Abstract

Dry skin is a characteristic feature of atopic dermatitis. The dryness probably results from a depletion of hydrophilic molecules leading to less water in the stratum corneum, insufficient lipids in the stratum corneum and other abnormalities related to protein and lipid synthesis. This epidermal defect can disrupt the integrity of the skin in its role as a barrier against adverse external agents. The concept of a barrier cream should, therefore, probably be applied to atopic dermatitis in terms of prevention and treatment. Emollients improve the elasticity of the stratum corneum, reduce painful fissuring and aid with desquamation. Studies on the efficacy of emollients show an improved transepidermal water loss which correlates well with the improvement of skin barrier function. There is a strong need to tailor specific emollients for use in patients with atopic dermatitis. To strengthen compliance, new products should be evaluated for irritation and sensitivity, with individual preference and the attractiveness of the product taken into account. To improve treatment in the future, studies must attempt to identify the barrier defects in atopic dermatitis on a biochemical and molecular level.

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