What Are Realistic Expectations for Treatment?
For many diseases, finding the right treatment means the end of symptoms. For chronic conditions like atopic dermatitis (also known as atopic eczema), even with treatment, symptoms like itching, scaling, redness, or bumps can recur again and again.
Do eczema flares mean that treatment isn't working?
When symptoms of atopic dermatitis (AD) flare up, it doesn’t mean that the treatment isn’t working. Recurrences are part of what defines AD as a chronic condition, and while treatment can reduce symptoms and help prevent future exacerbations, AD may still come back.1
It’s important for people with AD, and parents of children with AD, to understand the skin condition's chronic nature and keep up with healthy skincare and medications when symptoms recur.
Triggers and irritants
AD can be triggered by a number of factors, and it is important for anyone with AD to identify their personal triggers and avoid or prevent them wherever possible. Common triggers include dry skin, exposure to irritants (like certain fabrics, soaps, or chemicals), emotional stress, winter weather, infections, allergens, and sweat or saliva left on the skin.
Identifying triggers and irritants
It may take some experimentation, such as switching brands of soaps or laundry detergent, to identify an individual’s personal sensitivity to irritants that trigger their AD. It can be helpful to learn about common irritants and triggers and take steps to avoid them when possible.
What to do when triggers and irritants are unavoidable
When irritants can’t be avoided, follow-up skin care can help reduce the irritation. Bathing with water can remove irritants, as well as any allergens or scale from AD. As always, after bathing, moisturizers should be applied to damp skin to retain the hydration and help repair the skin barrier.2
Routine skin care
A critical part of treating and preventing relapses of AD is good routine skin care. Proper skincare habits are important during times of flares of AD and during times of remission to prevent future flares and keep the skin healthy.
- Short, daily bathing or showering with lukewarm water can help remove bacteria or other microorganisms that can cause infection, as well as helping to rehydrate the skin. Cleaning the skin should be done with a mild soap that is fragrance-free and with a neutral or low pH, or with a non-soap cleanser, as harsh soaps can trigger AD.
- For people with frequent bacterial skin infections, bleach baths can reduce the amount of bacteria on the skin and decrease the chance of repeat infections.
- Moisturizers should be used liberally and frequently, as they help repair the skin’s barrier and reduce dry skin that can lead to the itch-scratch cycle.2 They should be applied immediately after bathing to damp skin.
Medications and treatments
There are a variety of treatments available for AD, including topical treatments, systemic medications, and phototherapy. Some medications, like topical corticosteroids, are used only when symptoms are present, and others may be used on a maintenance schedule to prevent recurrences of AD. It’s important to use the medications as directed by a doctor or pharmacist to maximize their effectiveness and limit the risk of side effects.
Researchers continue to identify new potential treatments for AD. While the chronic nature of the disease can be frustrating, there is cause for hope. New treatments are being studied in clinical trials to treat the intense itching, as well as targeted treatments that focus on specific molecules that are involved in the disease process of AD.1