Skin Care Tips and Routines

Since atopic dermatitis (AD) is a chronic and relapsing skin condition, treatment strategies include treating and preventing flares. A critical part of treating and preventing relapses of AD is good routine skin care. Routine skin care involves bathing and moisturizing the skin, as well as avoiding skin irritants and scratching.

Bathing or showering

While some doctors have proposed that bathing too often may dry out the skin even more, most dermatologists agree that bathing can help hydrate the skin as well as remove any bacteria or other microorganisms that can cause infection. People with AD are at a greater risk of infection due to the damage to the skin barrier and scratching, which can further break the skin and introduce microorganisms. 1,2

Daily bathing or showering should be done using lukewarm water. Short showers or baths for less than 10-20 minutes are recommended to rehydrate the skin. Cleaning the skin should be done with a mild moisturizing soap that is fragrance free and with a neutral or low pH, or with a non-soap cleanser, as harsh soaps can trigger AD. 3

Bleach baths

For people with AD who have repeated skin infections, bleach baths 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. (A typical bathtub holds between 25-40 gallons of water.)1

Moisturizing the skin

The regular use of moisturizers is one of the most important aspects of caring for skin with AD. Moisturizers are one of the basic necessities for people with AD, regardless of the severity of their disease.

There are different types of moisturizers that may be used by people with AD, including:

  • Humectants, which attract and bind water from deeper layers of the skin
  • Emollients, which contain lipids (fats) naturally found on the skin and smooth skin by lubricating the skin
  • Occlusives, which form a hydrophobic film to reduce the loss of water from the skin 4

The choice of moisturizer is usually determined by a number of factors, such as individual preference, safety, effectiveness, and the absence of fragrances or other chemicals that may cause sensitivity.4 Most often, a cream or ointment will be recommended given that they are more moisturizing.

Avoiding irritants

Irritants are substances that irritate the skin. People with AD are more sensitive to irritants because AD damages the skin’s natural barrier.

Common irritants include:

  • Wool clothing
  • Man-made or synthetic fibers, such as rayon, acrylic, nylon, polyester, spandex, or modacrylic (often used in children’s sleepwear to be flame-resistant)
  • Soaps or bubble bath, particularly those that change the skin’s natural pH
  • Some laundry detergents
  • Cleaning solutions, including dish soap, disinfectants, or surface cleaners
  • Cosmetics
  • Perfumes
  • Chemicals like chlorine, mineral oil, or solvents
  • Dust or sand
  • Cigarette smoke 5-7

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. Avoiding irritants may involve wearing clothes from natural fibers, avoiding certain perfumes or cosmetics, and wearing rubber gloves when cleaning with detergents. 8

Avoiding scratching

The itch associated with AD is the most prevalent and distressing symptom, and both the symptom of itching and the scratching it provokes significantly contribute to the burden of AD. People with AD are advised to avoid the triggers for itch, including dry skin, hot baths or showers, sweat left on the skin, emotional stress, and irritants. There are also medications that can help reduce inflammation.9

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. 10

Emily Downward | June 2017
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