Transcript
Announcer:
This is DermConsult on ReachMD. On this episode, Dr. Lawrence Eichenfield will be sharing the American Academy of Dermatologyrecommendations on moisturization for atopic dermatitis prevention. Dr. Eichenfield is a Distinguished Professor of Dermatology and Pediatrics at UC San Diego School of Medicine as well as Chief of Pediatric and Adolescent Dermatology at Rady Children's Hospital San Diego. Let’s hear from him now.
Dr. Eichenfield:
All patients can benefit from moisturization in atopic dermatitis because the dry skin and barrier dysfunction in atopic dermatitis is a mixture of both what may be genetically inherited in patients who have deficiency in filaggrin protein and other proteins in the epidermis, so they end up constituently dry, but also with the inflammation of atopic dermatitis, which also impacts on the protein expression and makes patients dry as well. So moisturization can help across the spectrum of atopic dermatitis.
Now, the question of, “Can moisturizer prevent atopic dermatitis?” is a much trickier one. We've had a broad set of studies that are really interesting. The guideline group ended up saying evidence suggests regular moisturization under age two may reduce the risk of developing atopic dermatitis, but it doesn't support a protective effect in the general population—just those at risk.
But we know as experts—many of us who've spent time in the field—that there have been recent studies that had the reverse, where moisturizers can prevent atopic dermatitis in the general population, but not those in the patients who are at risk. On the other hand, it's not an uncommon thing where I'll have a parent come in who's pregnant and they have a kid with pretty severe atopic dermatitis. They want to know what they can do to decrease the chance of the next child having atopic dermatitis, and moisturizer from early infancy is probably a reasonable intervention.
When it comes to general moisturization practices, the clinical studies vary in terms of how aggressive they are in the design. So you always go from the evidence, and that's why it ends up with low level of evidence, because there's so many different ways of doing it. When it comes to actual topical treatment for prescription medicines, for instance, that's a totally different ballgame because in the clinical studies, you're measuring adherence. But in real practice, we try not to overburden people, understanding that topicals can be a huge amount of work, especially if you're doing multiple topicals for established eczema.
Announcer:
That was Dr. Lawrence Eichenfield discussing the guidelines of care for moisturization in atopic dermatitis prevention. To access this and other episodes in this series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
