Complementary and Alternative Medicine for Atopic Dermatitis

An Evidence-Based Review

Brittany L. Vieira; Neil R. Lim; Mary E. Lohman; Peter A. Lio;

Disclosures

Am J Clin Dermatol. 2016;17(6):557-581. 

In This Article

Methods

A review of the medical literature was completed following the recommendations of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement criteria.[6] In conjunction with a research librarian, a search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and Cochrane Database of Systemic Reviews, and the Global Resource for EczemA Trials (GREAT) databases was conducted through March 2015 to identify all studies reporting complementary or alternative therapies of AD. Medical subject headings (MeSH) used in the literature search included atopic dermatitis or atopic eczema and complementary therapies, alternative medicine, therapies, integrative medicine, natural, diet therapy, diet modification, nutrition therapy, dietary supplement, pyridoxine, vitamins, zinc, herb therapy, herbal medicine, homeopathy, massage, acupuncture, balneotherapy, phytotherapy, traditional Chinese medicine, aromatherapy, naturopathy, hypnosis, acupressure, oil, vitamin D, cryotherapy, hydrotherapy, and biofeedback, as well as permutations of these words found in the title or abstract.

The inclusion and exclusion criteria were prospectively limited to publications in the English language and randomized controlled trials (RCTs) of ten or more human subjects, and included adults, adolescents, children, or infants with AD. We excluded trials that did not assess the alternative or complementary therapy as the primary intervention to which the experimental group was exposed. Trials assessing probiotics were also excluded; while controversies remain, they have their own robust and more conventional literature. The primary outcomes of interest included clinical signs and symptoms, long-term control of flares, and quality of life.

The authors conducted a manual review of the titles and abstracts identified from the search. Details were independently obtained about the patient population, study design, intervention, and outcome measure. A study met inclusion criteria for this review if it was determined to be an RCT with a sample size of ≥10, if it evaluated an alternative therapy, and if it assessed clinical improvement of AD severity as the primary outcome; discrepancies were resolved by consensus. The authors obtained the full text of the studies for independent assessment and determined eligibility again after full-text review. Disagreements were resolved by discussion among all authors. The authors were not blinded to the names of authors, journals, or institutions.

Authors' conclusions are based on available evidence.

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