Atopic Dermatitis (AD) is a widespread condition which affects approximately 223 million patients globally per year, with 43 million of those affected being children between the ages of 1 and 4¹. AD can severely affect the quality of life, yet for many years treatment has been focused on topical corticosteroids with few advancements being made. Recently, however, several developments have been observed which could shift the treatment to having fewer side effects or offering patients more treatment choice if one option is inadequate. This article discusses some new developments in the topical treatment of Atopic Dermatitis and what this could mean for the quality of life for these patients.

What is Atopic Dermatitis?

Atopic dermatitis (AD) affects up to 10% of adults and 20% of children. Globally, it ranks 15th among non-fatal diseases in terms of disease burden and is the leading skin condition. Common symptoms during flare-ups include dry, itchy, inflamed, and cracked skin.

The causes of AD have not been fully mapped. Experts currently attribute its incidence to a combination of genetic factors and environmental influences. Genetics are believed to play a significant role with 30% of people with AD having a genetic mutation which decreases the protein Filaggrin, resulting in a weaker dermis. Other mutations which disrupt collagen and linoleic acid production are also being studied as relevant for the development of AD. These disruptions allow allergens to penetrate the skin, leading to inflammation. While AD is non-communicable, patients with AD have a widespread colonisation of the bacterium Staphylococcus aureus, which is known to cause skin infections. Additionally, AD has been observed to have a higher prevalence in industrialised countries as well as cold and dry climates. Nevertheless, a clear causal path for AD has not yet been established.

AD usually appears for the first time in childhood and can affect child development. It forms part of the “atopic triad” where children with Atopic Dermatitis are also more likely to develop allergies and asthma, and vice versa. The symptoms can progress as patients age, often resulting in psychological side effects such as social anxiety.

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