Impact of the menstrual cycle on exacerbations of atopic dermatitis: a systematic review

Atopic dermatitis (AD) is a chronic pruritic inflammatory skin condition. Patients with AD often report experiencing cutaneous deterioration associated with certain points of their menstrual cycle. Despite this, the literature surrounding this topic remains sparse. To summarize and compare recent publications considering the association between the different stages of the menstrual cycle and exacerbations of AD. A literature review was conducted following the PRISMA guidelines using Ovid MEDLINE, Embase, Cochrane Library, PubMed and Web of Science. Search terms and variations on these terms included 'menstruation', 'eczema' and 'atopic dermatitis'. A minimum of two authors independently screened each abstract and reviewed the full text for inclusion. Sixteen studies were included. All articles consistently acknowledged premenstrual deterioration in the control of AD, typically occurring in the week before menstruation. Our results highlight that premenstrual exacerbation of AD is a well-recognized phenomenon, typically occurring in the week before menstruation. Existing studies are of a low quality, and we identified minimal evidence on treatment strategies for premenstrual exacerbations of AD. Further large-scale studies are needed to explore treatment options for these patients, such as hormonal therapies.