Atopic Dermatitis Skin Care

At-Home Skin Care for Atopic Dermatitis

Atopic Dermatitis - "Leaky Skin"

In general, people who have atopic dermatitis have "leaky skin," meaning the barrier function of their skin does not work well. Practically this means:

• Anything that goes on the skin soaks in to the deeper layers that activate the immune system.
• The skin loses water and the natural oils that normally moisturize it and keep it supple.

These changes cause the skin to be drier than normal skin and more sensitive to anything that comes in contact with the skin.

Water - Good or Bad?

You would think that putting water on the skin would moisturize it more, but the opposite is true. Plain water that comes in contact with the skin evaporates and takes with it many of the skin's natural oils called natural moisturizing factor (NMF). The more often the skin has contact with water, the drier it gets unless those natural oils are replaced. Read more about atopic dermatitis and water contact.

Soaps for Atopic Dermatitis

The effect of soap on the skin is not good for people with atopic dermatitis. Most soaps, especially bar soaps, dry the skin out even more. Liquid cleansers are much less damaging to the skin than bar soaps. Using an emollient-rich liquid cleanser that leaves a moisturizer on the skin when the soap is washed off is the best choice for people with atopic dermatitis. For specific product recommendations, see the best soaps for eczema.

Moisturizers for Atopic Dermatitis

Not only is it important to use a moisturizer often (up to three times a day), it is important to use one that does not contain perfumes, fragrances or essential oils, because these are all potentially very irritating to eczematous skin.

I don't have one moisturizer I would recommend over the others -- they all have pros and cons. The following are different types of moisturizers to consider:

• The moisturizers for scaly eczema would be a good choice if you have a lot of flaking without a flare because they can sting if applied to open areas on the skin.
• The emollient moisturizers are a low-cost option, especially if you are in the middle of a flare-up, because they are not irritating.
• The new ceramide moisturizers help the skin heal faster during a flare. Most are expensive, but one is affordable -- less than $15. If you can afford them, these moisturizers would be a great choice with or without a flare.

  _Sources:

  Boguniewicz, Mark. "Atopic Dermatitis: Beyond the Itch that Rashes." Immunology and Allergy Clinics of North America 25(2005): 333-51.

  Chamlin, Sarah, et al. "Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: Changes in barrier function provide a sensitive indicator of disease activity." Journal of the American Academy of Dermatology 47(2002): 198-208.

  Choi, Myeong Jun, and Howard Maibach. "Role of Ceramides in Barrier Function of Healthy and Diseased Skin." American Journal of Clinical Dermatology 6(2005): 215-22.

  Coderch L, et al. "Efficacy of stratum corneum lipid supplementation on human skin." Contact Dermatitis. 3(2002):139-46.

  Halvarsson, K, and M. Loden. "Increasing quality of life by improving the quality of skin in patients with atopic dermatitis." International Journal of Cosmetic Science 29(2007): 69-83.

  Hanifin, Jon, et al. "Guidelines of Care for Atopic Dermatitis." Journal of the American Academy of Dermatology 50(2004): 391-404.

  Simpson, Eric, and Jon Hanifin. "Atopic Dermatitis." The Medical Clinics of North America 90(2006): 149-167.