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Atopic Dermatitis – Treatment Options

Anna Chacon, MD Anna Chacon, MD February 7, 2021
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"What treatment options are there for atopic dermatitis or eczema? The treatment options include topical medications, oral medications, and injectable therapies. There are also over the counter management recommendations, including regular use of emollients and gentle skincare guidelines. Treatment options are often necessary for long periods of time, and almost always include reduction of exposure to triggers, regular use of mullions and moisturizers and intermittent topical steroids. Management sometimes involves topical calcineurin inhibitors, intermittent, topical steroids, several ointment, antibiotics, anti-histamines, phototherapy and oral steroids. Long standing disease can be treated with immunosuppressants, such as methotrexate, azathioprine and cyclosporine. And newer biologics such as dupilumab, which can be used in moderate to severe atopic dermatitis. The major components in management of atopic dermatitis include treatment of an active flare or rash with an anti-inflammatory agent and maintenance and control to improve skin barrier function, avoiding trigger factors and controlling inflammation that may be subclinical. Treatment of atopic dermatitis proactively helps to provide better control of the disease and can help to interrupt the atopic march.

Basics of skincare are essential in preventing flares. This includes showering or bathing in lukewarm water and limiting use of soap to a mild cleanser that is gentle. Shortly after bathing or showering, emollients to the entire skin surface should be applied and topical steroids and calcineurin inhibitors can be used when indicated and where indicated. Ointments that minimize stinging and creams that may be less greasy are preferred to lotions and should be used twice a day. Emollients with serumides help to optimize the skin barrier and meanwhile products with lactic acid or licholic acid can lead to irritation and stinging and are best avoided."

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