Non-Ssteroidal Topical Therapies for Pediatric Atopic Dermatitis: Reducing Corticosteroid Dependence and Biologic Escalation

Severe eczema significantly affects children’s daily lives, often causing missed school days due to flare-ups and discomfort. Traditional treatments such as topical corticosteroids have been the mainstay for many years, but concerns over long-term use and adverse events have driven the development of newer topical therapies. These nonsteroidal options are proving effective in managing mild to moderate cases, reducing the reliance on systemic biologics. Real-world clinical experience reflects emerging data showing that many patients previously considered candidates for biologic therapies can be managed well with these newer topicals, delaying or even avoiding the need for more costly and complex systemic treatments.
Access to these advanced topical medications is critical, not only for patients with mild to moderate eczema but also as adjuncts for those on biologic therapy. Often, biologics do not fully clear the skin, leaving residual areas that still require management. Newer topical therapies provide a valuable tool to address these stubborn spots, improving overall quality of life and reducing the need to switch between systemic agents. However, insurance approvals remain a challenge; paradoxically, biologics are sometimes easier to get approved than newer topical treatments, which can frustrate clinicians and patients alike. Sample availability of these newer therapies also helps bridge this gap by allowing trial use before insurance hurdles are overcome.
Ultimately, the goal is to balance effective symptom control with cost-conscious care, ensuring patients receive the right treatment at the right time. Real-world evidence supports the notion that newer topical therapies significantly delay the need for biologics in many cases, keeping patients in a mild to moderate disease category rather than escalating to systemic treatment prematurely. As more data accumulate and access improves, clinicians can better personalize care plans, optimizing outcomes for children and families living with eczema while being mindful of health care resource utilization.