The patients should be asked to keep the skin and hair clean, take daily baths with an ordinary toilet soap and shampoo the hair daily if possible.
Applications of oils should be avoided even if the skin is dry because oils tend to accumulate more dirt and interfere with cleaning.
Acute Episode
An acute episode should be treated with normal saline or potassium permanganate compresses twice a day for exuding or crusted lesions and hypertonic saline compresses for lichnenified lesions.
Applications of ointments containing corticosteroids with or without antibiotics can be applied.
Severe itching can be controlled with oral antihistaminics. Patients having superadded bacterial infection should be given systemic anti-bacterial drugs as well.
The treatment should be continued till the activity of the disease subsides and gradually withdrawn.
This treatment is needs to be reinstituted whenever the lesions appear again. Attempt should be made to find out the causative antigens and when known should be avoided.
Atopic children should not be vaccinated when they are having active disease because there is risk of generalized eruptions.
The immunosuppressants tacrolimus and pimecrolimus can be used as a topical preparation in the treatment of severe atopic dermatitis instead of or in additoin to traditional steroid creams.
UV radiation exposure has been found to have a localized immunomodulatory effect on affected tissues, and may be used to decrease the severity and frequency of flares. However, UV radiation has also been implicated in various types of skin and thus UV treatment is not without risk.
Recently, bathing in a dilute household bleach solution has been found to be beneficial.
