Atopic dermatitis (AD), the most common form of eczema, is generally treated with skin moisturizing, trigger avoidance and topical anti-inflammatory medications. This approach to management is a standard in AD guidelines worldwide. But what options exist for patients with widespread severe eczema that doesn’t respond to topical therapies?
So, when does systemic treatment for atopic dermatitis become a good option?
In a 2017 publication featuring insights from 29 leading atopic dermatitis experts worldwide, recommendations were made by an expert panel from the International Eczema Council. Dr. Aaron M. Drucker, a Toronto-based dermatologist, researcher, and long-time volunteer medical contributor with ESC, explains. “When deciding with a patient whether to pursue systemic treatment after topical therapy is inadequate, the physician’s assessment of how severe the eczema is should be combined with an assessment of the patient’s symptoms and quality of life.”
Systemic treatment for AD is not without risk and shouldn’t be taken lightly. Healthcare providers, patients, and caregivers must carefully weigh the potential benefits against the risks.
Dr. Drucker adds, “That manuscript was written when systemic treatment options were limited – before we had any biologics or JAK inhibitors to treat eczema. Still, the same principles apply, that we need to incorporate patients’ experiences and values when deciding on a therapeutic strategy.”
Systemic treatments are improving patient quality of life, but safety comes first.
Dr. Drucker emphasizes, “When we move up the treatment ladder from topical to systemic therapy, we know that comes with more potential risk of side effects. That’s an important discussion to have with patients and caregivers.”
Dr. Drucker notes, “Most people with AD can successfully manage their eczema with moisturizers and prescription topical therapies. The good news is that we now have options for those who are still suffering.”
Eczema Society of Canada thanks Aaron Drucker, MD, FRCPC (Dermatology), for his volunteer contribution to this educational content.
Reference:
Journal of the American Academy of Dermatology (2017). When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council. Oct;77(4): 623-633. doi: 10.1016/j.jaad.2017.06.042.
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 the 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.
October 2023
