This handout is for atopic dermatitis (eczema). Your care team identified this based on: chronic / relapsing intensely pruritic eczematous rash in a flexural (adult/child) or facial-extensor (infant) distribution (uk working party criteria; aad 2023 topicals exec pmid 36623556).
Other reasons your team may use this plan: personal/family atopy (asthma, allergic rhinitis, food allergy — the atopic march) (aad 2022 comorbidities pmid 35085682); itch-dominant, sleep-disrupting disease with itch–scratch–lichenification cycle (aad 2023 topicals pmid 36623556); eczema refractory to adequate topical therapy → systemic-ladder + biopsy-for-ctcl entry (aad 2023 systemics pmid 37943240).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| emollient_moisturiser_high_volume | — | — | — | AAD 2023 topicals (PMID 36623556) STRONG rec — liberal moisturiser (~250 g/wk adult) reduces flares, itch, and TCS requirement; apply within 3 min of bathing (soak-and-seal). |
| trigger_mitigation_and_bathing_practices | — | — | — | AAD 2023 (PMID 36623556) — gentle non-soap cleanser, lukewarm short baths + immediate emollient; conditional bleach baths for recurrently infected eczema; mitigate irritants/aeroallergens/sweat/stress. |
| wet_wrap_therapy_for_acute_flare | — | — | — | AAD 2023 (PMID 36623556) conditional — wet wraps over diluted TCS for acute severe flares rapidly cool/hydrate and boost topical delivery. |
Plan: Atopic dermatitis — barrier-first + stepwise anti-inflammatory ladder (AAD 2023/2025)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Chronic-disease maintenance: lifelong emollient/barrier habit + written eczema action plan (green/yellow/red flare steps), proactive twice-weekly anti-inflammatory to recurrence-prone sites, trigger control, atopic-march + mental-health + sleep + comorbidity surveillance (AAD 2022), education on quantity (fingertip unit) and TCS-phobia counselling, and step-down/step-up criteria. Dermatology continuity for any systemic agent; reassess CTCL if course remains atypical.
Guideline: AAD 2023 Guidelines of care for AD — topical therapies (Sidbury et al, JAAD; exec PMID 36623556) + phototherapy & systemic therapies (Davis et al, JAAD; PMID 37943240, exec 37943241) + AAD 2025 focused update (Davis et al, JAAD; PMID 40531067: tapinarof, roflumilast, lebrikizumab, nemolizumab) + AAD 2022 comorbidities (Davis et al, JAAD; PMID 35085682) + AAD/AAAAI-ACAAI JTF 2023-24 concordance review (PMID 41416235)