Facial Atopic Dermatitis Treated with Chitosan

Background/Objectives: Facial atopic dermatitis (AD) is burdensome, and facial skin is vulnerable to steroid-related adverse effects. This study describes the clinical use, tolerability, and photographic response to topical 2% chitosan gel in a consecutive case series. Methods: Twenty patients applied the gel to affected facial areas twice daily for 4 weeks alongside standardized gentle skin care. Clinical and patient-reported outcomes were collected, and two independent physicians assessed paired photographs using the Photographic Atopic Improvement Scale (PAIS). An additional ultrasound-based imaging record was considered separately from the cohort analysis. Results: The chitosan-containing regimen was associated with improvement in overall facial appearance and the available clinical and patient-reported outcomes. Photographic responses varied, with residual inflammatory lesions in some examples. Mild transient stinging occurred in 3 of 20 patients (15%) and resolved spontaneously; no serious adverse events were recorded. The additional imaging record was descriptive and did not provide an independently validated measure of skin-quality improvement. Conclusions: Topical 2% chitosan gel was feasible and generally well tolerated in this hypothesis-generating series. The uncontrolled design, concomitant moisturization, and rescue treatment in two patients preclude attribution of improvement solely to chitosan. Controlled studies are needed to establish efficacy and validate the photographic and device-based outcomes.