Atopic Dermatitis (AD) remains the most prevalent dermatologic condition in infants and children, affecting an estimated 10-20% worldwide. For clinicians, pediatric AD presents unique challenges: balancing efficacy, safety, adherence, and long-term management. Increasingly, dermatology leaders are emphasizing an approach that integrates established fundamentals with new therapies to improve outcomes and reduce disease burden.
Foundational Care
Daily moisturization and barrier protection remain the cornerstone of pediatric AD management. Peter A. Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine, recently spoke with Dermatology Times about why rethinking the AD journey matters, and how personalized treatment plans can make a big difference to patients and their caregivers.
“I am a huge fan of eczema action plans,” said Dr. Lio, who will be sharing his expertise at the 2026 Masters of Pediatric Dermatology (MOPD) Symposium. “I find that when families help design the regimen, adherence and outcomes improve.”
He emphasized that clinicians need to work with patients, their families, and caregivers to find the right products, along with an easy-to-use care routine. Starting treatment with the right moisturization and basic foundational care provides what Dr. Lio considers “a safe, low-cost, and very effective way to strengthen and protect the skin barrier.”
Integrating New Therapies
Experts agree that a thoughtfully integrated combination of therapies can optimize patient outcomes. Shanna Miranti, MPAS, PA-C, a board-certified physician assistant at Riverchase Dermatology in Florida noted that even with systemic or biologic agents, the consistent use of topical therapies can be an essential element of success. Miranti likened topicals to “touch-up paint,” reinforcing the idea that multimodal strategies are now considered the way forward in pediatric AD.
New and emerging options include nonsteroidal topicals such as ruxolitinib, tapinarof, and roflumilast. These offer flexibility in pediatric AD treatment plans based on age and disease severity while reducing dependence on long-term corticosteroids.
- Tapinarof – FDA-approved for children 2-5 years and suitable for sensitive areas like the eyelids and groin.
- Roflumilast 0.15% – Indicated for children 6 years and older and especially useful in cases with seborrheic features.
- Ruxolitinib – Recently received expanded indication to include younger patients aged 2 years.
Addressing Unmet Needs
Despite recent advances, pediatric AD continues to be a complicated condition due to the many comorbidities associated with the disease, including sleep disruption, persistent itch, painful flareups, and residual inflammation.
In a recent Dermatology Times Expert Perspectives series, Miranti along with Tina Bhutani, MD, MAS, and Walter Liszewski, MD, highlighted areas where further progress is needed, including the need for larger tube sizes and simplified dosing schedules to support at-home treatment for families.
Practical Takeaways for Clinicians
Effective management of pediatric AD goes beyond prescribing treatments—it also requires guiding families and tailoring care to each child’s needs. Early intervention and consistent foundational routines provide the base for introducing new therapies as appropriate. By reinforcing adherence and personalizing plans based on age, comorbidities, and disease severity, clinicians can achieve better outcomes and quality of life for patients.
Key strategies:
- Barrier repair first – Foundational skin care remains essential.
- Expand thoughtfully – Incorporate nonsteroidal topicals and biologics based on patient age and disease profile.
- Target quality of life – Interventions that reduce itch and restore sleep can drive adherence and long-term patient satisfaction.
- Partner with families – Shared decision-making and action plans can improve disease control and empower patients and caregivers.
Key Takeaways
The management of pediatric AD reflects a broader trend in dermatology—integrating foundational practices with targeted, innovative therapies to achieve long-lasting relief and control. Clinicians who adopt a patient-centered, multimodal approach will be best positioned to address the ongoing challenges of the disease.
To learn more about evolving strategies and therapies, join us at MOPD 2026 where Dr. Lio, alongside other leading experts, will share practical insights into advancing pediatric AD care.
