Use of moisturizers in patients with atopic dermatitis

Abstract

Atopic eczema or dermatitis (AD) is a chronically relapsing dermatosis associated with pruritus, sleep disturbance, and impaired quality of life. AD affects 10-20% of school-aged children. The prevalence has increased two- to threefolds over the past three decades in industrialized countries, and there is evidence to suggest that this prevalence is increasing. AD is frustrating to both patients and caregivers and can impose considerable financial impact on the families. The pruritus and sleep disturbance can be intractable, and the disease has important physical and psychological implications. Avoidance of triggering factors, optimal skin care, and topical corticosteroids are the mainstay of therapy. There are two important dermatologic facets to its management, namely, preventive and therapeutic measures. Preventive measures refer to the frequent and proper application of skin moisturizers. When these preventive measures fail to control disease exacerbation, therapeutic measures such as topical/systemic corticosteroids, antibiotics, and immunomodulating agents may be required to control the skin inflammation. Proper moisturizer therapy can reduce the frequency of flares and the demand of topical corticosteroids or topical calcineurin inhibitors. Regular topical application of a moisturizer is the key in the management of patients with AD. Moisturizers can be in the form of creams, emollients, lotions, or ointments. A number of studies have been done to demonstrate how the efficacy of moisturizer therapy can be objectively measured and these studies will be reviewed.