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TOPLINE:

A systematic review found that premenstrual exacerbations of atopic dermatitis (AD) are common among women.

METHODOLOGY:

• Researchers conducted a systematic review of 16 studies on the menstrual cycle and AD, following Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines.
• The literature search was conducted using Ovid Medline, Embase, Cochrane Library, PubMed, and Web of Science databases with search terms that included menstruation, eczema, and AD.
• Seven were narrative reviews and one was a systematic review; eight were primary research studies, of which most had cross-sectional study designs.

TAKEAWAY:

• All review articles reported worsening of AD before the onset of menstruation, and 13.5%-50% of those in cross sectional studies experiencing premenstrual flares. Symptoms typically improved after the onset of menstruation.
• The worsening of AD around menstruation is attributed to hormonal influences, such as altered Th2 cell activity, increased skin permeability, changes in skin neuropeptides, dysregulated protease activity, and heightened cutaneous vascularity and metabolism.
• AD worsening was associated with premenstrual syndrome, younger age, allergies, higher total immunoglobulin E levels, and more severe itch and quality-of-life impacts.
• The evidence on treatment of menstruation-associated exacerbations of AD was limited.

IN PRACTICE:

“This review highlights the burden of AD in menstruating women and highlights the need for open discussion between the clinician and patient surrounding the effect of different stages of the menstrual cycle on symptoms of AD,” the authors wrote. Because of limited evidence regarding treatment strategies, they added, “further larger-scale studies are therefore needed to explore treatment options for these patients.” 

SOURCE:

This study was led by Niamh Theresa McSwiney, University Hospitals Dorset NHS Foundation Trust, Bournemouth, England, and was published online on April 2 in Clinical and Experimental Dermatology.

LIMITATIONS:

Study limitations included low-quality studies and reviews, questionnaire-based information, subjective reporting, and heterogeneity across the studies.

DISCLOSURES:

This study received no funding. One author reported being on advisory boards, receiving honoraria, receiving course fees, and or/ serving as a research collaborator for several cosmetics and pharmaceutical companies including, Leo, Loreal, and AbbVie.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.