Atopic Dermatitis (Eczema)
You or your child has been diagnosed with atopic dermatitis or eczema. Normally, our skin’s top layer acts as a
natural barrier that holds water in and keeps irritants out. This barrier consists of skin cells that are held together by
lipids and moisture. The lipids consist of ceramides, cholesterol and fatty acid esters.
In atopic dermatitis, the barrier is compromised and is not working correctly. This allows water from within the
body to be lost through the skin. This results in dry, scaling, and sometimes, cracked skin. The impaired barrier
also allows things that contact the skin to penetrate and cause irritation or allergic reactions. As a result, the skin
becomes red and itches.
The main goal of your treatment for atopic dermatitis is to repair and maintain your natural skin barrier. The most
important step in restoring the skin’s natural barrier is to moisturize regularly. Moisturizers such as Cerave
cream contain ceramides and other ingredients that add moisture to the skin. These ceramides are also absorbed by
skin cells and used by those cells to manufacture the natural oils that make up the skin barrier.
□Apply Cerave cream or _______________________ over the entire body at least twice a day. One of
these applications should be immediately after a bath.
The way you bathe can affect your barrier. Soaking in lukewarm water for 15 minutes every day will help
replenish the moisture in your skin. Although not as effective, showering for about 20 minutes can help. After
soaking or showering for 15 to 20 minutes, use a mild cleanser only on necessary areas such as underarms, hands,
feet, and groin. Most of the skin surface needs only to be rinsed with water. Avoid rubbing and scrubbing. Avoid
the use of a washcloth. Rinse the cleanser off thoroughly and pat (don’t rub) the skin dry. If there are signs of
infection or bacterial colonization of your skin, you may also be instructed to take baths containing diluted bleach
once a week.
□Use only mild cleansers such as Cerave, Cetaphil, Dove for Sensitive Skin, or ________________.
It is often necessary to treat the itching, red areas for a short time with topical corticosteroids. Use of these products
for more than a few days can actually damage the barrier and worsen the atopic dermatitis. For this reason, apply
them only to the affected areas for no more than a week.
□Apply your medicated cream (Cerave/ Campho-Phenique/Steroid solution mixture) or
_______________________to itching, red areas once or twice a day, as needed.
The itching is often at its worse around bedtime and sometimes makes sleep difficult. You may be given a
medication to make you drowsy and help you to sleep better.
□Take hydroxyzine ______ teaspoonful(s) or ____ tablets once daily, about 30 minutes before bedtime.
In order to reduce the risk of irritation from fragrances and dyes found in detergents and fabric softeners, use only
fragrance and dye-free products. Some brand names are All Free Clear and Tide Free.
Atopic dermatitis is treatable but it not really curable. Remember, the most important treatment is regular use
of a ceramide-containing moisturizer such as Cerave Cream.