Atopic Dermatitis Knowledge Centre
Treatment
Overview
There are a number of different treatment options currently available for atopic dermatitis. Non-pharmacological options for improving signs and symptoms include emollient creams, ultraviolet (UV) phototherapy, allergen avoidance, skin-care treatments – such as wet wraps or coal tar wraps – and psychological therapies. For a more detailed description of the most commonly used interventions, please refer to the non-pharmacological treatment subsection. Pharmacological approaches to the treatment of atopic dermatitis include topical corticosteroids, topical calcineurin inhibitors, systemic corticosteroids, antihistamines, purine synthesis inhibitors and antibiotics. Specific information relating to each of these treatments is provided in the pharmacological treatment subsection.
Regardless of the therapy options used, the objectives of treating atopic dermatitis remain the same. When treating acute flares episodes, the main focus is on sign and symptom relief (e.g. pruritis), treatment of associated infections, rehydration of the skin and restoration or improvement of skin-barrier functions. Long-term treatment aims to control the underlying inflammation (known to be present in both lesional and non-lesionall skin) to prevent flares from recurring.1,2 Ongoing active management of subclinical inflammation represents the new cornerstone of effective, long-term atopic dermatitis control.
As discussed in the management section of this knowledge base, the treatment strategies employed can vary from person to person. Specific approaches to treatment are decided upon after careful clinical assessment of the patient and are tailored to their individual needs. For long-term control of atopic dermatitis, close collaboration between patients, carers, and healthcare professionals are required before specific treatment plans are agreed upon. The International Consensus Conference on Atopic dermatitis (ICCAD) published recommendations, in the form of an algorithm (Figure 1), delineating the strategies and guidelines for the treatment of active pruritis and inflammation, and for long-term atopic dermatitis control and containment of underlying inflammation.3
Figure 1. ICCAD atopic dermatitis treatment algorithm3
Reproduced from Eichenfeld et al. Allergy 2004;59(Suppl.78):86–92 with the permission of the publisher Wiley. ©2004 Blackwell Munksgaard.
© February 2010 Astellas Pharma Europe LTD.
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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.