Patient discussions

Educate all patients on proper skin care and the avoidance of trigger factors (e.g., irritants, dietary allergens, or pollen, house dust mite, animal dander, and smoke) in patients with a clear history of disease flares secondary to these triggers.[50]​​[181]​​​ Recommend avoiding irritant clothing (e.g., wool with coarse fibers) to prevent exacerbation of symptoms in patients with sensitive skin. Advise patients that there is no need for them to restrict normal everyday physical activity.[50]

Advise patients that atopic dermatitis is a chronic disease, and that emollients are required to maintain their skin's barrier function even when their disease is well controlled. Depending on the severity of their atopic dermatitis, other topical or systemic medications may be necessary in order to control the disease.

Atopic dermatitis is associated with depression, anxiety, and reduced quality of life. It is difficult to determine whether psychological distress is a cause or consequence of the condition; in many cases it is probably both. There is a positive correlation between maternal stress and offspring atopic dermatitis. Although evidence from larger studies is lacking, patients report that stress induces itch and flaring of the disease. Screen for mental health problems during appointments and offer referral for psychological support or to educational programs to cope with stress if required.[50]

The severity of a child’s atopic dermatitis should be discussed with their parents or caregivers.[45] Parents and guardians of children with atopic dermatitis may benefit from a written set of instructions on skin care, bathing regimens, and other strategies that assist in the effective management of their child’s skin disorder.[45]

The written treatment plan should not serve as a substitute for education while in the clinic.[163] Many parents are grateful to have instructions that can be used as a reference when they return home to implement the care and guidance provided by their physician.[164][165]

Even in ideal circumstances, with committed parents, guardians, and caregivers, caring for those with atopic dermatitis can be stressful. Offer support and make the necessary referrals when psychological stresses are noted or felt to be of concern.[45][179][182] Giving parents the support and the means to improve their own lives can contribute to the success of other key components of care.[183]

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