Featuring Dr. Jan Dutz, Dermatologist, Skin Care Centre

Duration: 3 minutes, 15 seconds

We treat atopic dermatitis by trying to avoid triggers that make the skin drier and itchier, and that can include using soaps that have too much perfume in them, soaps that are too harsh, exposure to things like wool or drying environments.

We also try to improve the skin barrier, and we try to improve that by using moisturizers. Patients with atopic dermatitis should use moisturizers daily, and preferably twice daily. In areas where they get inflammation, we can treat that inflammation with topical medicines.

Those are either creams or ointments that we put on once or twice a day. They can be based on anti-inflammatory medication such as steroids, and they’re also medications that don’t have steroids in them that have good anti-inflammatory properties and work for atopic dermatitis. Good skincare is important to decrease the number of bacteria on the skin, and that includes a gentle washing, patting the skin dry after washing, and then putting on the moisturizers to improve that barrier and seal the skin.

What if the basic steps that I’ve just outlined don’t work, are there any other options, and what do we do then? Well, if atopic dermatitis becomes very extensive, and involves a large part of the body surface, where there’s severe itch where patients can’t work, or can’t sleep, then it’s time to start thinking about more generalized treatments that affect the whole body. Options there include treatment such as special light treatment called phototherapy at your doctor’s office that can decrease the inflammation in the skin.

Treatments can include taking pills that decrease inflammation, both in the short term and long term. And those pills can include short courses of antibiotics that can help when there’s a flare, or -inflammatories such as short courses prednisone, or more specialized medications that decrease the inflammation.

These medicines can be methotrexate, cyclosporine, azathioprine, those are the three most common. If those fail, there are now new options such of so-called biologic medicines. These are medicines that have been only tailored to block the inflammatory pathways or inflammatory molecules that are specifically involved in atopic dermatitis.

These drugs are therefore effective, with potentially less side effects than our traditional treatments. If you have any further questions about atopic dermatitis and its treatment, please go see your doctor or your skin specialist.

Presenter: Dr. Jan Dutz, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist