Atopic Dermatitis Knowledge Centre
- Overview
- Signs & symptoms of atopic dermatitis
- Area of the body commonly affected by atopic dermatitis
- Diagnosis
- Assessment
- General Management
- Education
General Management
Non-pharmacological therapy
Patients with atopic dermatitis typically suffer from an increased water loss from the skin, as a result of dysfunction of the skin barrier and disruption of the skin’s usual lipid composition (see ‘Pathophysiology’ under the Understanding Atopic Dermatitis section of this website). Therefore, an important aspect of any management strategy for atopic dermatitis, is to restore and maintain the skin’s moisture. All patients should receive advice on the various methods to keep their skin hydrated. This includes care when bathing (brief, lukewarm baths are recommended) and the use of non-soap based cleaners, such as aqueous cream. Regular application of moisturisers helps to both soothe symptoms and to prolong the periods between flares. The use of emollients is beneficial both during periods of flare to treat areas of dry skin and relieve itching, and as a long-term therapy during flare-free periods to replenish lost moisture from the skin and replace lipids thus helping to reduce the risk of flare. A number of emollient treatments are available – those containing lipids similar to the skin’s natural composition are most effective in restoring the skin’s barrier function. For more information on emollients, please refer to the treatment section of this Knowledge Centre).
Regardless of the severity of their disease, it is important for all patients to identify the factors that may trigger their disease, so that they can avoid or reduce their exposure, and therefore, reduce the risk of disease flare. Listed below are some of the potential trigger factors for disease flare. These factors should be considered in discussion with the patient/their carer, and recommendations made for any lifestyle changes or further assessments.
| Potential trigger | Source of irritation |
|---|---|
| Clothing and bedding | Fibres from wool or synthetic material Dust mite faeces |
| Cosmetics | Perfume Additives in some make- up |
| Airborne factors | Dust Solvents Animal dander and fur Cigarette smoke |
| Climate | Heat Dry air |
| Emotions | Stress Anger |
| Diet | Potential allergenic foods include: eggs, peanuts, milk, fish, soy products, wheat |
It may be beneficial to suggest to the patient that they keep a diary detailing diet and exposure to possible irritants, so that any pattern of exposure corresponding to periods of disease flare can be identified. Should an allergy to a potential irritant be suspected, the patient may be referred for skin patch testing to help identify the substances that provoke a reaction. It is important to note that the patch test will not identify an absolute cause of atopic dermatitis, but can provide some additional information to help the disease be managed more successfully.
© February 2010 Astellas Pharma Europe LTD.
Disclaimer:
The Atopic Dermatitis Knowledge centre contained within www.epgonline.org and available at www.atopicdermatitisinfo.org is intended to be for educational use only and not designed to provide medical advice or professional services.