Treatments for atopic dermatitis

Treatments for atopic dermatitis SUMMARY Atopic dermatitis usually develops in childhood, but can occur in adults.Management involves drug and non-drug treatments to clear the skin.Not all patients with atopic dermatitis have allergies.Most patients have trigger factors that can be avoided.All patients should use soap substitutes and bath oils.Moisturisers are important for improving the condition of the skin.Topical corticosteroids are the main drug treatment.The choice of corticosteroid depends largely on the site of the atopic dermatitis.Topical calcineurin inhibitors can be considered for sensitive sites such as the face where potent topical corticosteroids are potentially harmful.Adjunctive treatments given during flares of dermatitis include bleach baths and wet dressings.Antihistamines may help to relieve itch.Phototherapy may be considered by a specialist for adults if there is inadequate response to treatment.Severe cases of atopic dermatitis may require systemic treatment.Immunosuppressants, such as ciclosporin, have been used and now dupilumab and upadacitinib are available for severe chronic atopic dermatitis.should be educated to avoid overheating and use cool compresses when their skin is hot or itchy. IrritantsSoaps, detergents, rough fabrics, seams, clothing labels and exfoliants may all aggravate atopic dermatitis. AllergensNot all patients with atopic dermatitis have allergies, but allergens can play a role in some patients.Fragrance is the most common cause of contact allergy, followed by preservatives in consumer products, for example methylisothiazolinone.Patients should always use fragrance-free products.Do not use products containing essential oils (e.g.lavender oil), or food ingredients (e.g.oatmeal, goats' milk, nut oils, pawpaw); these have a high risk for causing sensitisation and consequent food allergy.Sensitisation to contact allergens is more common in atopic individuals due to their impaired skin barrier, but can also occur in those without a known history of atopy.Dietary restrictions are to be minimised, particularly in infants, without input from specialists.Animal dander, house dust mite, 1 pollens and grasses are other potential allergens to recognise