Occlusive therapy in atopic dermatitis: Overview

Abstract

Introduction: Occlusive therapy, including both dry and wet (‘wet-wrap therapy’) offers a treatment option in atopic dermatitis (AD) which may be underutilized in clinical practice due to concerns about burdensome regimens and potential complications. This review examines current evidence for the use of occlusion in AD. Methods: Keyword and title searches in PubMed and EMBASE were used to examine data on the use of occlusive therapy in AD from January 1966 to February 2009. Results: Eighteen studies were found examining the use of occlusive therapy in AD. Of the 14 studies examining wet-wrap therapy, five were randomized controlled trials. All wet-wrap therapy studies demonstrated efficacy in severe or acute, moderate and chronic AD. Of the four studies examining dry occlusive therapy, a single controlled study of dry occlusion does not support a benefit over conventional open therapy. Increased cutaneous bacterial counts or clinical infection were reported in all studies using dry occlusion and in four of 14 studies utilizing wet-wrapping techniques. Conclusions: Available data are encouraging, though limited by the lack of adequate study controls and standardized designs. More controlled trials are indicated.

Keywords::

• atopic dermatitis
• corticosteroids
• eczema
• occlusive dressings
• topical administration
• wet wrap

Acknowledgements

Declaration of Interest:

Dr John Koo has been a clinical researcher, consultant, and speaker for Abbott, Allergan, Amgen, Astellas, Galderma, Genentech, JSJ, Photomedex, Roche, Warner-Chilcott, and Teikoku. Dr Sabrina Braham, Dr Howard I. Maibach, and Rupa Pugashetti have no conflicts of interest to report.

Funding sources: none.