Topical Treatment of Atopic Dermatitis: A Review

the MPR take:

In order to help clinicians make informed decisions for patients suffering with allergic skin diseases, 24 recent publications on the treatment of atopic dermatitis were reviewed in an article published in the journal Current Opinion in Allergy and Clinical Immunology.  When conservative measures fail, topical treatment with corticosteroids continues to be a first-line treatment. Based on literature review, topical calcineurin inhibitors (TCIs) were shown to be as effective as corticosteroids, if not more with regards to improving skin barrier.  Barrier therapy (creams, ointments, moisturizers) are a fundamental aspect of treatment; the literature does not support use of one barrier therapy over another.  With regards to natural oils, sunflower seed oil, mineral oil, and coconut oil have shown positive effects, while olive oil has shown negative effects in patients with atopic dermatitis.  Textile clothing (made of cellulose fibers with silver ion-enriched seaweed), while somewhat effective, cannot be recommended due to low-quality evidence. Since microbial colonization and superinfections contribute to atopic dermatitis flares, the literature supports the use of bleach baths as an adjunctive therapy.  Researchers conclude that there is strong evidence for the use of anti-inflammatory and barrier therapies.  For patients concerned with the potential side effects of topical corticosteroids and TCIs, alternative therapies such as textiles, natural oils, and bleach baths may be used; however, evidence remains limited for these therapies.

To review recent literature on the topical treatment of allergic skin diseases to help clinicians make informed evidence-based decisions.

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