Learn more about a topical PDE4 inhibitor for atopic dermatitis from dermatologist Dr. Maxwell B. Sauder
Topical PDE4 (phosphodiesterase 4) inhibitors are steroid-free eczema therapies that have been available in Canada since 2018. Topical PDE4 offer another option to help manage atopic dermatitis. Eczema Society of Canada asked dermatologist Maxwell B. Sauder, MD, FRCPC, FAAD, FCDA, about the topical PDE4 inhibitor Zoryve® (roflumilast) and it is used to treat atopic dermatitis (AD), the most common form of eczema.
What are topical PDE4 inhibitors?
Topical PDE4 inhibitors block the enzyme phosphodiesterase 4 (PDE4) from allowing excess inflammation to occur in the skin. Cells in our immune system produce PDE4, which promotes the production of cytokines, proteins that contribute to inflammation. Sometimes, as in the case of atopic dermatitis (AD), cytokines are mistakenly elevated in the body, leading to inflammation that can result in eczema flares.
What is Zoryve®?
Zoryve® is the latest steroid-free topical PDE4 inhibitor used for the treatment of AD in patients 6 years of age and older. Clinical trial data shows a reduction in AD symptoms such as itching, redness, dryness and skin thickening.
How do I use Zoryve®?
Zoryve® 0.15% is a topical cream and is applied to the skin once daily to affected areas. It is indicated as safe for use on all skin surfaces; however, it should not be applied directly into the eyes, mouth, or vagina. Speak with your health care professional to learn more about this treatment.1
Does Zoryve® come in a cream or an ointment?
Zoryve® comes in a cream base (sometimes called a “vehicle”). This base is specially formulated to be comfortable for patients to apply on affected areas of atopic dermatitis. It is also available in a foam for seborrheic dermatitis.
Do I apply a moisturizer with Zoryve®?
There is no need to apply a moisturizer under or over Zoryve® as the vehicle is hydrating to the skin. Adding a moisturizer could change how the treatment works.
Does Zoryve® have side effects?
Zoryve® rarely has side effects. However, from the small number of people that experience a side effect, the most common reported symptoms are headaches and nausea. If you or your child are experiencing this or have any concerns about the treatment, you should consult the prescribing health care professional. All medications have risks and benefits, and the details of the risks and benefits should be reviewed with the prescribing health care professional.
What if my atopic dermatitis does not get better?
If you find your AD is not responding to treatment, let your doctor know, as your treatment plan may need to be adjusted. A qualified health care professional, such as a dermatologist, can help reassess your or your child’s condition and can potentially adjust the treatment plan. There is no cure for AD, but there are now many treatments that can help patients and are safe to use chronically, such as Zoryve®.
Eczema Society of Canada thanks Maxwell B. Sauder, MD, FRCPC, FAAD, FCDA, for his volunteer contribution to this educational content.
Reference: 1 Arcutis Canada, Inc. (March 2025). Zoryve® (roflumilast) [Product Monograph], Phosphodiesterase-4 (PDE-4) Inhibitor.
Disclaimer: Information provided in this resource does not constitute medical advice and is not intended to be used as a diagnostic tool. The information is up-to-date at time of publication. All medications, interventions, and treatment plans have risks and benefits, and it is important that individuals discuss their or their child’s specific health care needs with a qualified health care professional.
