ATOPIC DERMATITIS

Atopic dermatitis is the predominant form of eczema, which is a skin condition characterized by persistent itching and the development of red patches, typically found on the face, arms, and legs. Although it primarily affects children, it is important to note that it also impacts a significant number of adults, with an estimated 18 million individuals affected.

The hallmark of atopic dermatitis is its cyclical nature, wherein the rashes tend to flare up, subside, and then reappear periodically. This pattern of flare-ups and remissions can vary in frequency and severity among individuals. During flare-ups, the affected skin may become intensely itchy, leading to scratching, which can further exacerbate the condition.

The exact cause of atopic dermatitis is not fully understood, but it is believed to be a combination of genetic and environmental factors. People with a family history of allergies, asthma, or atopic dermatitis itself may be more prone to developing the condition.

Managing atopic dermatitis involves a multifaceted approach aimed at relieving symptoms and preventing flare-ups.
It is important for individuals with atopic dermatitis to work closely with healthcare professionals specializing in dermatology to develop a personalized treatment plan tailored to their specific needs. By effectively managing symptoms and reducing flare-ups, individuals with atopic dermatitis can experience improved quality of life and relief from the discomfort associated with this chronic skin condition.

Treatment

Topical

Skincare routine

Establishing a consistent skincare routine is essential for managing atopic dermatitis.This includes gentle cleansing with mild, fragrance-free cleansers and moisturizing the skin regularly with emollients or moisturizers to keep it hydrated and prevent dryness.

Topical calcineurin inhibitors

In cases where corticosteroids are not suitable or effective, topical calcineurin inhibitors like tacrolimus or pimecrolimus may be prescribed. These medications help reduce inflammation and are particularly useful for sensitive areas such as the face or skin folds.

Topical corticosteroids

Topical corticosteroid creams or ointments are commonly prescribed to reduce inflammation and itching during flare-ups. These medications help calm the skin and alleviate symptoms. It’s important to use them as directed by a healthcare professional and gradually taper their use to prevent potential side effects.

Crisaborole

Crisaborole is a topical phosphodiesterase-4 (PDE-4) inhibitor. PDE-4 plays a role in the inflammatory response, and by inhibiting this enzyme, crisaborole helps to reduce inflammation and relieve symptoms of atopic dermatitis. It is available as a prescription ointment and has been approved for the treatment of mild to moderate atopic dermatitis.

Topical or oral antihistamines

Antihistamines can help relieve itching associated with atopic dermatitis. They can be used topically in the form of creams or taken orally. Non-sedating  ntihistamines are often preferred to minimize drowsiness.

Wet wrap therapy

Wet wrap therapy involves applying moisturizers or medicated creams to the affected areas and then wrapping them in damp dressings or clothing. This helps enhance the absorption of topical medications and moisturizers, soothes the skin, and reduces itching.

Immunomodulatory therapies

Recent advances in medical research have led to the development of new immunomodulatory therapies for atopic dermatitis. These therapies aim to modulate the immune response and provide targeted treatment options.

Dupilumab

Dupilumab is a monoclonal antibody that targets specific proteins involved in the immune response, specifically interleukin-4 (IL-4) and interleukin-13 (IL-13). These proteins play a role in the inflammation and itchiness associated with atopic dermatitis. Dupilumab has shown significant efficacy in reducing symptoms and improving skin condition in clinical trials and has been approved for the treatment of moderate to severe atopic dermatitis.

Omalizumab

Omalizumab is a monoclonal antibody that targets immunoglobulin E (IgE), a key player in allergic reactions. It has been used primarily for the treatment of allergic asthma, but studies have shown its potential in managing severe atopic dermatitis by reducing IgE levels and mitigating the immune response associated with the condition.

Janus kinase (JAK) inhibitors

JAK inhibitors are a class of drugs that block the action of certain enzymes involved in the immune response. In the context of atopic dermatitis, JAK inhibitors target specific signaling pathways that contribute to inflammation. Several JAK inhibitorsapproved for AD treatment  include the oral ones like baricitinib, abrocitinib and upadacitininb and the topical JAK ruxolitinib.

These new immunomodulatory therapies provide additional options for the treatment of atopic dermatitis, particularly for individuals with moderate to severe symptoms who have not responded well to other treatments. It’s important to note that these therapies require a prescription and should be administered under the guidance of a healthcare professional who can assess individual suitability and monitor treatment response.

As research continues, more innovative immunomodulatory therapies may emerge, offering even greater potential for targeted and effective management of atopic dermatitis.

Dr. Ciocca is a highly regarded dermatologist and an esteemed researcher who is actively involved as a principal investigator in ongoing clinical trials for phase 2 and 3 of innovative immunomodulatory treatments for Atopic Dermatitis.

If you are interested in participating in these promising trials or seeking more information, we encourage you to reach out to our dedicated research team at www.skinresearchsf.com.

They will provide you with the necessary details and assist you professionally throughout the process.

recommendations

Here are some general recommendations for managing atopic dermatitis:

Moisturize
regularly

Apply a moisturizer to your skin daily, especially after bathing, to help restore and maintain the skin’s natural moisture barrier. Opt for fragrance-free and hypoallergenic moisturizers.

Identify and
avoid triggers

Pay attention to factors that may trigger or worsen your atopic dermatitis symptoms, such as certain fabrics, irritants (like harsh chemicals or soaps), allergens (such as dust mites or pet dander), or extreme temperatures. Take steps to minimize exposure to these triggers.

Gentle
skincare routine

Use mild, fragrance-free cleansers and avoid harsh soaps or cleansers that can strip the skin of its natural oils. Take short, lukewarm showers or baths, and gently pat your skin dry with a soft towel.

Choose skin-
friendly clothing

Wear soft, breathable fabrics, such as cotton, and avoid rough or scratchy materials that can further irritate your skin. Consider washing new clothes before wearing them to remove any potential irritants.

Keep nails
short

Trim your nails regularly and avoid scratching the affected areas to prevent skin damage and potential infection.

Avoid excessive
heat and sweat

Overheating and excessive sweating can trigger flare-ups. Stay in a cool environment, dress in breathable clothing, and consider using a fan or air conditioning during warmer weather.

Stress
management

Stress can aggravate atopic dermatitis symptoms. Explore stress-reduction techniques such as mindfulness, meditation, yoga, or engaging in activities you enjoy to help manage stress levels.

Seek medical
advice

Consult with a dermatologist for a proper diagnosis and personalized treatment plan. They may recommend over-the-counter or prescription medications, such as topical corticosteroids, calcineurin inhibitors, or antihistamines, depending on the severity of your symptoms.

Follow prescribed
treatments

If your dermatologist prescribes medications, follow the instructions carefully and use them as directed. Report any concerns or side effects to your healthcare provider.

Supportive
care

Joining support groups or seeking counseling can provide valuable emotional support and practical tips for managing atopic dermatitis.

Remember!

Each individual’s experience with atopic dermatitis may vary, so it’s important to work closely with a healthcare professional to develop a personalized treatment plan that suits your specific needs.