Nutritional management for symptom control of atopic dermatitis in children and adolescents: an integrative review

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin condition with multifactorial etiology and high prevalence in childhood and adolescence, with impact on quality of life. Nutrition has increasingly been investigated as a potential modulator of disease severity, leading to growing interest in complementary strategies to conventional dermatological treatment. This integrative review aimed to synthesize evidence on nutritional interventions for the management of AD in children and adolescents, focusing on clinical severity and applicability to practice. Thirteen studies published in the past five years were included, encompassing supplementation with probiotics, prebiotics, synbiotics, vitamin D, and omega-3 fatty acids. Seven interventions demonstrated a significant reduction in Scoring Atopic Dematitis (SCORAD) or Eczema Area and Severity Index (EASI) scores compared with controls, including two probiotic-based interventions, two with vitamin D, two with omega-3 fatty acids, and one synbiotic. Four studies also reported reduced need for topical corticosteroids or immunosuppressants in the intervention group. However, interpretation is limited by methodological heterogeneity, lack of standardization of strains and dosages, small sample sizes, and insufficient control of medication use in trials. Despite promising results, current evidence does not support definitive clinical recommendations. Further rigorously designed trials with standardized outcomes are essential to guide evidence-based clinical decision-making.