Management of Itch in Atopic Dermatitis

Janelle Pavlis, Gil Yosipovitch

Research output: Contribution to journalReview article

28 Scopus citations

Abstract

Atopic dermatitis (AD) is the most common itchy dermatosis that affects millions of children and adults worldwide. Chronic itch in this condition has significant impact on measures of quality of life, such as sleep. Treating itch in AD has been challenging for decades, but new drugs have emerged in the last year with significant anti-pruritic effect. The optimal treatment regimen for atopic itch addresses barrier dysfunction, inflammation, neural hypersensitivity, and the itch–scratch cycle. Topical moisturizers remain the foundation of treatment and should be used by all patients with AD-associated pruritus. Step-wise therapy, from topical anti-inflammatory creams to systemic monoclonal antibodies and immunosuppressants, is recommended. There are multiple adjuvant therapies that can be used, especially to target itch in the setting of minimal skin inflammation. Finally, patient education, sleep management, and stress relief are important components to optimize outcomes. This review assesses the latest advances and treatment recommendations for pruritus in AD. Finally, suggested therapeutic ladders and emerging treatments are discussed.

Original languageEnglish (US)
Pages (from-to)319-332
Number of pages14
JournalAmerican Journal of Clinical Dermatology
Volume19
Issue number3
DOIs
StatePublished - Jun 1 2018

ASJC Scopus subject areas

  • Dermatology

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