In a clinical report published online May 19 in Pediatrics, the American Academy of Pediatrics presents updated guidance for the treatment of children with atopic dermatitis (AD).

Noting that many pediatricians may not feel comfortable treating AD or other dermatologic conditions, Jennifer J. Schoch, M.D., from the University of Florida in Gainesville, and colleagues reviewed pediatric AD and provided an up-to-date approach to skin-directed management incorporating recent advances.

The authors note that successful AD treatment involves the triad of maintenance skin care, topical anti-inflammatory medications, and avoidance of triggers. General recommendations for treatment include frequent bathing (daily or every other day) with lukewarm water and a gentle cleanser. Products with added fragrance, dyes, or essential oils should be avoided, as they are potential irritants and/or contact allergens.

Topical anti-inflammatories, including corticosteroids and calcineurin inhibitors, should be applied once to twice daily to active eczema patches; unless specifically instructed, topical medications should not be mixed with topical emollients, as this dilutes the potency of the medication.

Dupilumab and Janus kinase inhibitors are emerging treatments for AD. In patients with AD, moisturizers should be applied liberally to the entire body skin surface at least daily, especially after a bath or shower. Flares can be reduced with reduction of triggers and proactive treatment with topical anti-inflammatories. Patients with severe, recalcitrant, and/or complicated AD should be referred to subspecialists.

"Ongoing collaboration between pediatric primary care providers and AD specialists can optimize care for patients with complex AD, " the authors write.

More information: Jennifer J. Schoch et al, Atopic Dermatitis: Update on Skin-Directed Management: Clinical Report, Pediatrics (2025). DOI: 10.1542/peds.2025-071812  Journal information: Pediatrics

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