Dr Alice Rudd Explains: Atopic Dermatitis and Its Treatment Options in Australia



What is Atopic Dermatitis?
Atopic dermatitis (AD), commonly known as eczema, is a chronic inflammatory skin condition characterised by dry, itchy, and inflamed skin. It often occurs in people with a family history of allergies, asthma, or hay fever and can significantly impact the quality of life due to its persistent and uncomfortable symptoms. AD is most common in children but can also affect adults.

Causes and Symptoms
The exact cause of atopic dermatitis is unknown, but it is believed to result from a combination of genetic, environmental, and immunological factors. The skin barrier in individuals with AD is typically weaker, making it more susceptible to irritants, allergens, and microbes.
Common symptoms include:
- Intense itching
- Red, inflamed skin
- Dry, scaly patches
- Thickened, leathery skin from chronic scratching
- Fluid-filled blisters in severe cases

Current Treatment Options in Australia
Managing atopic dermatitis involves a combination of lifestyle modifications, skincare routines, and medical treatments. Here are some of the current treatment options available in Australia:

1. Emollients and Moisturisers 
Regular use of emollients and moisturisers is crucial for maintaining skin hydration and preventing flare-ups. Products such as QV, Aveeno, and Cetaphil are widely recommended. They should be applied immediately after bathing and throughout the day as needed.

2. Topical Corticosteroids
Topical corticosteroids are the mainstay treatment for reducing inflammation and itching during flare-ups. They come in various strengths, and their use should be supervised by a healthcare professional to avoid side effects such as skin thinning. Commonly used corticosteroids in Australia include hydrocortisone, betamethasone, and mometasone.

3. Topical Calcineurin Inhibitors
For sensitive areas like the face and neck, topical calcineurin inhibitors (TCIs) such as tacrolimus (Protopic) and pimecrolimus (Elidel) are effective alternatives to corticosteroids. They work by modulating the immune response and reducing inflammation without the risk of skin thinning.

4. Systemic Treatments
For moderate to severe cases that do not respond to topical treatments, systemic treatments may be necessary. These include:
- Oral corticosteroids: Used for short-term control of severe flares.
- Cyclosporine: An immunosuppressive agent used for severe cases.
- Methotrexate: Another immunosuppressive medication that can be effective in severe cases.
- Biologic therapies: Dupilumab (Dupixent) is a biologic medication approved for use in Australia, targeting specific pathways in the immune system to reduce inflammation and control symptoms.

5. Phototherapy
Phototherapy, or light therapy, involves exposing the skin to ultraviolet (UV) light under medical supervision. This treatment can help reduce inflammation and itchiness and is often used when topical treatments are insufficient.

6. Antihistamines
Oral antihistamines can be used to manage severe itching, especially at night. Non-sedating options like cetirizine and loratadine are commonly recommended.

7. Complementary Therapies
Some patients find relief through complementary therapies such as acupuncture, herbal treatments, and dietary changes. While these should not replace conventional treatments, they can be used as adjuncts under professional guidance.

Lifestyle and Skincare Tips
In addition to medical treatments, incorporating the following lifestyle and skincare tips can help manage atopic dermatitis:
- Avoid triggers: Identify and avoid triggers such as certain fabrics, soaps, and allergens.
- Maintain a humid environment: Using a humidifier can help keep the air moist and prevent skin dryness.
- Take lukewarm baths: Hot water can dry out the skin. Lukewarm baths with mild cleansers are recommended.
- Wear breathable fabrics: Cotton and other natural fibres are less likely to irritate the skin.

Atopic dermatitis is a challenging condition, but with the right treatment and management strategies, individuals can significantly reduce symptoms and improve their quality of life.

In Australia, a range of treatment options is available, from topical and systemic medications to innovative biologic therapies. Working closely with healthcare professionals to tailor a treatment plan is essential for optimal outcomes.

If you'd like to explore treatment with us at Skindepth Dermatology, please get in touch by emailing our friendly team at reception@skindepth.com.au
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