Patient Handouts : Skin Care for Atopic Dermatitis and Very Dry Skin

Skin Care for Atopic Dermatitis and Very Dry Skin

1. Use soap sparingly and infrequently, and do not take hot showers or baths

Soap removes oils as well as dirt. If you want to clean a greasy cooking pot, you use hot water and lots of soap. But if you use hot water and soap on your skin, it will strip natural oils out of the skin. These oils are designed to protect your skin, and keep it from drying out. Our skin is NOT designed to be soaped up every day. Skin is normally pretty resilient and tough, and many people can tolerate daily treatment with soap all over their skin -- but not people with atopic dermatitis or sensitive skin. So:

  • When you take a shower, only soap your armpits and groin; do not use cleanser on the rest of your skin unless it is visibly dirty.
  • Do not take long, hot showers: even without cleanser this will irritate the skin. If your skin is already itching, the hot water will feel VERY good -- but will make the skin feel worse, later.
  • If you take baths, do not make them very hot. AND, do not use any soap or shampoo at all until you are about ready to get out! Again, use cleanser only in the armpits & groin, or visibly dirty areas, and rinse off immediately.
  • If you must use an antibacterial soap, I recommend Lever 2000 or Cetaphil antibacterial bar.
Very Mild Cleansers
  • Aquanil
  • Del Clens
  • Cetaphil liquid cleanser
Mild Cleansers
  • Dove Unscented bar
  • Olay Body bar
  • Cetaphil bar
  • Eucerin cleansing lotion
  • Neutrogena cleansing wash
  • Purpose liquid cleanser

Remember that as long as the water is only warm instead of hot, water will generally not bother your skin. It will even help to moisturize it -- a benefit that is protected if you apply a moisturizer as soon as you are finished.

2. Use moisturizing CREAMS or OINTMENTS -- not lotions

Moisturizers do NOT really add moisture to the skin, but they help add a protective coating that reduces water loss, allowing the skin to moisturize itself from the inside.

For people with very dry atopic skin, LOTIONS ARE MOSTLY USELESS, and many of them will irritate the skin.

Creams (oil in water emulsions; too thick to make "drops") are generally good moisturizers, and ointments are the best of all, but ointments are greasy and not very elegant -- most people don't enjoy using them.

3. Apply cream or ointment twice a day, and after every shower/bath

Moisturizers can be applied as often as desired; use them liberally at least twice a day. The most important time to apply a moisturizer is right after bathing or showering, before the skin is completely dry.

Most moisturizing creams will do the job: it is safest, however, to choose creams that do not have added fragrance.

Recommended creams
  • Cetaphil Cream
    (my favorite: very effective and very well tolerated)
  • Cutemol
  • Eucerin Cream
    (pretty thick, and hard to apply, but very effective; no odor)
  • Neutrogena Hand Cream
  • Vanicream
    (especially good for sensitive skin)
Ointments
  • Vaseline (petroleum jelly)
  • Aquaphor
  • Elta
  • DML Forte

4. Avoid contact with irritants and solvents

  • Wool clothing, or any rough fabric
  • Alcohol will strip oils from the skin: most toners have alcohol
  • Kitchen cleansers and solvents
  • Bleach