Atopic Dermatitis and Cosmetics — How to Choose Products for a Compromised Skin Barrier

What is atopic dermatitis?

Atopic dermatitis (AD, atopic eczema) is a chronic inflammatory skin disease marked by recurring episodes of itching, dryness, redness and inflammation. It affects both children and adults — in developed countries, an estimated 15–20% of children and 1–3% of adults live with it.

Important disclaimer: this article is for informational purposes only and is not a substitute for a consultation with a dermatologist. Atopic dermatitis is a condition that requires medical care. We only describe what to look for in the formulations of cosmetics that support your daily routine — but it is your doctor who decides on treatment.

A damaged barrier — the heart of the problem

In people with atopic dermatitis, the epidermal barrier is structurally and functionally compromised. A key discovery was the identification of mutations in the filaggrin gene (FLG) in a significant proportion of AD patients. Filaggrin is a protein essential for the proper formation of the skin's outermost layer (the stratum corneum).

The consequences of a weakened barrier:

• Increased water loss (TEWL) — the skin is chronically dry
• Easier penetration of allergens and irritants — the skin is more reactive
• Disrupted skin microbiome — Staphylococcus aureus dominates during flare-ups
• Ceramide deficiency — the intercellular lipids fail to do their job

This is why the daily use of emollients is the cornerstone of atopic dermatitis care — not a luxury, but a medical necessity. You can read more about the role of the skin barrier in our guide to caring for sensitive skin.

Emollients — the foundation of daily atopic dermatitis care

Emollients are not „ordinary" moisturisers — in the context of atopic dermatitis, they play a therapeutic role. They should be applied at least twice a day, and even more often during flare-ups. How much? Dermatologists recommend 250–500 g per week for adults with extensive lesions.

Types of emollients

• Occlusive emollients — rich in lipids, they form an occlusive layer (e.g. based on petroleum jelly or paraffin). Ideal in winter and overnight
• Moisturising emollients — lighter, with humectants (glycerin, urea). Better in summer and for daytime use
• Barrier-repairing emollients — they contain ceramides, cholesterol and free fatty acids in physiological proportions. The latest generation, supporting the skin's natural barrier regeneration

Key ingredients in cosmetics for atopic skin

Ceramides

Ceramide deficiency is one of the markers of atopic dermatitis. Cosmetics containing Ceramide NP, Ceramide AP, Ceramide EOP combined with cholesterol and free fatty acids help rebuild the lipid barrier. This is not marketing magic — numerous clinical studies confirm the effectiveness of ceramides in atopic skin care.

Urea — with a caveat

Urea at a concentration of 5–10% is an excellent moisturiser and a component of NMF (Natural Moisturizing Factor). With atopic dermatitis, however, it requires caution:

• On intact skin — well tolerated, hydrates effectively
• On damaged, cracked or inflamed skin — it can sting strongly and cause irritation
• In young children — use with care, starting at low concentrations (3–5%)

Rule of thumb: use urea during remission as a preventive measure, not during flare-ups on active inflammatory lesions.

Glycerin

A safe, well-tolerated humectant. At a concentration of 5–20% it hydrates effectively without the risk of irritation. Ideal in emollients for everyday use.

Panthenol (D-Panthenol)

It hydrates, soothes and speeds up the regeneration of the epidermis. Well tolerated even by very sensitive skin. Check its profile in our ingredient encyclopedia.

Petrolatum (Petroleum Jelly)

The most effective occlusive, reducing TEWL by as much as 98%. It has been used in atopic dermatitis care for decades. Despite its simple composition, it works. It is important to use high-purity, pharmaceutical-grade petrolatum.

What to avoid in formulations at all costs

Fragrances — enemy number one

This is probably the most important rule when choosing cosmetics for atopic skin. Fragrances (Parfum/Fragrance) are among the most common contact allergens. In the INCI list they can hide under various names:

• Parfum / Fragrance — the general term for a fragrance blend
• Linalool, Limonene, Citronellol, Geraniol — individual fragrance allergens that must be declared
• Essential oils — natural, but just as potentially irritating

Look for products labelled „fragrance-free", not „unscented" — the difference matters. „Unscented" can mean that masking agents have been added to cover up a scent, and these can be irritating in their own right.

Other ingredients to avoid

• Sodium Lauryl Sulfate (SLS) — a harsh surfactant that damages the barrier
• Alcohol Denat. — drying
• Methylisothiazolinone (MI) / Methylchloroisothiazolinone (MCI) — potent allergens, banned in leave-on products in the EU but still present in some rinse-off products
• Dyes — unnecessary and potentially irritating

How to read labels — practical tips

1. Check whether the formulation contains Parfum/Fragrance — if so, consider an alternative
2. Look for ceramides, glycerin, panthenol — these are your allies
3. The shorter the INCI list, the lower the risk of irritation
4. Don't trust claims like „hypoallergenic" or „dermatologically tested" — they are not legally regulated

Use our ingredient search tool to quickly identify potentially problematic substances.

Working with a dermatologist

Let us say it again firmly: atopic dermatitis is a disease, not a cosmetic concern. Emollients and well-chosen cosmetics are an important part of daily care, but:

• During flare-ups, prescription medications may be needed (topical corticosteroids, calcineurin inhibitors)
• A dermatologist can help identify the triggers behind flare-ups
• Modern biologic therapies (e.g. dupilumab) are revolutionising the treatment of severe atopic dermatitis

Cosmetics support, but do not cure. Treat them as everyday prevention between visits to your specialist.

Want to check whether your emollient has a safe formulation? Search our ingredient database →