless nights, extensive care routines, frequent doctor visits. If only one parent carries the main burden, this can lead to overwhelm and conflict.
It is important not to give attention only when the child is scratching. Attention should be given regardless of skin condition. Relaxation rituals, fixed daily structures, and emotional stability help the nervous system to calm down.
Stool analysis: making the gut visible
If atopic dermatitis does not improve despite skin care and dietary changes, a stool analysis can be useful. It shows the composition of the gut flora.
It examines beneficial bacteria such as bifidobacteria and lactobacilli, potentially harmful microbes such as clostridia or staphylococci, fungal load such as Candida albicans, inflammatory markers such as calprotectin, and digestive performance.
Based on this analysis, targeted regulation can be implemented. With probiotics, prebiotics, dietary adjustments, and, if necessary, antifungal treatment in cases of fungal overgrowth.
Gut restoration is not a quick fix. It takes weeks to months. But it addresses the cause, not just the symptom.
When is conventional medical support necessary?
In severe flares or bacterial superinfections, conventional medical support is useful. Cortisone creams can quickly reduce acute inflammation. Their use should be limited in time and under medical supervision.
Even with pronounced symptoms that significantly impair daily life, a pediatric evaluation should be carried out.
Naturopathy does not replace acute emergency treatment. But it can support regulation alongside and in the long term.
Atopic dermatitis in children is not just skin
Atopic dermatitis in children is complex. Genetics, antibiotic use in infancy, skin barrier, immune system, gut, diet, pets, psyche, and environment all interact.
From a naturopathic perspective, it is crucial not only to treat symptoms, but to support the system. Gut health is central. Dietary adjustments, phytotherapy, skin care, and stress regulation are not extras. They are the foundation for helping the body learn to regulate again.
Around two thirds of affected children outgrow atopic dermatitis or experience significant improvement. This shows: regulation is possible.
Patience, consistency, and a holistic perspective are key.
I am Nadia Licci, a certified naturopath. In my practice Total Balance in Zurich, I support families in understanding atopic dermatitis not as an isolated skin problem, but in the context of gut health, immune regulation, and holistic support.
