Find out the best treatment for the atopic dermatitis to have a soft, comfortable skin.
The most important step in healing atopic dermatitis is rehydration of the stratum corneum. Adequate rehydration preserves the stratum corneum barrier, minimizing the effects of irritants and allergens on your skin and maximizing the effect of applied therapies, so it will decrease the need for topical steroids.
It is ideal to have Lukewarm soaking baths that lasting 10-20 minutes. But you should avoid extremely hot water to prevent vasodilation, which can trigger pruritus, and the damage to your skin barrier that caused by scalding.
You can add small amounts of bath oils or emulsification agents to hydration benefits in older children. Bath oils agents result in slippery conditions; warn patients of the resultant risks of trauma and drowning after a fall. There are many available over-the-counter bath agents including Aveeno Colloid Oatmeal, RoBathol, Maypo, cottonseed oil with Brij 93, or mineral oil.
We recommended you to use soaps that are mild and unscented with a neutral Ph such as Dove, Oil of Olay, Caress, Camay, Aveeno, and Purpose. However, these mild soaps are usually too drying for atopic skin. Postpubertal patients need to use soap in the axillae and groin but do not need it elsewhere.
If soaps are irritating to your skin, hydrophobic lotions and creams may be used. Such agents have wonderful cleansing properties and low potential for irritation. You should apply them without water and rub gently over the skin surface until a light foaming occurs. Then, apply soft cotton cloth or tissue can to wipe away the agent, leaving behind a protective film of stearyl alcohol and propylene glycol.
You can also use baby shampoo to manage scalp dermatitis.
You should follow baths with the immediate application of an occlusive emollient over the skin surface in order to retain moisture in the epidermis. If you don’t apply an emollient within 3 minutes of leaving the bath, the evaporation causes excess drying of your skin. Be careful, skin should not be dried with a towel prior to application of the emollient; instead, patting the skin with a towel to remove excess moisture is sufficient.
We frequently recommended you to use emollients which are hydrophobic and ointment-based as these include Vaseline petrolatum jelly, Crisco, vegetable oil, Aquaphor, and Elta. Moreover, parents can find these agents too greasy for everyday use and cream-based alternatives may be offered. Common creams include DML Forte, Moisturel, Aveeno, Curel, Purpose, Dermasil, Neutrogena, and Eucerin. This group of moisturizers is less effective because of the weaker occlusive effects of creams as compared to ointments; so, they should be used only when the ointment-based emollients are not well tolerated.
Ceramide-dominant is the newest type of moisturizing product. lipid-based emollient aimed at repairing the stratum corneum barrier function lost in atopic dermatitis. There is a study that showed a significant decrease in clinical severity scores and a decrease in transepidermal water loss in children whose traditional moisturizers were replaced by TriCeram for 3 weeks.
Urea-containing products can soften and moisturize dry skin.
Wet dressings are very useful for diverse types of atopic dermatitic flares and severe recalcitrant atopic dermatitis. They can be used on dry lichenified lesions to increase the penetration of topical corticosteroids and to improve hydration and. They also work well to dry weeping or oozing lesions via evaporation. The cooling sensation on your skin that results from slow evaporation with wet dressings has an anti-inflammatory effect and suppresses itching.
The mechanical barrier of the wet dressing can prevent scratching, allows more rapid healing of lesions, and offers protection from contact with allergens and bacteria. You should delay wet wrap implementation at least 2-3 days after beginning antibiotic treatment for superinfected lesions to allow for observation of clinical improvement of infected sores.
Burow solution is a commonly used wet dressing because it is germicidal and directly suppresses weeping lesions by precipitation of protein. Using lukewarm water is essential because hot water induces vasodilatation with increased weeping and pruritus, where cold water causes vasoconstriction and secondary vasodilation. Submerge a soft cloth into the solution until wet but not dripping. You need to place the dressing over the affected skin site, rewetting the compress. In the severe cases, you can apply a topical corticosteroid after the compress for enhanced penetration and action of the medication.
If emotional stressors are a contributing factor to atopic dermatitis, seek psychologic counseling, biofeedback, relaxation techniques, massage therapy, and behavioral modifications.
Ultraviolet light may benefit some patients. Ultraviolet light in the UVB range can provide control and eliminate or reduce the need for steroids. The new narrow band units are effective. Ultraviolet light in the UVA range has been used alone, in combination with oral psoralen administration (PUVA), or with high-dose UVA 1.
There is a significant decline in the usage of UVA light therapy that has been recently observed because this regimen clearly accelerates photoaging and increases the risk of skin cancer. UVA 1 spectrum light works by reducing cellular immunoglobulin E, binding sites and inducing apoptosis in inflammatory cells and has demonstrated significant efficacy in treating atopic dermatitis. A small number of patients develop erythema or disease flares with light treatment.
Allergen immunotherapy is indicated only for patients with allergic rhinitisor allergic asthma. But several small randomized controlled trials have shown a significant clinical benefit of subcutaneous immunotherapy or sublingual immunotherapy with house dust mite extract in patients sensitized to the house dust mite. To confirm these findings, larger randomized, double-blind, placebo-controlled trials are needed