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The authors review the existing literature addressing strategies for managing atopic dermatitis (AD) in patients with low socioeconomic status. For itching, dilute bleach baths, home acupressure (LI11 point on the lateral forearm), and refrigerated moisturizers are more affordable than marketed anti-itch creams. Generic petroleum jelly–based moisturizers demonstrate the best cost–benefit ratio. Wet wraps using readily available gentle fabric may replace expensive wound care supplies or eczema specialty clothing. A single higher-potency topical corticosteroid can be diluted to a 1:4 or 1:2 ratio with a generic moisturizer for sensitive anatomic regions rather than prescribing a separate low-potency corticosteroid. A written action plan for what to do during an eczema flare can prevent utilization of emergency services and the high costs incurred by emergency department visits.
In the United States, patients with low socioeconomic status have a median income of $25,000/year; the average $1000 to $4000 yearly AD-related costs may equate to 16% of their yearly income. Low socioeconomic status is also associated with higher disease severity. Providers can improve the care of these patients by being aware of cost-saving treatment alternatives.
– Margaret Hammond, MD
This abstract is available on the publisher's site.
Atopic dermatitis (AD) is a chronic inflammatory dermatosis presenting with inflamed and itchy skin. Recent studies have shown an inverse relationship between socioeconomic status and the severity of AD. Low socioeconomic status (LSES) individuals with AD face specific barriers that may impede management. These include forgoing doctor's appointments due to transportation costs, inability to take time off from work, and lack of affordable childcare services. Unaffordable medications and over-the-counter products for managing AD further present as significant challenges for LSES patients. This article aims to offer practical and affordable recommendations to help mitigate the challenges faced by LSES patients with AD and thereby alleviate disease burden and improve treatment outcomes.