Atopic dermatitis guidelines: topical and systemic care
Current priorities in barrier care, anti-inflammatory treatment and escalation for moderate to severe disease.
Updated: 2026-09-13
Written for clinicians and medical students
This section is a teaching reference for doctors, residents and medical students. It is not patient guidance and not a substitute for clinical examination, and it must not be used for self treatment.
Core recommendations
- Moisturisers remain foundational. Topical corticosteroids and topical calcineurin inhibitors are strongly supported; newer non-steroidal topicals may be options according to approval and availability [1].
- Wet-wrap therapy can help selected significant flares when supervised. Routine topical antimicrobials, antiseptics and antihistamines are not recommended solely to treat dermatitis [1].
- For adults requiring systemic therapy, current AAD guidance strongly supports dupilumab, tralokinumab and selected oral JAK inhibitors, while recommending against routine systemic corticosteroids [2].
- Agent choice requires infection risk, vaccination, pregnancy plans, laboratory monitoring and access to be reviewed. Pediatric approvals and dosing vary by age and jurisdiction.
Guideline boundary
Guidelines organise evidence but do not replace an individual severity assessment, treatment history, local product licence or shared decision. Check the living guideline before initiating advanced therapy [2,3].