The Primary Prevention of Atopic Dermatitis

The development of a cost-effective prevention strategy for atopic dermatitis would represent a major public health advance. The disease is highly prevalent around the world and often heralds the onset of immunoglobulin-E-mediated allergic diseases. Most studies to date have utilized allergen avoidance strategies or dietary supplementation. More recently, a relatively large body of literature supports the use of probiotic supplementation to prevent atopic dermatitis, although the effect is modest and more confirmatory studies are needed. The use of partially hydrolyzed formulas for high-risk infants may also be considered when exclusive breastfeeding is not possible. Dietary restrictions and the delayed introduction of complimentary foods are not effective and may cause harm. The data do not support dust mite avoidance or omega fatty acid supplementation. Newer prevention strategies focusing on improving skin barrier dysfunction are under evaluation.