Current concepts in the prevention of atopic dermatitis

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition with a profound social, economic, and psychologic impact. An effective prevention strategy would have significant socioeconomic implications worldwide. The aim of this review is to evaluate the current evidence for prevention strategies, including early intervention neonatal emollient therapy, antihistamine use, and probiotic supplementation. Although studies were fairly heterogeneous in their designs, the current cumulative data support early daily emollient therapy to reduce the incidence of AD in at-risk infants. The evidence for antihistamine use is limited, and further investigation is necessary to assess its potential role in AD prevention. Although several studies reveal a significant reduction in AD incidence with prenatal and/or postnatal probiotic supplementation, they differ in the strains, timing, dose, treatment duration, and measurement of clinical outcomes. Consequently, there are currently no firm guidelines or recommendations in place for probiotic use in pregnancy or infancy to prevent AD. Ultimately, atopic prevention remains a work in progress, and further investigations are needed to better understand the pathogenesis of AD and determine the most effective prevention strategies.