Beyond basic hydration: multidirectional components of emollients plus for the control of atopic dermatitis symptoms (Expert Council Resolution dated December 18, 2025)

A scientific meeting in the format of an expert council was held on December 18, 2025, in Moscow and focused on the practical aspects and prospects of using an updated lipid-replenishing balm with antipruritic action. The discussion focused on current scientific concepts regarding the skin microbiome and its crucial role in the mechanisms underlying chronic dermatological disorders, particularly atopic dermatitis.

Current understanding of emollients extends beyond basic hydration: products in the “emollients plus” category, owing to additional non-pharmacological components, provide antipruritic, antimicrobial, and anti-inflammatory effects. At the same time, there is no generally accepted classification that physicians can rely on when selecting such a product, although emollients plus remain a basic recommendation for atopic dermatitis of any severity.

Aim — to review the key mechanisms involved in the pathogenesis of atopic dermatitis and the targets of individual components of basic-care products that determine the rational choice of an emollient plus, using an updated lipid replenishing balm with anti-itch actions as an example.

The review successively addresses skin-barrier impairment and the “outside-in” and “inside-out” hypotheses; the pathophysiology of the itch-scratch cycle and the concept of the neurobiome, which combines the antiprotease fraction and a filamentous bacterium lysate and microresyl from Ophiopogon japonicus plant extract; alterations in the skin microbiome associated with overcolonization by Staphylococcus aureus and the potential for their correction with postbiotics; qualitative and structural imbalances in stratum corneum lipids and principles of its replenishment; and the synergistic effects of emollients plus and topical corticosteroids, including their steroid-sparing effect. The multi-target active complex is shown to act on interconnected mechanisms involved in the pathogenesis of atopic dermatitis and itch, including inhibition of the PAR2, PAR4, TRPV1, and MRGPR receptors. The choice of an emollient plus should be based on the spectrum and concentration of its additional active components and on the evidence base of the particular product; the renewed lipid replenishing balm with anti-itch action meets these requirements, which justifies its use in patients with atopic dermatitis for faster disease control.