Atopic Dermatitis / Eczema

Atopic Dermatitis (Teenagers)

Symptoms

Red slightly scaling patches with prominent itching, most commonly located on the wrists, ankles, arms, back of the knees or on the hands. Can occur on the face, although it is much less common in teenagers. Often flares in the winter, or with stress or sweating. Atopic dermatitis is also known as eczema. There is typically a history of atopic dermatitis in childhood when it occurs in teenagers.

Recovery

Dr. Harlan typically treats his teenage patients for atopic dermatitis on the body by having them apply SmartLotion® 4x per day for up to 4 weeks. If the atopic dermatitis appears on the patient's face or another sensitive area, Dr. Harlan instead instructs the patient to only apply SmartLotion® 2x per day for up to 2 weeks.

As long as the patient sees improvement during the initial 2 weeks, after 2 weeks he typically recommends tapering down to 3x per day for 2 weeks then to 2x per day for 2 weeks then to 1x per day for 2 weeks. The rate of tapering should vary based on how quickly the rash is healing.

Dr. Harlan says that moisturizing 2x per day is a must for atopic dermatitis patients, regardless of whether a rash is present or not. For severe, thickened areas, he 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.

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

Cat dander often aggravates. Avoid cat exposure.

For a list of Dr. Harlan's recommended moisturizers, please click here.

Prevention

Unfortunately, atopic dermatitis will likely never permanently go away. 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, some patients require intervals of 2x and 1x every other day SmartLotion® applications for complete flare-up control. 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: Eczema treatment.