Atopic dermatitis: Nonpharmacologic interventions recommendations

  • The application of moisturizers should be an integral part of the treatment of patients with AD as there is strong evidence that their use can reduce disease severity and the need for pharmacologic intervention.

Level of Evidence: I Strength of Recommendation: A

  • Bathing is suggested for patients with AD as part of treatment and maintenance; however, there is no standard for the frequency or duration of bathing appropriate for those with AD.
Level of Evidence: III Strength of Recommendation: C

  • Moisturizers should be applied soon after bathing to improve skin hydration in patients with AD.
Level of Evidence: II Strength of Recommendation: B

  • Limited use of nonsoap cleansers (that are neutral to low pH, hypoallergenic, and fragrance free) is recommended.
Level of Evidence: III Strength of Recommendation: C

  • For the treatment of patients with AD, the addition of oils, emollients, and most other additives to bath water and the use of acidic spring water cannot be recommended at this time, because of insufficient evidence.
Level of Evidence: III Strength of Recommendation: C

  • Use of wet-wrap therapy with or without a topical corticosteroid can be recommended for patients with moderate to severe AD to decrease disease severity and water loss during flares.
Level of Evidence: II Strength of Recommendation: B

Navigate section 2 of the AD guideline: Topical therapy

Citation note 

When referencing this guideline in a publication, please use the following citation: Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014 Jul;71(1):116-32.

 


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