Treatment of Atopic Dermatitis (AD) using Hyperbaric Oxygen Therapy (HBOT)

Atopic dermatitis (AD) is a chronic condition that affects the skin. It is mainly characterized by inflammation that results from excessive stimulation of the body’s immune cells. The condition results when there is an imbalance in the regulation of the inflammatory response by the skin. Some of the most common symptoms of atopic dermatitis include skin dryness, swelling, redness, itchiness (pruritus), and skin discoloration. Also, lesions crop up on different parts of the body, including the elbows, knees, trunk, hands, and feet. Other symptoms that affect the quality of life include insomnia, irritability and short temper, stress, and social functioning disorders such as attention deficit hyperactivity disorder (ADHD) and social phobia.

 Some of the triggers of the skin condition are allergens, stress, and irritants. Some of the factors mentioned above include living a sedentary lifestyle, contact with air and water pollutants, abrupt and extreme changes in temperature or humidity, anxiety, poor nutrition, and excessive consumption of alcohol and drugs. The condition is more prevalent in highly modernized societies. Some of the most explored forms of treatment for the condition include antihistamines, emollients, steroid ointments, topical corticosteroids, calcineurin inhibitors, hydroxyzine, and oral antipruritic drugs. Hyperbaric oxygen therapy (HBOT) was introduced as adjunctive therapy to improve the efficacy of some of these forms of treatment.

Mechanism of Action

HBOT reduces inflammation associated with atopic dermatitis through immunosuppression. The latter is enabled through a reduction in the production of inflammatory mediators, e.g., nitric oxide (NO), prostaglandin E2 (PGE2), tumor necrosis factor (TNF-α), interleukin (IL), and interferon. Increased reactive oxygen species (ROS) aids in the restoration of the skin’s structural properties. The skin is able to resume optimal levels of hydration and elasticity.

The introduction of hyperbaric oxygen (HBO) also leads to increased immunoglobulin proportions in the serum of the patient’s skin. The immunity of the skin is improved, and therefore, it is able to fight off pathogenic organisms. ROS destroys the cellular membranes of pathogenic microorganisms, thus leading to their deterioration and death.

The compromised skin barrier compromised by the condition is restored to its optimal state. This way, it is able to fight off pathogenic attacks and also remain steadfast during attacks by various causative factors such as irritants and allergens, e.g., pollutants. Reduced susceptibility means one is less prone to contract such illnesses as secondary infections that result from weak skin immunity.  

Other symptoms of atopic dermatitis addressed by HBOT include improved sleep quality and reduced anxiety. HBOT also reduces the chances of relapse of AD. In the long run, the quality of life is improved since the daily functioning of the body and, specifically, the skin is kept at an optimal level. The economic implications associated with chronic conditions are lessened as well. 

References

Mews, J., Tomaszewska, A., Siewiera, J., Lewicki, S., Kuczborska, K., Lipińska-Opałka, A., & Kalicki, B. (2021). Effects of hyperbaric oxygen therapy in children with severe atopic dermatitis. Journal of Clinical Medicine, 10(6), 1157. https://doi.org/10.3390/jcm10061157  

Olszański, R., Konarski, M., & Siermontowski, P. (2017). Hyperbaric oxygen therapy (HBOT) as a therapeutic option for patients with atopic dermatitis (AD) – own experiences and literature review. Polish Hyperbaric Research, 60(3), 13–18. https://doi.org/10.1515/phr-2017-0012