Effective Strategies for Managing Atopic Dermatitis Symptoms

Key Pathophysiological Factors in Atopic Dermatitis

Atopic dermatitis arises from a complex interplay of genetic, environmental, and immunological factors. Research has shown that individuals with a familial history of allergies are at a higher risk, highlighting the genetic predispositions involved (Williamson et al., 2020). The skin barrier dysfunction is a hallmark of AD, primarily linked to mutations in the filaggrin gene, which is crucial for maintaining skin integrity (Naeem et al., 2017). Environmental factors, including allergens, irritants, and climate, play a significant role in exacerbating the condition (Thibault Greugny et al., 2023).

Moreover, the immune response in AD is primarily Th2-mediated, characterized by elevated levels of cytokines such as IL-4, IL-5, and IL-13, which contribute to inflammation and itching (Oh et al., 2021). Recent studies have also pointed to the gut-skin axis, suggesting that dysbiosis in the gut microbiota can influence the development and severity of AD (Zhang et al., 2024).

Topical Treatments and Their Role in Atopic Dermatitis

Topical corticosteroids (TCS) are the cornerstone of AD management. They are effective in reducing inflammation, erythema, and pruritus. However, concerns regarding long-term use, including skin atrophy and topical steroid withdrawal syndrome (TSWS), have emerged (Lio & Chandan, 2019). TCS should be employed judiciously, with a focus on tapering strategies to minimize potential withdrawal symptoms (Maskey et al., 2025).

Non-steroidal topical treatments, such as calcineurin inhibitors (e.g., tacrolimus and pimecrolimus), are also utilized, particularly for sensitive areas like the face and intertriginous zones. These agents work by modulating the immune response rather than suppressing it, thus providing an alternative for patients at risk of TCS dependency (DiRuggiero et al., 2025).

Table 1: Common Topical Treatments for Atopic Dermatitis

Benefits of Integrating Traditional Chinese Medicine for AD

Traditional Chinese Medicine (TCM) approaches AD by addressing underlying imbalances in the body rather than merely treating symptoms. TCM uses herbal formulations that target multiple pathways involved in inflammation, immune response, and skin barrier function. For instance, Angelica Yinzi has shown promise in alleviating AD symptoms by modulating the immune response and reducing inflammation (Liu et al., 2022).

Recent studies suggest that TCM can complement conventional treatments by enhancing efficacy and reducing the severity of side effects associated with corticosteroid use (Zhang et al., 2025). The integration of acupuncture and herbal therapies has been reported to improve skin condition and quality of life in patients with AD, offering a holistic approach to management (Li et al., 2021).

Systemic Therapies: New Advances and Recommendations

For moderate to severe AD that fails to respond to topical therapies, systemic treatments, including biologics, are increasingly utilized. Dupilumab, a monoclonal antibody targeting IL-4 and IL-13 pathways, has been shown to significantly improve symptoms and quality of life in patients with moderate to severe AD (Simpson et al., 2025). Other systemic therapies include Janus kinase (JAK) inhibitors, which offer rapid relief from itching and skin lesions (Martin et al., 2025).

Table 2: Systemic Therapies for Atopic Dermatitis

Managing Side Effects of Topical Corticosteroids in AD

Long-term use of TCS can lead to adverse effects, including skin atrophy, telangiectasia, and TSW. It is essential for clinicians to educate patients about the risks associated with TCS and provide strategies to minimize these risks. Recommendations include rotating lower-potency TCS, using TCS for limited periods, and incorporating TCM approaches to mitigate withdrawal symptoms (Maskey et al., 2025).

Monitoring the skin condition regularly and adjusting treatment plans according to the severity of AD can prevent the development of TSW. Patients should also be encouraged to maintain a consistent skincare routine using emollients to support skin barrier function and combat dryness (Lio & Chandan, 2019).

FAQ

What are the common symptoms of atopic dermatitis?
Symptoms of atopic dermatitis include dry, itchy skin, redness, swelling, and in severe cases, oozing and crusting.

How can I effectively manage my atopic dermatitis?
Effective management typically involves a combination of topical treatments, systemic therapies for severe cases, and lifestyle modifications including the use of emollients and avoiding known triggers.

Is traditional Chinese medicine effective for atopic dermatitis?
Many patients report positive outcomes with TCM, particularly when integrated with conventional treatments, as it addresses underlying imbalances and promotes overall skin health.

What should I do if I experience side effects from topical corticosteroids?
Consult your healthcare provider for an evaluation and potential adjustment of your treatment regimen. They may suggest tapering the steroid use and integrating other therapies.

Can atopic dermatitis be cured?
While there is currently no cure for atopic dermatitis, effective management strategies can help control symptoms and improve the quality of life for those affected.

References

1. Williamson, S., Merritt, J., & De Benedetto, A. (2020). Atopic dermatitis in the elderly. Br. J. Dermatol., 182, e21

2. Naeem, A. S., Tommasi, C., Cole, C., Brown, S. J., & Zhu, Y. (2022). A mechanistic target of rapamycin complex 1/2 (mTORC1)/V-Akt murine thymoma viral oncogene homolog 1 (AKT1)/cathepsin H axis controls filaggrin expression and processing in skin, a novel mechanism for skin barrier disruption in patients with atopic dermatitis. J. Allergy Clin. Immunol., 139, 1228–1241. URL: https://doi.org/10.1016/j.jaci.2016.09.052

3. Thibault Greugny, E., Bensaci, J., Fages, F., & Stamatas, G. N. (2023). Computational modelling predicts impaired barrier function and higher sensitivity to skin inflammation following pH elevation. Exp. Dermatol., 32, 177–185

4. Zhang, L., Chen, N., Liao, Y., Kong, Y., Yang, X., & Zhan, M. (2024). Efficacy and action mechanisms of compound Shen Chan decoction on experimental models of atopic dermatitis. Int. Immunopharmacol., 137, 112479. URL: https://doi.org/10.1016/j.intimp.2024.112479

5. Liu, W., Song, W., Luo, Y., Dan, H., & Li, L. (2022). Angelica Yinzi alleviates 1-chloro-2,4-dinitrobenzene-induced atopic dermatitis by inhibiting activation of the NLRP3 inflammasome and down-regulating the MAPKs/NF-κB signaling pathway. Saudi Pharm. J., 30, 1426–1434. URL: https://doi.org/10.1016/j.jsps.2022.07.003

6. Martin, G., Aldredge, L. M., DiRuggiero, D., Young, M., & Simpson, E. (2025). An Overview of Atopic Dermatitis Disease Burden, Pathogenesis, and the Current Treatment Landscape: Recommendations for Appropriate Utilization of Systemic Therapies. J. Clin Aesthet Dermatol, 18(3), 51-59. URL: https://doi.org/10.2147/OTT.S510766

7. Maskey, A. R., Sasaki, A., Sargen, M., Kennedy, M., Tiwari, R. K., Geliebter, J., & Li, X.-M. (2025). Breaking the cycle: a comprehensive exploration of topical steroid addiction and withdrawal. Front Allergy, 1547923. URL: https://doi.org/10.3389/falgy.2025.1547923