How to Create an Action Plan for Handling Flares
Reviewed by: HU Medical Review Board | June 2017 | Last updated: December 2020
Action plans can be helpful for people living with or caring for a child with atopic dermatitis (AD). A written action plan details the different products and medications used, as well as a skin care routine, and can help keep the needed regimen of treatment in place when AD flares up.
The action plan should include instructions on bathing, moisturizing, when and how to use prescription or over-the-counter medications, as well as symptoms to watch out for, such as signs of an infection.1
Instructions for bathing
A written action plan should include instructions on bathing with AD. Bathing is an important step in skin care, as it hydrates the skin and removes scale, crust, irritants, and allergens. Adequate hydration of the skin is required to help preserve the skin’s natural barrier and minimize the effects from irritants or allergens, which can worsen AD.
Since hot water can trigger itching and may worsen dry skin, the optimal water temperature for people with AD is warm water. Harsh soaps should be avoided. Non-soap cleansers or soaps that are hypoallergenic, fragrance-free, and have a neutral to low pH (less than 5.5) may be tolerated. For some people with moderate to severe AD who have repeated skin infections, adding bleach to the bath can reduce the amount of bacteria on the skin’s surface and decrease the risk of infections.2,3
Moisturizers for eczema
Moisturizers are one of the most important elements in good skin care for people with atopic dermatitis (AD), regardless of the severity of their disease, and instructions on which moisturizers to use and how often should be detailed in the written action plan.
Moisturizers may be the main treatment for mild AD and should be a part of therapy for moderate to severe AD. While there is not an official recommendation for frequency of application, it is generally believed that moisturizers should be applied often enough that dry skin (xerosis) is minimal. It is especially important to apply moisturizers after bathing, when the skin is still damp. This helps seal the water into the skin.2
Any medications that are used for the treatment of AD should also be described in the written action plan. Most topical medications are applied to affected areas of the skin twice daily, however, the written instructions should follow the doctor or pharmacist’s recommendations. Other medications may be taken orally, such as immunosuppressants, antibiotics or antihistamines, and some medications are given by injection.
The action plan should include instructions for the frequency and dose, as well as the timing of the dose of the medications. Different topical medications may be applied to different areas of the body, and this should also be included in the action plan.
Signs of infection
AD puts a person at greater risk of developing skin infections, and the written action plan can include signs and symptoms to watch for, such as oozing, drainage, pus bumps, or yellow crusts. Fever, swollen glands, fatigue, and other systemic symptoms may also be signs of infection. A doctor should be seen right away if symptoms of infection are found so that proper treatment can be given.1