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Holistic Skincare Approach of Cleanse-Treat-Moisturize-Protect (CTMP®) in Atopic Dermatitis Management: Indian
Sanjay Choudhary1, Dinkar Sadana2, Vijayabhaskar C3
1Medicine, Galderma India Pvt Ltd., Mumbai, IND.
Insights
Barrier-focused skincare is crucial for managing atopic dermatitis (AD), improving skin health and quality of life. However, challenges in India include poor awareness and adherence, requiring better education and accessible strategies for effective long-term care.
Area of Science:
- Dermatology and Immunology
- Pediatric Dermatology
- Public Health
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting quality of life, especially in children.
- Epidermal barrier dysfunction is a key feature of AD, necessitating targeted management strategies.
- Current treatments focus on anti-inflammatory therapies, but barrier repair is increasingly recognized as vital.
Purpose of the Study:
- To review evidence on barrier-directed skincare for atopic dermatitis management.
- To examine pediatric care considerations and challenges in the Indian healthcare context.
- To identify future directions for integrating skincare into AD management.
Main Methods:
- Narrative review of clinical studies and national guidance on AD skincare.
- Analysis of survey data on caregiver awareness and adherence in India.
- Exploration of emerging skincare modalities and implementation challenges.
Main Results:
- Emollient use significantly improves skin hydration, barrier function, and quality of life in AD patients.
- National guidelines recommend age-appropriate bathing and prompt emollient application.
- Significant gaps exist in India regarding caregiver awareness, diagnosis, and adherence due to cost and access issues.
Conclusions:
- Barrier-focused skincare is an essential adjunct to pharmacologic therapy for atopic dermatitis.
- Effective integration in India requires enhanced caregiver education, context-specific guidance, and strategies to improve accessibility and adherence.
- Future research should focus on pragmatic trials and epidemiological studies for scalable, evidence-based care.
Abstract:
Atopic dermatitis (AD) is a chronic, relapsing inflammatory dermatosis characterized by epidermal barrier dysfunction, immune dysregulation, and significant impairment in quality of life, particularly among pediatric populations. Although topical anti-inflammatory therapies remain central to acute flare control, growing evidence supports barrier-directed skincare as a fundamental component of long-term disease management. This narrative review synthesizes current evidence on cleansing, moisturization, photoprotection, and preventive strategies in AD, with specific consideration of pediatric care and real-world challenges within the Indian healthcare context. Clinical studies consistently demonstrate that regular emollient use enhances skin hydration, accelerates barrier recovery, alleviates symptom burden, and improves quality of life, with additive benefits when combined with topical corticosteroids. National guidance further emphasizes age-appropriate bathing practices, including delayed bathing in low-birth-weight infants and gentle cleansing followed by prompt emollient application. Despite these recommendations, Indian surveys reveal persistent gaps in caregiver awareness, delayed diagnosis, intermittent moisturizer use, and suboptimal adherence driven by cost constraints, loss to follow-up, and preference for alternative therapies. While emerging modalities, including biomimetic formulations, digital health platforms, and personalized skincare, offer potential future directions, current evidence remains largely exploratory, with limited data on cost-effectiveness and real-world implementation. Overall, barrier-focused skincare represents an important adjunct to pharmacologic therapy in AD; however, effective integration into Indian clinical practice will require strengthened caregiver education, context-specific guidance, and system-level strategies addressing accessibility and adherence, supported by future pragmatic trials and epidemiological studies to enable scalable, evidence-based care.
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