The basic therapy refers to the skin care that should be carried out daily for children with atopic dermatitis. The resulting protection for the skin barrier is a cornerstone in the therapy of atopic dermatitis and aims to prevent deterioration and flares.

1 – The Role of the Skin Barrier in Atopic Dermatitis

The skin barrier is compromised in children and adults with atopic dermatitis. This impairment leads to an increased transepidermal water loss, meaning that the skin is unable to retain sufficient moisture. At the same time, irritating substances and allergens can penetrate the skin more easily, leading to inflammation and itching. The guidelines for atopic dermatitis emphasize that the basic therapy aims to stabilize the compromised skin barrier by increasing the moisture content of the skin and restoring the lipid layer. A stable skin barrier is essential to prevent flares and to maintain long-term skin health.

2 – Basic Therapy as the Foundation of Treatment

The basic therapy is the first and most important measure in the treatment of atopic dermatitis. It should be applied continuously, regardless of whether acute flares are currently present or not. It helps to strengthen the skin barrier, keep the skin supple, and reduce the risk of inflammation and itching.

The basic therapy should be tailored to the current skin condition of the patients. For very dry skin, fatty ointments are better suited, while lighter creams or lotions should be used for less severely affected skin. It is important that the care products are free from irritating or allergenic substances such as fragrances or preservatives.

3 – Prevention of Inflammation and Flares

An essential advantage of the basic therapy is the prevention of atopic dermatitis flares. According to the guidelines for atopic dermatitis, consistent and continuous basic therapy can help to reduce the frequency and intensity of flares. A well-cared-for skin barrier is less susceptible to external irritants and allergenic substances, which are often triggers for inflammation. It therefore has a firm place in secondary and tertiary prevention, enhances quality of life, and can thus reduce the need for anti-inflammatory medications, such as topical corticosteroids.

4 – Long-term Improvement Thanks to Basic Therapy

Continuous basic therapy in atopic dermatitis has a positive impact on the skin microbiome. It helps to stabilize the compromised skin barrier and restore the balance of microorganisms on the skin. An intact skin barrier and regular moisturization prevent the growth of pathogenic bacteria, such as Staphylococcus aureus, which are often associated with atopic dermatitis flares. This reduces the risk of inflammation and promotes long-term skin health.

Sources

1. AWMF (2024). S3 Guidelines Atopic Dermatitis.

2. Wollenberg A et al. (2023). Atopic Dermatitis in Children and Adults—Diagnosis and Treatment. Dtsch Arztebl Int.