In a JAMA Clinical Guidelines Synopsis, authors provide these major recommendations from the American Academy of Dermatology’s 2023 Guidelines of Care for the Management of Atopic Dermatitis (AD) in Adults With Topical Therapies:
• Moisturizers should be part of a comprehensive regimen with pharmacologic treatments to reduce disease severity and pruritus in AD (strong recommendation; moderate certainty of evidence)
• Topical corticosteroids are effective for AD of all types and severities (strong recommendation; high certainty of evidence). However, the risks of routine topical antimicrobials, antihistamines, and antiseptics may outweigh the benefits (conditional recommendations against use; low certainty of evidence)
• Twice-weekly use of medium-potency topical corticosteroids as maintenance therapy reduces flares and relapses (strong recommendation; high certainty of evidence).
• The topical calcineurin inhibitors tacrolimus and pimecrolimus are safe, steroid-sparing alternatives for treatment of AD (strong recommendation; high certainty of evidence)
• For mild to moderate AD, the topical phosphodiesterase 4 inhibitor crisaborole (strong recommendation; high certainty of evidence) and the topical Janus kinase (JAK) inhibitor ruxolitinib (strong recommendation; moderate certainty of evidence) are recommended as alternatives to topical corticosteroids or calcineurin inhibitors.