Atopic Dermatitis

Atopic Dermatitis (AD) is a chronic, relapsing, eczema-like disorder that affects up to 1% of the total population and up to 10% of children. A secondary bacterial infection may periodically complicate the management of this disorder. The treatment is based on attempting to restore skin integrity. The following recommendations are given to reduce the severity of this problem.

Hydration: AD is often an inherited disorder of the skin, in which excess evaporation of water and absorption of allergic/irritating substances occurs. Skin is primarily lubricated by water, not oils. To insure adequate hydration, and improve the barrier function of the skin, adhere to the following recommendations:

    Bathe 1-3 times daily in warm (not hot) water. 15-20 minutes of bathing is optimal. A shower is better than a bath when it becomes impossible to keep the trunk and arms constantly wet. In young children especially, the wearing of a long sleeve shirt in the bath may be a better alternative

    Aveno or baking soda added to bath water may be soothing in some individuals

    Soap: The best products are of a neutral pH

    Dove, Tone, Alpha Keri, Moisturel, Neutrogena, Oilatum, and Purpose are all recommended

    If a bacterial skin infection occurs, temporary usage of Dial (or other antibacterial soap) is recommended

    Topical Therapy: After bathing, the water added to the skin needs to be "locked in" by reducing evaporation

    Barriers such as oils, creams, and lotions must be applied within 3 minutes after bathing to be effective. It is best to have your product immediately handy as you step out of the bath and, after a light and quick toweling, immediately apply your barrier

    Vaseline and even Crisco can be very effective, and may be better than many other creams or lotions since they do not contain additives. Mineral oil may be an alternative. Needless to say, some may consider these products to be quite messy

    Recommended ointments, creams and lotions include: Aquaphor Ointment, Eucerin Cream, Moisturel Cream and Lotion, Neutrogena Emulsion, DML Cream and Lotion, Lubriderm Cream, and Aveno Lotion. These should be applied as frequently as desired, usually of 3-4 times daily is recommended, and especially after washing

    "Itch Pills": Antihistamines may offer relief. Many experts feel that their primary effect is to produce drowsiness, whereby you are too sleepy to scratch. For night-time scratchers, higher doses are usually recommended. The newer non-sedating antihistamines are often less helpful

    Avoidance: Reducing contact with allergic/irritating substances may prevent worsening of the problem

    After washing clothes, double rinse to remove any residue of soap. The brand detergent “ALL” is a particularly safe detergent

    Wash new clothes before wearing to remove irritating substances introduced during manufacturing

    Do not use fabric softener

    Maintain the humidity between 45-50% for improved comfort. A humidity gauge, at $5-$10, can be purchased at larger department/hardware stores

    After using a swimming pool, a thorough showering is necessary to remove excess chlorine

    Avoid emotional upset. Anger, frustration and anxiety are factors that aggravate itchy skin. This condition is due to chemical substances released by nerves in the skin. These nerves are directly connected to emotional centers in the brain. Such chemicals are released by all people but are not as troublesome as in those with a preexisting skin condition

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	Bathe 1-3 times daily in warm (not hot) water. 15-20 minutes of bathing is optimal. A shower is better than a bath when it becomes impossible to keep the trunk and arms constantly wet. In young children especially, the wearing of a long sleeve shirt in the bath may be a better alternative
	Aveno or baking soda added to bath water may be soothing in some individuals
	Soap: The best products are of a neutral pH
	Dove, Tone, Alpha Keri, Moisturel, Neutrogena, Oilatum, and Purpose are all recommended
	If a bacterial skin infection occurs, temporary usage of Dial (or other antibacterial soap) is recommended
	Topical Therapy: After bathing, the water added to the skin needs to be "locked in" by reducing evaporation
	Barriers such as oils, creams, and lotions must be applied within 3 minutes after bathing to be effective. It is best to have your product immediately handy as you step out of the bath and, after a light and quick toweling, immediately apply your barrier
	Vaseline and even Crisco can be very effective, and may be better than many other creams or lotions since they do not contain additives. Mineral oil may be an alternative. Needless to say, some may consider these products to be quite messy
	Recommended ointments, creams and lotions include: Aquaphor Ointment, Eucerin Cream, Moisturel Cream and Lotion, Neutrogena Emulsion, DML Cream and Lotion, Lubriderm Cream, and Aveno Lotion. These should be applied as frequently as desired, usually of 3-4 times daily is recommended, and especially after washing
	"Itch Pills": Antihistamines may offer relief. Many experts feel that their primary effect is to produce drowsiness, whereby you are too sleepy to scratch. For night-time scratchers, higher doses are usually recommended. The newer non-sedating antihistamines are often less helpful
	Avoidance: Reducing contact with allergic/irritating substances may prevent worsening of the problem
	After washing clothes, double rinse to remove any residue of soap. The brand detergent “ALL” is a particularly safe detergent
	Wash new clothes before wearing to remove irritating substances introduced during manufacturing
	Do not use fabric softener
	Maintain the humidity between 45-50% for improved comfort. A humidity gauge, at $5-$10, can be purchased at larger department/hardware stores
	After using a swimming pool, a thorough showering is necessary to remove excess chlorine
	Avoid emotional upset. Anger, frustration and anxiety are factors that aggravate itchy skin. This condition is due to chemical substances released by nerves in the skin. These nerves are directly connected to emotional centers in the brain. Such chemicals are released by all people but are not as troublesome as in those with a preexisting skin condition