The Adjunctive Toolbox for Atopic Dermatitis

Skin care, diet, supplements, probiotics, and microbiome-directed strategies in clinical context

After establishing why adjunctive strategies matter in atopic dermatitis care, Cynthia Trickett, PA-C, and Peter Lio, MD, turn to the practical questions clinicians hear constantly: Do natural oils have a role? How much does diet really matter? What about probiotics, vitamin D, hypochlorous sprays, or antimicrobial cleansers?

For Dr Lio, skin care and barrier repair are so central to the biologic therapy treatment plan that he’s coined the term “Advanced Dermatologic Care,” or ADC, to describe the intentional use of OTC topicals, cleansers, moisturizers, written eczema action plans, and other supportive strategies that help patients and families understand what to do day to day and during flares. The conversation moves through natural oils, black tea compresses, diet myths, the risks of over-restriction, vitamin D supplementation, probiotics, and emerging microbiome-directed approaches, always returning to the same clinical foundation of evidence, safety, practicality, and individualized recommendations that support quality of life.

Of the many adjunctive options patients may ask about, Dr Lio says, “part of our job is to try to filter them down into things that have some evidence, that are safe and are practical.”  

This discussion makes space for it all, and contextualizes what may be overstated, unproven, or potentially harmful. He reminds clinicians not to chase every trend, but to help build an adjunctive plan that protects the barrier, respects the microbiome, and avoids doing harm. 
 

Upcoming: In Part 3, Trickett and Dr Lio turn from what clinicians can add to how they can do it safely, with practical guidance on supplement quality, follow-up, treatment monitoring, and patient-led decision-making.