The use of detergents, moisturizers and the experience with therapeutic education among Italian pediatric patients with atopic dermatitis

Daily skin care using appropriate detergents and moisturizers is essential in the management of pediatric atopic dermatitis (AD). Despite guideline recommendations, real-life adherence and caregiver practices vary widely. Therapeutic education is considered a key tool to improve awareness and optimize disease management. The aim of this study is to evaluate the use of detergents, moisturizers, and the experience with therapeutic education among a large cohort of Italian children with AD. An observational multicenter study was conducted on 529 pediatric patients aged ≤ 18 year with a physician-confirmed diagnosis of AD, who were evaluated between June 2020 and December 2021 across seven specialized centers in Italy. Clinical and demographic data was collected through physician interviews. Patients’ skin care routines, including cleansing practices and moisturizer use, were analyzed alongside reported therapeutic education experiences. Categorical variables were analyzed using the chi-squared test or Fisher’s exact test; continuous variables were compared using Student’s t-test or the Wilcoxon-Mann-Whitney test, depending on distribution. Normality was assessed with the Kolmogorov-Smirnov test. Statistical significance was set at p-value ≤ 0.05. Overall, 73.9% of patients used lukewarm water for bathing and 74.4% dried their skin by tamponing. Specific detergents were used by 56.0% of participants, most commonly during both flare-ups and remission. A moderate correlation was found between detergent use (ml/week) and body surface area (BSA) (r = 0.300, p-value < 0.0001). Specific moisturizers were used by 65.4% of patients; 73.0% applied them in both acute and remission phases, mainly after bathing. No significant correlation was found between moisturizer volume and BSA (r = 0.087, p-value = 0.085). Therapeutic education was received by 69.0% of families, mainly through physician counseling. Educational exposure was significantly associated with better adherence to recommended practices, including higher usage of specific detergents and moisturizers, more appropriate bathing techniques, and broader product application. Families who received physician-led education also reported significantly greater confidence (p-value < 0.0001) and satisfaction (p-value = 0.007) in managing AD care. This study highlights significant variability in general washing and moisturizing practices among Italian pediatric AD patients and underlines the potential key role of therapeutic education in improving adherence to skin care, along with greater caregiver confidence and satisfaction. These findings support the implementation of structured, multidisciplinary educational programs to enhance disease management and patient outcomes.