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Atopic dermatitis (AD), also referred to as eczema, is a widespread chronic inflammatory skin disease affecting millions worldwide.
Emerging nonsteroidal topical therapies offer safer and more effective alternatives for atopic dermatitis management.
Atopic dermatitis (AD), also referred to as eczema, is a widespread chronic inflammatory skin disease affecting millions worldwide. Despite its high global prevalence, the standard treatment approach has remained largely unchanged for years. Conventional first-line therapies—such as topical corticosteroids and topical calcineurin inhibitors—continue to dominate clinical practice.
However, concerns over long-term use, including local skin reactions and potential systemic side effects, have highlighted the urgent need for safer and more effective alternatives. Recently, several innovative topical treatments have received approval from the U.S. Food and Drug Administration (FDA), signaling a shift in the AD treatment paradigm. This systematic review explored the evolving landscape of topical therapies for AD, focusing on newly approved treatments, their mechanisms of action, and their comparative potency and safety versus traditional therapies.
Literature review was carried out using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Agency for Healthcare Research and Quality (AHRQ) methodology. Data sources included the FDA Label (no date restrictions), PubMed, and ClinicalTrials.gov, covering studies. The analysis focused on FDA-approved prescription topical treatments for AD.
Currently, 52 non-generic, FDA-approved topical prescription therapies are available for AD management. The majority are traditional treatments, including topical corticosteroids (n=11; 52.4%) and topical calcineurin inhibitors (n=4; 19.0%). Notably, recent years have witnessed the emergence of innovative nonsteroidal therapies with novel mechanisms of action (n=3; 7.6%). These encompass:
These advanced therapies offer targeted anti-inflammatory effects with potentially improved safety profiles when compared to conventional options.
Over the past five years, remarkable progress has transformed the topical treatment landscape for AD. The introduction of next-generation therapies—including JAK inhibitors, AhR modulators, and PDE4 inhibitors—offers clinicians with more potent and safer treatment options. Integrating these novel topical agents into routine clinical practice may enhance disease control, minimize adverse effects, and boost patient quality of life.
The Journal of Clinical and Aesthetic Dermatology
Expanding the Topical Therapeutic Landscape for Atopic Dermatitis: A Systematic Review
Joshua Burshtein et al.
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