Atopic Dermatitis (Eczema)
Publication Date: December 17, 2023
Last Updated: December 19, 2023
Diagnosis
Good Practice Statement: Clinicians managing all severities of atopic dermatitis should, before issuing any new therapy, (1) ensure the correct diagnosis and identify complicating diagnoses, (2) provide education, for instance an information guide about the disease5 and an action plan, (3) address trigger avoidance, (4) ensure proper medication use/adherence, and (5) encourage application of a bland moisturizer titrated to symptomatic benefit (at least once, often multiple times, per day). (U, U)
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Topical Treatments
Prescription Moisturizers
In patients with atopic dermatitis, the JTF panel suggests using a standard, bland (free of fragrance and other potential contact allergens) over-the-counter moisturizer over a prescription moisturizer medical device (eg, Atopiclair, Eletone, Epiceram, MimyX, Neosalus, Zenieva, and PruMyx). (C, L )
Conditions to consider:
- Different moisturizers (either prescription or over-the-counter) have different odors and textures/consistency that may importantly influence decision-making.
- Patients with an insurance plan that covers the cost of prescription moisturizer, or those that otherwise can easily absorb the direct cost, and who place a higher value on the small potential benefits of prescription moisturizers over their costs, burdens, and lower accessibility may prefer them vs over-the-counter ones.
- Patients who have not improved sufficiently with routine use of standard over-the-counter moisturizers may prefer a trial of prescription moisturizer before adding better proven topical anti-inflammatory medications (see next recommendations).
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Overview
Title
Atopic Dermatitis (Eczema)
Authoring Organizations
American College of Allergy, Asthma, and Immunology
American Academy of Allergy, Asthma & Immunology