Atopic dermatitis is a persistent inflammatory skin disease that often affects areas such as the face, hands, feet, or the folds of skin behind the elbows or knees. The exact cause is uncertain, as factors such as genetics, environment, and an overactive immune system contribute to inflammation and persistent itching. The notorious cycle of itching and scratching worsens the rash and causes watering, oozing, and crusting, which can be painful.

The study, which evaluates more than 200 trials involving more than 43,000 people with atopic dermatitis, sheds light on the effectiveness of various prescription creams and ointments. These treatments fall into five categories, including topical corticosteroids, Janus kinase inhibitors, PDE4 inhibitors, calcineurin inhibitors, and other topicals such as antibiotics and prescription moisturizers.

The research aimed to identify medications that significantly improved patients’ quality of life, reduced severity, itching, sleep disorders or flare-ups, caused fewer serious side effects, and were the least discontinued due to adverse effects.

The standout winners in the study were two calcineurin inhibitors, namely pimecrolimus (Elidel) and tacrolimus (Protopic), along with moderate-potency topical corticosteroids such as fluocinolone acetonide (Synalar cream 0.025%) and triamcinolone acetonide (Kenalog 0.1% cream/ointment).

Pimecrolimus stood out in six of seven results and was shown to be effective in reduce sleep disorders and eczema outbreaks. High doses of tacrolimus (0.1%) demonstrated improvement in five outcomes, particularly reduction in itching and asthma attacks. Moderate-strength steroids, a larger group, were effective in four to six of the seven outcomes, excelling in relieving eczema itch, flare-ups, and serious side effects.

The study also revealed a surprising finding: Using a topical cream twice a day was not significantly more effective than using it once a day. While the traditional advice is twice a day, once a day might be more convenient without compromising effectiveness.

On the other hand, the study identified topical antibiotics as one of the least effective treatments for eczema.

While the study involved a substantial number of participants, individual responses may vary. When determining a treatment plan, factors such as age, affected skin areas, severity of eczema, and possible side effects should be considered.

The bottom line? If your current treatment works well without serious side effects, continue with it. However, if your regimen is not giving the desired results, consult your healthcare provider or dermatologist to explore alternative prescription creams or ointments.