Continuing Medical Education
Non-pharmacological treatment modalities for atopic dermatitis
Non-pharmacological measures to improve the management of atopic dermatitis (AD) are as important as pharmacotherapy for true healing of the skin. Skin dryness (which contributes to inflammation, loss of suppleness (leading to fissuring), impaired barrier function, and increased adherence of Staphylococcus aureus organisms) can be overcome by the use of emollients. Ointments and creams provide better barrier function than lotions.
Bathing is an important part of the management of AD. Regular, once-daily bathing in warm (not hot) water to hydrate the skin and debride crusts is important. Scented soaps should be avoided and replaced with a moisturising cleanser. After bathing, patients should pat the skin dry and apply emollients immediately.
Routine use of topical or systemic antibacterial or antifungal agents is not recommended for AD, but during flares such agents may be invaluable.
There is no specific diet for the treatment of AD. Elimination diets are not routine treatment and are potentially harmful. Food elimination should be reserved for those children who have been proven to be allergic to the specific food.
G Todd, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
A I Manjra, Westville Hospital, Durban, South Africa
W Sinclair, Department of Dermatology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
R J Green, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, South Africa
M E Levin, Division of Asthma and Allergy, Department of Paediatrics, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
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Date published: 2014-08-25
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