What Are Ways to Manage Symptoms and Treat Atopic Dermatitis?

RATE

There is no known cure for atopic dermatitis (AD), but proper treatment can control the symptoms, including the itchiness, redness, inflammation, and dryness. AD commonly begins in children, with 90% of all cases being diagnosed before the age of 5. Rarely (in 5% of all cases), AD begins in adulthood. Remission occurs in approximately 65% of children with AD by the age of 11, although that clearance rate falls to 53% as some of those children have recurrences of AD in their teenage years. Some people have AD persist into adulthood, and others find that their AD becomes localized, such as hand eczema, in contrast to when they were children.1-3

Most patients with AD find that their symptoms improve with treatment, but as a chronic disease, AD can have a varying course. One prospective study that followed 1,314 children from birth to age 7 years found that prognosis was mostly determined by the severity of AD and the presence of atopic sensitization. Atopic sensitization is the genetic predisposition to produce immunoglobulin E (IgE) in response to exposure to allergens. Children who had more severe AD and atopic sensitization had a worse prognosis.4,5

Treatment for atopic dermatitis

Treatment for AD is important to prevent the symptoms from worsening, to relieve the pain and itch, to prevent infections from developing, and to stop the skin from thickening, also called lichenification. While treatment for AD includes medicines, proper skin care and lifestyle changes are also critically important to reduce symptoms and prevent flare-ups.6

Medications for atopic dermatitis

 

There are several medications used in the treatment of AD:

Medications for AD are always recommended in combination with proper skin care.4,7

Phototherapy for atopic dermatitis

Phototherapy, which uses ultraviolet light waves directed at the skin, is a second-line treatment strategy. That is, it is only recommended for use after topical treatments and lifestyle approaches have failed to improve symptoms of AD. Phototherapy is sometimes used as a maintenance therapy in people with chronic AD.7

Routine skin care for atopic dermatitis

 

Moisturizers

Using moisturizers on the skin is one of the most important strategies for treating AD, as well as preventing future flares. Children and adults with AD are encouraged to bathe in lukewarm water. Following bathing or showering, the skin should be gently pat dry and moisturizer should be applied immediately, usually within 5 minutes, to seal in the moisture.8

Soap and other cleansers

Harsh soaps should be avoided during bathing or even when washing hands. Non-soap cleansers that have a neutral to low pH, are hypoallergenic, and are fragrance-free are recommended.8

Wet-wrap therapy

Wet-wrap therapy, with or without a topical corticosteroid, is another technique that can help moderate to severe AD. Wet- wrap therapy involves applying the medication (if using) and wrapping the affected area in a layer of wetted gauze, cotton, or bandages, followed by a layer of dry bandages. Wet-wrap therapy helps improve the moisture of the affected skin, improves the penetration of the topical medicine, and provides a physical barrier against scratching.8

Bleach bath

For people with moderate to severe AD who have repeated skin infections, the addition of bleach to the bath can be helpful to decrease the amount of bacteria on the skin’s surface and reduce the chance of infections. Bleach baths involve adding 2 teaspoons of bleach per gallon of water. Clinical studies have proven that bleach baths can reduce the bacteria found on the surface of the skin and reduce infections.8

view references
  1. Lyons JJ, Milner JD, Stone KD. Atopic dermatitis in children: clinical features, pathophysiology, and treatment. Immunol Allergy Clin North Am. 2015;35:161-183.
  2. Tollefson MM, Bruckner AL. Atopic dermatitis: skin-directed management. Am Acad Pediatrics. 2014 Dec;134(6):e1735-1744. doi: 10.1542/peds.2014-2812.
  3. Bieber Th. Atopic dermatitis 2.0: from the clinical phenotype to the molecular taxonomy and stratified medicine. Allergy. 2012;67:1475-1482.
  4. Medscape. Accessed online on 4/7/17 at http://emedicine.medscape.com/article/1049085-overview
  5. Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, Wahn U, Multicenter Allergy Study Group. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. 2004 May;113(5):925-931.
  6. American Academy of Dermatology. Accessed online on 4/7/17 athttps://www.aad.org/public/diseases/eczema/atopic-dermatitis#treatment.
  7. Sidbury R, Davis DM, Cohen DE, et al. Guidelines of care for the management of atopic dermatitis. J Am Acad Dermatol. 2014;71:327-349.
  8. Eichenfield LF, Tom WL, Chamilin SL, et al. Guidelines of care for the management of atopic dermatitis. Journal of the American Academy of Dermatology 2014;70:338- 351.
advertisement
SubscribeJoin 1,000 subscribers to our weekly newsletter.

Your username will be visible to others.


View Written By | Review Date
Emily Downward | June 2017