Skin Care for Atopic Dermatitis

Background: Interplay of numerous constitutional and precipitating factors are involved in the development of atopic dermatitis (AD). Most of these etiologic factors are not controllable, but barrier dysfunction can be managed. Correction of barrier abnormalities has been accepted as a first-line therapy with effective anti-inflammatory therapy. Objective: We wished to establish standardized skin care guidelines for Korean patients who suffer from atopic dermatitis. Methods: The skin care guidelines were proposed by the Korean Atopic Dermatitis Association (KADA), with a particular emphasis for barrier dysfunction in AD from a review of more than 100 published studies and related documents in the clinical literature by a task force team (TFT) of the KADA. The TFT also evaluated the reliability of the studies based on scientific evidence and the size of the study populations. The TFT disregarded controversial findings and summarized all of the collected studies. Results: Skin care guidelines were proposed by the KADA, particularly for barrier dysfunction in AD. A warm bath for approximately 20 minutes was recommended once daily. Soap can be used two or three times per week and aggressive skin scrubbing should be avoided. A topical moisturizer should be applied at least twice a day. Immediate application of emollient is required after bathing. The donning of clothing made of cotton is recommended. Nails should be cut short to reduce skin damage caused by a skin scratch. Conclusion: Application of moisturizer immediately after appropriate bathing may be the most important treatment for skin care. A topical steroid should be used whenever AD develops. Nail care and proper clothing are also be helpful for the prevention of dermatitis aggravation. Proper ways to bathe, use of moisturizer and topical steroids and nail care and appropriate clothing were considered.