THERAPEUTIC MANAGEMENT OF ATOPIC DERMATITIS: HYDRATION AND SKIN BARRIER RESTORATION PROTOCOLS

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itching, scaly erythematous plaques, and persistent xerosis, with a high prevalence in the pediatric population. The pathophysiology of AD is multifactorial, involving a complex interaction between genetic predisposition, immune dysregulation, and, fundamentally, epidermal barrier dysfunction. This study is a narrative literature review, based on articles published in the last five years in the PubMed database, aiming to compile and critically evaluate recent scientific evidence on the therapeutic management of atopic dermatitis, with an emphasis on hydration and restoration of the skin barrier. The results show that the diagnosis of the disease remains predominantly clinical and that basic therapy with emollients represents the central pillar of treatment in all phases of the disease. The use of formulations rich in physiological lipids is crucial for restoring the skin barrier, as it promotes the integrity of the stratum corneum and consequently reduces transepidermal water loss (TEWL), in addition to mitigating the penetration of exogenous irritants. Furthermore, emollients with added active ingredients and strategies aimed at balancing the skin microbiome have shown benefits in reducing symptoms and decreasing the need for more intensive anti-inflammatory therapies. In short, effective management of atopic dermatitis requires a multimodal and integrated approach. This should prioritize the restoration of barrier function, the identification and exclusion of specific environmental triggers, and the rational escalation between topical and systemic therapies, according to the phenotype and severity of the clinical picture.