Topical PDE4 (phosphodiesterase 4) inhibitors are relatively new to the world of eczema therapies and offer another option to help manage atopic dermatitis. Eczema Society of Canada asked dermatologist and clinical researcher Melinda Gooderham, MD, FRCPC about topical PDE4 inhibitors and how they are used in the treatment for atopic dermatitis (AD), the most common form of eczema.
What are topical PDE4 inhibitors?
Topical PDE4 inhibitors work to block an enzyme called phosphodiesterase 4 (called PDE4 for short) from allowing too much 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, such as in the case of atopic dermatitis (AD), cytokines are mistakenly triggered in the body, and this inflammation results in flares.
What is Crisaborole?
Crisaborole is a topical PDE4 inhibitor used for the treatment of mild-to-moderate AD. Clinical trial data shows a reduction in the symptoms of AD such as itching, redness, weepy rash, raw lesions and skin thickening.
How do I use Crisaborole?
Crisaborole comes in a 2% topical ointment and is applied to the skin twice daily in a thin layer to the affected areas. It is indicated as safe for use on all skin surfaces, however should not be applied directly into the eyes, mouth, or vagina. Speak with your doctor to learn more about this treatment.
Does Crisaborole come in a cream or an ointment?
Crisaborole comes in an ointment base (sometimes called a “vehicle”). This base is a specially formulated petrolatum ointment, which acts as a moisturizer for the skin as well as a vehicle for the medication.
Do I apply moisturizer with Crisaborole?
There is no need to apply a moisturizer under or over crisaborole as the vehicle is hydrating to the skin and adding a moisturizer could change the way the treatment works.
Does Crisaborole have side effects?
While all medications can carry risks and benefits, the only side effect reported in the clinical trial was pain from temporary stinging or burning of the skin where the treatment was applied, and was reported by 4% of patients.
Eczema Society of Canada thanks Melinda Gooderham, MD, FRCPC for her volunteer contribution to this educational content.
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.
August 2021
