New, Updated Guidelines for Managing Atopic Dermatitis

The American Academy of Dermatology (AAD) has published new, updated guidelines in the Journal of the American Academy of Dermatology for caring for and managing atopic dermatitis (AD) in adults with topical therapies^.1

This is the second in a series of updated guidelines the AAD is producing on the condition; the last update was in 2014. The updates were developed by a workgroup of 12 physicians (including 11 dermatologists, 1 allergist and 1 patient representative) and outline the best practices or topical treatments of the disease. The workgroup provided new recommendations for non-prescription methods, as well as prescription treatments.

The recommendations are as follows:

• Moisturizers to help relieve dry, cracked skin, eliminate inflammation, and reduce the severity of, and time between flare-ups.
• Topical calcineurin inhibitors (pimecrolimus 1% cream and tacrolimus 0.03% or 0.1% ointment) to reduce itching and inflammation and reduce flare-ups.
• Topical corticosteroids to relieve itching, decrease inflammation and decrease infections
• Phosphodiesterase-4 inhibitor (crisaborole ointment) to reduce inflammation, help relieve itching, and decrease infections.
• Ruxolitinib (Opzelura; Incyte) cream used in short term to relieve inflammation and chronic itch.

Guidelines were also made for the use of bathing and wrap therapy. Conditional recommendations were made for bleach baths, which can help prevent infection and eliminate skin bacteria. Wet wrap therapy uses wet bandages to hydrate and soothe skin. The treatment can also reduce bacteria on the skin.

The guidelines made conditional recommendations against the use of topical antimicrobials, antiseptics, and antihistamines due to the low certainty of evidence, which means the true effect may be substantially different from the estimated effect.

Board-certified dermatologist, Mark D. Kaufmann, MD, FAAD, president of the AAD said the guidelines should help enable dermatologists to optimize topical treatments to provide adult AD patients with expert care.

Reference

1. American Academy of Dermatology issues updated guidelines for the management of atopic dermatitis in adults with topical therapies. News release. American Academy of Dermatology Association. January 11, 2023. Accessed January 12, 2023. https://www.newswise.com/articles/american-academy-of-dermatology-issues-updated-guidelines-for-the-management-of-atopic-dermatitis-in-adults-with-topical-therapies.