Prevention of Atopic Dermatitis in Children: Can It be Done?

Atopic dermatitis (AD) poses a significant financial and disease burden on affected patients and families, prompting increased interest in primary prevention strategies. This review summarizes promising interventions aimed at preventing AD in childhood, with a focus on evidence from recent clinical trials and large cohort studies.

While prophylactic emollient use for AD prevention initially appeared promising, recent follow up studies have cast doubt on its effectiveness. Perinatal probiotics may moderately reduce the risk of childhood AD, especially among children at high-risk of allergic disease. However, there are insufficient high-quality studies to support prebiotic supplements, breastfeeding, partially hydrolyzed infant formula, other perinatal nutritional supplements, or specific material diets for prevention of AD.

Given the prevalence of AD, interventions with relatively small effect sizes would have a major impact on population health. Based on available evidence, the use of probiotic supplements for infants, pregnant women, and breastfeeding mothers is the most promising strategy. However, additional large clinical trials are likely needed before universal recommendations can be issued.