Atopic Dermatitis Daily Care Guide

Dermatologist Hua-Ching Chang

Atopic dermatitis (AD) is a chronic skin condition requiring long-term management. In addition to following a doctor's advice for medical treatment and regular follow-up, daily skincare is crucial for maintaining stable condition. This includes three main aspects: cleansing, moisturizing, and sun protection. There are many products designed for sensitive and AD-prone skin, each with unique features. Patients and their families often feel overwhelmed by the variety of products available. This article offers dermatologists' insights on daily skincare routines and suggestions for product selection for AD patients.

Cleansing Products

Cleansing is the basic step for maintaining normal skin metabolism. The water temperature should be close to or below body temperature, and the overall bathing time should not exceed 10 minutes. It's recommended to avoid cleansing products containing "soap base," including handmade and commercial soaps. You can use plain water or choose products with "amino acid surfactants" as the main cleansing ingredient. The latter can gently cleanse the skin without over-cleaning, preserving the skin's natural barrier, and aligning with environmentally friendly sustainable development goals due to high biodegradability.

Moisturizing Products

Moisturizing is highly recommended in both domestic and international AD treatment guidelines. It is essential at all stages of the disease's severity. Regular use of moisturizers helps repair the damaged skin barrier, reduce water loss, enhance the skin's resistance to external irritants, and lower the frequency of disease exacerbations. The best time point to apply moisturizers is right after bathing, within a few minutes after drying the skin. At this time, the stratum corneum retains moisture, enhancing the absorption of moisturizers and reducing the amount needed. Moisturizers can also be applied to particularly dry or itchy areas throughout the day. Apply moisturizers in gentle, dot-like patterns without excessive rubbing.

When choosing moisturizers, consider texture, ingredients, and safety. During hot and humid summer months, choose lightweight, non-greasy products that still provide effective moisture. Many well-known brands originate from continental climates in Europe and America, where highly moisturizing products are more suitable for the low-humidity winter season or for patients with extremely dry skin. Choose products with simple, confirmed ingredients that have passed skin sensitivity tests. Avoid added fragrances and dyes. Given current understanding of AD pathophysiology, consider products with ingredients that help regulate inflammation, itching, barrier defects, or skin microbiome imbalance. Ensure the product is produced in internationally regulated facilities, the ingredients are third-party tested, and it includes safe, legally compliant preservatives.

Sun Protection Measures

Sunlight, high temperatures, and sweat are adversaries for AD patients. It's recommended to stay in cool environments, avoiding high temperatures and sweat that can irritate the skin. Prefer indoor activities in temperature-controlled venues and dry off sweat or shower promptly after exercising. Prioritize physical sun protection measures like umbrellas, sun hats, or protective clothing. For sunscreen, choose products with low-irritation physical sun blockers such as zinc oxide and titanium dioxide, which physically block sunlight without being absorbed by the skin, thereby reducing the risk of irritation or allergies.

Conclusion

Since AD patients have more sensitive skin, it's important to understand whether products have been clinically tested on AD patients. More importantly, when using any product for the first time, apply a small amount to a localized area for a few days to test for sensitivity. If no significant irritation or allergic reaction occurs, you can expand its use. Discontinue use immediately and seek medical assistance if any abnormal or unexpected reactions occur.

References:

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2. Piquero-Casals J, Carrascosa JM, Morgado-Carrasco D et al. The Role of Photoprotection in Optimizing the Treatment of Atopic Dermatitis. Dermatol Ther (Heidelb) 2021;11(2):315-325.

3. Araviiskaia E, Pincelli C, Sparavigna A, Luger T. The Role of a Novel Generation of Emollients, 'Emollients Plus', in Atopic Dermatitis. Clin Cosmet Investig Dermatol 2022;15:2705-2719.

4. Elias PM. Optimizing emollient therapy for skin barrier repair in atopic dermatitis. Ann Allergy Asthma Immunol 2022;128(5):505-511.

5. Pagliaro M, Pecoraro L, Stefani C, Pieropan S, Piacentini G, Pietrobelli A. Bathing in Atopic Dermatitis in Pediatric Age: Why, How and When. Pediatr Rep 2024;16(1):57-68.