What lifestyle modifications should I recommend to patients with atopi

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Lifestyle modifications for patients with atopic eczema to help manage symptoms include:

Use emollients regularly and liberally on the whole body, even when the skin appears clear, to maintain skin hydration and prevent flares. Emollients should be applied in larger amounts and more often than other treatments, smoothing rather than rubbing them into the skin. Offer unperfumed emollients and consider alternatives if irritation occurs. Prescribe sufficient quantities to allow use throughout the day, including at nursery, school, or work settings .
Start treatment for flares promptly as soon as signs and symptoms appear, and continue treatment for about 48 hours after symptoms subside to reduce severity and duration .
Provide patients and carers with clear information on the nature of atopic eczema, how to recognise flares (increased dryness, itching, redness, swelling), and how to manage them according to a stepped-care plan tailored to severity ,.
Advise on avoiding scratching to prevent skin damage, delayed healing, and infection; emollients may help ease itching and break the itch-scratch cycle .
Address fears and concerns about topical corticosteroids to improve adherence and avoid undertreatment .
Identify and manage trigger factors, including irritants and allergens, through clinical history and assessment; dietary exclusion diets should only be implemented and monitored by specialists if food allergy is suspected .
Encourage good skin care routines and access to quality information and support to empower self-management .

What lifestyle modifications should I recommend to patients with atopic eczema to help manage their symptoms?