From the Guidelines
Moisturizers, such as White Petrolatum, are the primary adjunct therapy that assists in skin barrier repair for atopic dermatitis. These should be applied at least twice daily, especially after bathing while the skin is still damp to trap moisture. Effective moisturizers include petroleum jelly (Vaseline), mineral oil-based products, ceramide-containing moisturizers, and products with ingredients like glycerin, hyaluronic acid, and urea. For optimal results, thick creams and ointments are generally more effective than lotions because they create a stronger barrier against moisture loss. Patients should apply a generous amount, using about one ounce (enough to fill a shot glass) to cover the entire body. Moisturizers work by restoring the compromised skin barrier function in atopic dermatitis, reducing water loss, preventing irritant penetration, and decreasing inflammation. Regular moisturizing can reduce the need for topical corticosteroids and help prevent flare-ups by maintaining skin hydration and integrity, as supported by recent guidelines 1.
Key Points
- Moisturizers are essential for skin barrier repair in atopic dermatitis
- Apply moisturizers at least twice daily, especially after bathing
- Effective moisturizers include petroleum jelly, mineral oil-based products, and ceramide-containing moisturizers
- Thick creams and ointments are more effective than lotions
- Regular moisturizing can reduce the need for topical corticosteroids and prevent flare-ups, as recommended by the American Academy of Dermatology guidelines 1
Recommended Moisturizer
- White Petrolatum is a suitable option for skin barrier repair in atopic dermatitis, as it helps to lock in moisture and protect the skin from irritants, consistent with the principles outlined in the management of atopic dermatitis 1
From the Research
Adjunct Therapies for Atopic Dermatitis
The following options are available as adjunct therapies for atopic dermatitis:
- A topical corticosteroid: Topical corticosteroids are commonly used to treat atopic dermatitis, but they do not directly assist in skin barrier repair 2, 3.
- Antihistamine: There is no evidence to suggest that antihistamines assist in skin barrier repair for atopic dermatitis.
- Pramoxine cream: There is no evidence to suggest that pramoxine cream assists in skin barrier repair for atopic dermatitis.
- White Petrolatum: White petrolatum can increase stratum corneum hydration, but it is not as effective as other moisturizers, such as nicotinamide cream, in improving skin barrier function 4.
Effective Moisturizers for Skin Barrier Repair
Effective moisturizers for skin barrier repair in atopic dermatitis include:
- Ceramide-dominant barrier repair lipids: These lipids can alleviate childhood atopic dermatitis and improve skin barrier function 5.
- Nicotinamide cream: Nicotinamide cream is a more effective moisturizer than white petrolatum and can improve skin barrier function in atopic dermatitis 4.
- Physiological lipid-based barrier repair therapy: This type of therapy can correct the barrier abnormality and reduce inflammation in atopic dermatitis 6.