Atopic Dermatitis / Eczema

Symptoms

On the body, atopic dermatitis appears as red, slightly scaling patches with prominent itching, most commonly located on the wrists, arms, back of the knees or on the hands. On the face, atopic dermatitis appears as red, slightly scaling patches with prominent itching, most commonly located on the lateral face, ears, eyelids, neck or jawline. Often flares in the winter, or with stress or sweating. Atopic dermatitis is also known as eczema.

Recovery

Dr. Harlan typically treats his adult patients for atopic eczema located on the body and other thicker skin by having them apply SmartLotion® 4x per day for up to 4 weeks and moisturizing 2x per day.

For facial atopic dermatitis and other sensitive areas, he has his adult patients apply SmartLotion® 2x per day for up to 2 weeks and moisturizing 2x per day.

Dr. Harlan's recommended moisturizer is Perfect Repair™, a moisturizer he formulated specifically for dermatitis patients.

As the skin improves, he typically recommends tapering down by 1 application per day every 2 weeks, until they are down to a few applications per week for prevention, or as needed when flares occur. The rate of tapering should vary based on how quickly the rash is healing.

For a successful recovery from atopic dermatitis, Dr. Harlan insists that his patients moisturize a minimum of 2x per day. When moisturizing and applying SmartLotion® at the same time, he recommends that his patients moisturize first before applying SmartLotion®.

He instructs his patients to reduce soap, showers, and perspiration-inducing activities temporarily while recovering from the flare-up.

For moisturizers, please use Perfect Repair™ found at this link or review Dr. Harlan's favorite moisturizers when you click here.

For severe, thickened eczema, Dr. Harlan prescribes a steroid cream to use together with SmartLotion®: betamethasone dipropionate 0.05% cream on the body, or desonide 0.05% cream on the face and ears, 2x per day on the severe, thickened areas only, 3 weeks on and 1 week off. SmartLotion® goes on the less severe areas right away, then everywhere once the thickened areas improve.

Cat dander often aggravates. Avoid cat exposure.

Prevention

After initial control and tapering, Dr. Harlan recommends his patients adopt a long term routine that works for them.

In addition to 2x per day moisturizer applications, Dr. Harlan instructs his adult patients to apply SmartLotion® 1x to 2x per day for the body and 1x per day for the face. Some patients require 1 application per day, and some only require 3 applications per week.

This is why long-term safety was so important to Dr. Harlan when he formulated SmartLotion®. For whatever maintenance schedule his patients require, he wanted to ensure that there would be no chance of side effects. Rest assured, SmartLotion® is 100% safe for long term use, as demonstrated in his peer-reviewed safety study.

Read Dr. Harlan's peer-reviewed safety study.

If the itching isn't controlled: the next steps in Dr. Harlan's plan

Dr. Harlan's eczema plan doesn't stop at the first line. Each step is added on top of the ones before it, and SmartLotion® and moisturizing continue through all of them:

• 2nd line, for itching that isn't controlled: Elyzia Cream, a compounded prescription (niacinamide 4% / tacrolimus 0.1%), 1x per day on active areas, plus an oral antihistamine such as Benadryl, Zyrtec or Claritin.
• 3rd line, for severe eczema: a prednisone taper.
• 4th line: Zoryve (roflumilast) 0.3% cream or foam 1x per day, or a referral for a biologic such as Dupixent.

The first follow-up is at 6 weeks.

On the HarlanMD blog: How eczema is treated.