Abstract
Background
Atopic dermatitis (AD) often manifests in infancy or early childhood, with significant impacts on quality of life and potential persistence into adulthood. Environmental factors are key contributors to pruritus, barrier dysfunction, and inflammation associated with AD.Methods
A panel of 7 pediatric dermatology experts employed a modified Delphi process, including a face-to-face meeting and online follow-up, to evaluate current evidence and formulate consensus recommendations for managing pediatric AD.Results
The panel identified environmental factors that affect skin barrier function and contribute to the development and severity of pediatric AD. Consensus recommendations emphasize minimizing environmental exposures and highlight strategies to reduce skin barrier disruption. Early and continuous use of gentle, non-alkaline cleansers and ceramide-containing moisturizers, initiated from birth, may help mitigate AD risk and severity, particularly in high-risk children.Conclusions
Recognizing and addressing environmental factors is an important component of pediatric AD management. Addressing modifiable environmental factors and initiating early barrier-supportive skincare, including ceramide-containing moisturizers, represents a practical approach to reducing disease severity and flare development. These findings highlight the importance of clinician education to improve awareness of environmental risk factors and effective mitigation strategies.  .