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Integrative Medicine as Adjunct Therapy in the Treatment of Atopic Dermatitis—the Role of Traditional Chinese Medicine, Dietary Supplements, and Other Modalities

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Abstract

Atopic dermatitis (AD) is becoming increasingly prevalent in the pediatric population, with rates reportedly as high as 18–25 %. Westernized medicine has traditionally used a combination of emollients, antihistamines, corticosteroids, and immunomodulating agents to combat this often frustrating disease. Of late, integrative medicine has become the subject of more research as concerns grow regarding prolonged use of corticosteroids and their side effects in pediatric patients. Probiotics have been extensively studied to define their role in the treatment and prevention of AD in children. Unfortunately, results are varying showing significant improvement in some patients but not all. With regard to prevention, studies show that the use of probiotics during pregnancy does decrease the incidence of AD in children. Prebiotics and synbiotics are also a conceivable option for prevention of AD. A number of studies on Chinese herbal medicine have been performed, with a collective result of symptom improvement and decreased levels of inflammatory cytokines. However, there were reports of asymptomatic transaminitis in a few patients that warrant further testing. While the herbs tested in more recent randomized clinical trials were free from corticosteroids, a previous study showed high levels of dexamethasone in unlabeled herbal eczema creams. Vitamins and minerals have also been suggested as an alternative treatment of AD. Studies however have not yet demonstrated improvement of AD with vitamin or mineral supplementation. Topical vitamin B12 is the exception to this; however, no topical vitamin B12 preparation is available for use. Finally, relaxation techniques are also being investigated as adjunctive methods of treatment, but well-designed scientific studies are lacking.

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Abbreviations

AD:

Atopic dermatitis

CAM:

Complementary and alternative medicine

CDLQI:

Children's Dermatology Life Quality Index

CS:

Corticosteroid creams

DC:

Dendritic cells

FOS:

Fructo-oligosaccarides

GOS:

Galacto-oligosaccharides

IGADA:

Investigator's Global Atopic Dermatitis Assessment

PHF:

Pentaherbs formulation

PUFA:

Polyunsaturated fatty acids

RCT:

Randomized control trial

RCU:

Relative copy units

RDBPCT:

Randomized double-blind placebo controlled trial

SCORAD:

Scoring of Atopic Dermatitis

TCM:

Traditional Chinese medicine

TLR:

Toll-like receptor

XFS:

Xiao-Feng-San

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Acknowledgments

The authors would like to thank Matthew T. Jones for his assistance with the illustrations.

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Authors and Affiliations

  1. Division of Allergy, Asthma and Immunology, Thomas Jefferson University, Wilmington, DE, USA

    C. DiNicola & C. Chang

  2. Nemours/A.I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA

    A. Kekevian & C. Chang

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  1. C. DiNicola
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  2. A. Kekevian
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Correspondence to C. Chang.

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DiNicola, C., Kekevian, A. & Chang, C. Integrative Medicine as Adjunct Therapy in the Treatment of Atopic Dermatitis—the Role of Traditional Chinese Medicine, Dietary Supplements, and Other Modalities. Clinic Rev Allerg Immunol 44, 242–253 (2013). https://doi.org/10.1007/s12016-012-8315-1

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