What are the Australian guidelines for atopic dermatitis (also known as eczema)?

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Last updated: March 15, 2025View editorial policy

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From the Research

Atopic dermatitis management in Australia involves a stepped approach, starting with regular moisturizer use, and progressing to topical corticosteroids, calcineurin inhibitors, and systemic treatments as needed, according to the most recent guidelines 1. The management of atopic dermatitis is crucial for controlling symptoms, preventing flares, and improving quality of life.

  • The foundation of treatment involves regular use of moisturizers (emollients) applied at least twice daily, even when the skin appears normal.
  • For mild flares, low-potency topical corticosteroids like hydrocortisone 1% should be applied once daily to affected areas for 7-14 days.
  • Moderate to severe cases may require stronger corticosteroids such as mometasone furoate or methylprednisolone aceponate, applied once daily for up to 2-4 weeks.
  • Topical calcineurin inhibitors (tacrolimus, pimecrolimus) are recommended as steroid-sparing agents for sensitive areas like the face and skin folds.
  • Trigger avoidance is essential, including minimizing exposure to irritants like soaps, detergents, and known allergens.
  • Antihistamines may help manage itching, particularly sedating ones like promethazine at night.
  • For severe, widespread disease unresponsive to topical treatments, systemic immunosuppressants like cyclosporine, methotrexate, or biologics such as dupilumab may be considered under specialist care, as supported by recent studies 1, 2. The Australian guidelines, as outlined in the most recent study 1, prioritize a multifaceted approach to address both the skin barrier dysfunction and immune dysregulation that underlie atopic dermatitis.
  • This approach aims to control symptoms, prevent flares, and minimize side effects from treatments.
  • The use of soap substitutes, bath oils, and moisturizers is crucial for improving the condition of the skin.
  • Topical corticosteroids are the main drug treatment, with the choice of corticosteroid depending largely on the site of the atopic dermatitis.
  • Adjunctive treatments, such as bleach baths and wet dressings, may be considered during flares of dermatitis.
  • Phototherapy may be considered by a specialist for adults with inadequate response to treatment, as mentioned in the study 1.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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