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Effectiveness of Cosmetic Products in Treating Atopic Dermatitis

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Non-prescription over-the-counter cosmetic products can be effective in treating atopic dermatitis. Read this article to know more.

Medically reviewed by

Dr. Sandhya Narayanan Kutty

Published At December 7, 2022
Reviewed AtJune 7, 2023

Introduction:

Self-care is synonymous with everyday routine in the present age. As the awareness and need for skin care have increased, more and more people are taking adequate measures to treat their skin problems outside the doctor's office. And modern medicine has extended its service to retail products in addition to prescription and over-the-counter medications. This amalgamation of medicine in cosmetic products is an adjutant in treating skin problems. Atopic dermatitis is a disease with numerous symptoms, such as redness, dryness, inflammation, and skin infections. It also dramatically affects the patient's quality of life as it is associated with sleep disturbances and pruritus (itchy skin). It is a chronic inflammatory skin disorder in which the skin barrier is disrupted. It is a multifactorial disease caused by infections, irritants, stress, environmental agents, allergens, and temperature fluctuations.

How Does Atopic Dermatitis Occur?

The skin may have inherent defects which get triggered by external factors that cause an immune response and inflammation. Fault in skin barrier integrity reduces renewal function, and disruption in the skin barrier may cause an inflammatory response. It is characterized by dry skin, itching, and eczema flare-ups. It is observed in children's scalp, face, and extensor areas and flexural areas in older children and adults. This disease which can appear in the early years of life can affect the quality of life, as it affects sleep and social rejection and may cause anxiety. Children may have difficulty in school, participating in sports, and other psychological problems.

How Do the Products Work?

The go-to solution for treating atopic dermatitis is to keep the skin barrier intact. This is so that it improves any defect the skin has, protects it from any damage, and improves the turnover rate of the skin. It is done by using emollients and topical medications. In the expert treatment of the disorder, a doctor may prescribe medicines that prevent skin barriers break down and those that prevent an inflammatory response. However, cosmetic products help create an occlusive barrier and retain moisture. In addition, newer products have antimicrobial properties that prevent infections. These cosmetic products are formulated in such a way that it tackles the various problems that trigger atopic dermatitis.

1) Moisturizing Properties:

This helps to reduce transepidermal water loss. Moisturizers and emollients are terms with similar meanings and functions. They form a barrier on the skin, which prevents or slows down water loss. Humectants are those that attract water vapor to moisturize the skin.

When moisturizers mimic the functions of lipid bilayers, free fatty acids, and cholesterol; humectants resemble corneocytes (outer skin cells); emollients fill the gap in the skin layer that is caused by the disruption of corneocytes and smoothen out the skin. Products that have the functional properties of moisturizers are olive oil, lanolin, mineral oil, paraffin, ceramide, and silicone. Glycerin, sorbitol, and alpha hydroxy acids act as humectants. Shea butter, elastin, collagen, and glyceryl stearate act as emollients.

2) Anti-itch Properties: This prevents any rashes from occurring.

3) Antimicrobial Properties: It prevents infection that may trigger an inflammatory response.

4) Anti-inflammatory Properties: This helps reduce the immune response. These combinations of properties help to repair the skin's barrier, prevent water loss, increase moisture content, and prevent infections, thereby, helping to tackle the multifactorial problem.

What Are the Various Ingredients That Are Used?

The ingredients in cosmetic products can be categorized into:

  • Plant Based:

    • Aloe vera.

    • Coconut oil.

  • Animal Based:

    • Lanolin.

    • Horse oil.

  • Special Ingredients:

    • Ceramides.

    • Antimicrobial.

    • Ectoin.

    • Natural moisturizing factors.

1. Aloe Vera: It is a succulent plant; it has a flesh that has antibacterial and antifungal properties and is widely used in the skincare industry. It also has moisturizing properties. In addition, certain studies have shown that it has anti-inflammatory properties to some extent.

2. Coconut Oil: It is another plant-based ingredient that is commonly used in products that are used for atopic dermatitis. It can be used as coconut or virgin coconut oil; both have comparable results; however, some studies show that pure coconut oil derived from the cold-press technique has more active components. Both help to reduce the severity of eczema.

3. Lanolin: It is a product derived from the sebaceous glands of sheep, so it is called wool wax or wool grease. Like coconut oil, different variants of lanolin are available based on the method of extraction. These are useful in treating atopic dermatitis as it helps improve the hydration of the skin and provide an occlusive effect.

4. Horse Oil: It is an animal-derived product that has anti-inflammatory properties. It helps reduce hypersensitivity and thereby improves atopic dermatitis. It is more popular in Asian countries.

5. Ceramides: The normal skin layer has lipid molecules in the outermost layer of skin (stratum corneum). They help to prevent water loss by protecting the skin barrier. Patients with atopic dermatitis have a lower level of these lipid molecules called ceramides. Therefore, the addition of them into the cosmetic formulation helps improve the skin barrier function.

6. Natural Moisturizing Factors: Urea, carboxylic acid, amino acids, and glutamic acids are collectively called natural moisturizing factors. These small molecules help hydrate the skin by absorbing water into corneocytes (cells of stratum corneum- the outer layer of skin). They form a rigid barrier in the stratum corneum by aggregating keratin filaments and forming a bundle. They help retain moisture for a long period of time by absorbing water from the atmosphere.

7. Antimicrobial Peptides: These are the newer additions to cosmetic formulations that act as broad-spectrum antibiotics. It is effective against gram-negative and gram-positive bacteria, fungi, and viruses. They also help to improve immunity.

8. Ectoin: This is an organic compound that helps prevent dehydration and bacterial infection.

Choosing the right product is a major hurdle for the patient; most products have similar ingredients consisting of glycerin, petrolatum, paraffin, plant-derived oils, and butter. Recent developments have incorporated ceramides that help reestablish the stratum corneum structure.

How to Choose the Right Product?

A person suffering from atopic dermatitis can include non-prescription cosmetic products in their everyday routine. They must be careful to choose formulations that help improve the condition and avoid those that trigger a response.

What to Choose?

  1. Shea butter, glycerin, and lanolin help moisturize the skin.

  2. Niacinamide: It helps to reduce eczema by improving the skin barrier. This helps to reduce the reddish flare-ups.

  3. Hyaluronic acid: Helps to attract moisture from the air to the skin. These can help reduce the peeling, dry, flaky skin by improving the moisture content.

In addition to these components, petrolatum, paraffin, olive oil, and mineral oil also help to improve the condition.

What Not to Choose?

  • Preservatives:

Most cosmetic products have preservatives such as methylparaben or other paraben derivatives. These may act as an allergen and trigger an inflammatory reaction. These ingredients are used to prolong the shelf life of the product. Neem oil or grapefruit seed extract are good alternatives.

  • Salicylic Acid, Retinol, and Glycolic Acid: These components cause the skin to dry out, thereby worsening the condition. In patients with eczema, who already have difficulty retaining water in the skin, these components will irritate the skin.

  • Fragrances: These components can cause eczema to flare up.

  • Aqueous-Based Creams: These have lower acceptability than other moisturizers. These contain sodium lauryl sulfate that can trigger skin irritation, and long-term use of aqueous creams has been found to reduce the thickness of the stratum corneum and increase moisture loss. They can also cause peeling of the skin and cause inflammation.

Other than these components, some products may contain allergens, eczema-prone skin may exhibit sensitization to these ingredients, and flare-ups may occur.

Conclusion:

Atopic dermatitis is a condition that can reduce the quality of life of an individual. The new-age cosmetic products such as moisturizers and emollients have been developed to incorporate ingredients that help improve skin conditions. Atopic dermatitis is characterized by compromised skin structure; even in patients with no symptoms, the barrier integrity may be compromised. Therefore daily moisturizing helps in repair and protection. The standard rule is to apply moisturizer two times a day. This helps improve the skin structure and prevents flare-ups. Many products are now available in the market, and a patient can choose one based on his condition.

Frequently Asked Questions

1.

What Is the Best Treatment for Atopic Dermatitis?

The most effective way to manage atopic dermatitis is to use daily moisturizers to stop the skin from becoming dry and maintain the moisture of the skin. In addition, topical corticosteroids such as creams and ointments can alleviate swelling and redness in flare-ups.

2.

Which Products Help Severe Atopic Dermatitis?

The dermatologist may prescribe pills for severe atopic dermatitis to help control symptoms. Medications such as cyclosporine, methotrexate, mycophenolate, prednisone, and azathioprine can help alleviate and soothe the symptoms. These medications are effective, but a person should not use them for longer due to their potentially serious side effects.

3.

What Is the Role of Moisturizers in Relieving Atopic Dermatitis?

Moisturizers can penetrate skin layers. They can hydrate the skin and also repair skin barrier function. Hence, the doctor recommends moisturizer as a critical step for the management of atopic dermatitis, together with avoiding triggers and other therapeutic measures to control and alleviate symptoms and inflammation.

4.

What Is the First Line of Management for Atopic Dermatitis?

Topical corticosteroids and emollients (moisturizers) such as Eucerin, Cetaphil, and Nutraderm are the first line of therapy for atopic dermatitis. Along with these products' topical application, avoiding the triggers is also an essential step for managing atopic dermatitis.

5.

What Worsens Atopic Dermatitis?

Exposure to external triggers like allergens and irritants may make contact with the affected person's skin and can cause a flare-up of atopic dermatitis. Some internal triggers, such as food allergies and stress, can also cause higher inflammation in the body, which may worsen the rash or atopic dermatitis.

6.

Does Moisturizer Stop Dermatitis?

Moisturizer can not cure or stop atopic dermatitis, but keeping the skin's moisture intact is one of the most essential things to help control atopic dermatitis and prevent flare-ups. Moisturizers and lotions can also help protect the outer layer of skin, which acts as a barrier. In addition, dryness is one of the most common reasons for dermatitis. Hence, sufficient skin moisturization is the core step in controlling atopic dermatitis.

7.

Which Products Should Be Avoided on Atopic Dermatitis?

A person with atopic dermatitis should avoid the use of products having the following ingredients:
- Fragrances.
- Essential oils. 
- Lanolin. 
- Retinoids. 
- Cocamidopropyl betaine.
- Urea. 
- Propylene glycol. 
- Ethanol.

8.

How Long Does the Treatment of Atopic Dermatitis Take?

Using emollients (moisturizers) in case of atopic dermatitis can help restore the epidermal (skin) barrier following each application. Still, a long-lasting protective barrier function improvement takes two to four weeks of regular treatment. Clinical trials suggest that topical corticosteroids are also effective and safe for treating atopic dermatitis. Topical corticosteroids during flare-ups may help control dermatitis if used for up to four weeks.

9.

What Do Dermatologists Recommend for Dermatitis?

- Dermatologists specialize in skin conditions. Thus, they can provide specific help for atopic dermatitis with diagnosis, management, and follow-up care. Most atopic dermatitis treatments are topical. However, oral or injectable medications may be needed for more severe eczema. A dermatologist may prescribe various methods of treatment depending on the type and severity of a person's dermatitis condition as below:
- Complete emollient (moisturizer) therapy.
- Antibiotics and antiseptics in case of infected dermatitis
- Topical calcineurin inhibitors such as pimecrolimus cream and tacrolimus ointment when topical dermatitis is not responding to topical steroids. 
- Antihistamines for their antiallergic properties.
- Bandaging (dressings), known as wet wraps, can help keep topical products from rubbing off and stop scratching the site. 
- Ultraviolet light may benefit in some cases.
- Severe or widespread atopic dermatitis may require oral or injected treatments.

10.

How to Treat Atopic Dermatitis on the Face?

The treatment on the face, in case of atopic dermatitis, will be the same as other body parts, except the affected person should use very mild or moderate corticosteroid topical products for treating topical dermatitis on any sites where the skin is very thin and sensitive including on the face.

11.

Can You Cure Atopic Dermatitis Permanently?

Genetic and physiologic studies data support the idea of atopic dermatitis as a lifelong condition, and there is no permanent cure. Many studies suggest that some individuals improve with age. However, most continue to have active atopic dermatitis at multiple time points. Hence, atopic dermatitis is a chronic and relapsing condition, meaning symptoms' intensity may fluctuate over time.

12.

Why Is Atopic Dermatitis Not Curable?

The exact cause of atopic dermatitis is unclear, but genes, the immune system, and environmental factors can influence the disease. In addition, many studies established that the cause of atopic dermatitis involves many factors such as dysregulation of immune responses, skin barrier defects, adaptive immune response disorder with strong type 2 immunity development, and altered skin microbiome. All these factors may interfere with the permanent cure of atopic dermatitis and cause recurrence of the condition.
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Dr. Sandhya Narayanan Kutty
Dr. Sandhya Narayanan Kutty

Venereology

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