Atopic dermatitis: the problem of adherence to emollients

Use of emollients plays a key role in basic therapy for prevention of atopic dermatitis (AD) relapses. Objective. To assess the adherence to therapy with emollients among adult patients and parents of children with AD as well as to identify key causes that influence their irregular use. The authors performed interviews with 127 subscribers of the #UAtopiiEstLitso channel (8 men, 104 women, 15 persons did not indicate gender). We analyzed 300 negative reviews on emollients from marketplaces (Ozon, Wildberries, «Golden apple»). Results. Most parents and patients with AD recognize the need to use emollients forrecovery of the skin barrier. Despite this, the regularity of the emollients application differs. Adherence to therapy with emollients is higher for parents of patients with AD — 47 (70.1%) respondents strictly adhered to a daily application, among adult patients only 28 (46.7%) followed the regime; 25 (41.6%) adult patients and 17 (25.4%) patients missed application because of the fatigue after the procedure. High cost of emollients is the main barrier for 27 (40.3%) parents and 29 (48.3%) adults. The need for frequent application is the second most important limiting factor for 25 (37.3%) parents and 28 (46.7%) adults. Unpleasant subjective sensations (oiliness, stickiness, feeling that «skin does not breathe») also significantly affected the regularity of use. Adult patients noted oiliness and gloss after application in 18 (30.0%) cases, parents — stickiness in 19 (28.4%) observations. Adult patients changed emollients more frequently — 37 (61.7%) compared to parents — 36 (53.7%). Conclusion. Parents of children with AD are more compliant to therapy with emollients than adult patients. Main causes of low adherence: high cost, frequency of application, unsatisfactory organoleptic qualities, adverse effects after agent use (oiliness, stickiness, dense texture) and insufficient understanding of the role and action of emollients.