Environmental risk factors and their role in the management of atopic dermatitis

ABSTRACT

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.

KEYWORDS:

• Eczema
• atopic dermatitis
• environment
• prenatal
• pregnancy
• irritant
• allergen
• climate
• humidity
• temperature
• ultraviolet
• precipitation
• latitude
• pollution
• hygiene hypothesis
• pathogen
• bacteria
• virus
• herpes
• skin-barrier
• inflammation
• gene-environment

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This publication was made possible with support from the Agency for Healthcare Research and Quality (AHRQ), grant number [K12HS023011], and the Dermatology Foundation. No honorarium, grant or other form of payment was given to anyone to produce the manuscript.