Atopic dermatitis (AD), commonly called eczema, affects approximately 15 percent of children worldwide and one to three percent of adults. Although often a harmless, topical skin disorder that causes itching and inflammation, secondary infections can be dangerous. Now scientists want to offer more information on new treatment options for people dealing with AD.
In a new paper published in the Annals of Allergy, Asthma and Immunology, researchers from the American College of Allergy, Asthma and Immunology (ACAAI) provide an updated on the the various treatments that have recently become available to give people with AD a variety of new therapeutic options.
AD often develops before babies turn one year old, causing itchy, dry, and scaly patches, often on the scalp, forehead, and face. Scratching that accompanies itchy patches can lead to secondary infections, the worse-case scenario being multi-organ and systemic infections. The strongest risk factor is a family history of AD, asthma, or hay fever, but AD is not contagious.
Treatment controls AD, but it does not cure it. An individual with AD can at best expect relief of pain and itching, prevention of infections, prevention of further progression of AD, reduction of inflammation, clearance of existing scaly patches, and prevention of future patches with treatment that modern medicine has to offer.
“We want physicians who see patients with AD on a regular basis to know there are effective treatment options available," explained lead author Mark Boguniewicz, MD. “We offer definitions of disease severity, review treatment failures, address treatment in a stepwise fashion, and cover the emerging science and implications for new therapies."
Of great significance is the authors’ detailed information on when to give certain medications at different stages of AD diagnosis. Medications are now available to both relieve symptoms and treat underlying mechanisms of AD. A topical treatment for mild to moderate AD, Crisaborole, reduces itching and inflammation. Crisaborole, also known as Eucrisa, is the first medication in over 15 years to be FDA-approved for the treatment of mild to moderate AD. Another option is an injectable medication called Dupilumab, used for older AD patients with more severe disease and who haven’t responded to topical medications like Eucrisa.
In addition to drugs, moisturization is key, says co-author Luz Fonacier, MD. “Even when patients step up to stronger medications, they should still continue basic treatment of bathing with warm water followed immediately with heavy moisturization.” This is a technique Fonacier and others call “the soak and seal.”
And there are even more new treatments to come, ACAAI researchers say.
“Allergists have the right training and expertise to diagnose AD, and to offer relief with the right treatments,” Fonacier said. “We're glad we can add these treatments to our arsenal of weapons to combat the symptoms of AD."