Periorbital dark circles and lichenification in Black AD patients may be due to rubbing and scratching to reduce pruritus.8
AD patients with darker skin have a higher risk of developing post-inflammatory dyspigmentation, which is a sequela that can last for months to years.8 In less severe cases, dyspigmentation may subside within weeks to months; however, chronic excoriation may result in permanent dyspigmentation.8
Statement 3: Cultural factors related to bathing and moisturization preferences need to be considered. Increased scrubbing, cleansing, and fragrance use may be more common in some SOC populations and vary according to cultural and geographic norms. Cleansing habits should be considered when treating AD in these patient populations.
Clinical guidelines, consensus papers, and algorithms on AD diagnosis, treatment, and maintenance are available per region with different racial/ethnic populations; however, few address racial/ethnic-specific skincare as an individual approach to AD (Table 1).19-38 Increasingly, guidelines address skincare, using gentle cleansers and moisturizers as part of topical therapy or adjunct to systemic treatment.20,21 The Asian-Pacific AD guidelines recommend moisturizers (i.e., those containing virgin coconut oil, ceramides or glycyrrhetinic acid, V. vinifera, shea butter, and hyaluronic acid) as the mainstay of treatment and should be liberally and frequently used in the prevention of ADprone skin.20,21 As a practice point, the authors of the Asian-Pacific AD guidelines stated that moisturizers must be suitable for the patient's climate, humidity, and environmental conditions. They should be applied directly after bathing and up to three times per day.20,21 European-based guidelines recommend skincare as part of essential therapy, which focuses on treating skin barrier dysfunction as monotherapy or an adjunct to prescription therapy and maintenance.23,24 The guidelines point out specific benefits of using moisturizers that contain skin lipids.23
Like the European guidelines, Japanese guidelines integrate regular use of skin care products as the basic approach to prevention, monotherapy, adjunctive treatment, and maintenance. The guidelines further recognize the benefits of moisturizers in the treatment of atopic dermatitis.28
The Latin American and Caribbean guidelines found few studies conducted in the region that take into account socio-economic, geographical, cultural, and health care system characteristics.29 The clinical guide is aimed at AD patients, families, primary care physicians, and specialists and includes skincare as part of general care.28
The Mexican guideline proposed four steps for treating AD in addition to general care and education on AD and its treatment, which included skincare.30,31
