New Nonsteroidal Options Are Reshaping Pediatric Atopic Dermatitis Care

A wave of new nonsteroidal topical therapies has changed how clinicians can approach pediatric atopic dermatitis (AD), according to Linda Stein Gold, MD, director of dermatology clinical research at Henry Ford Health.

Stein Gold presented "Practice Pearls for Pediatric AD" at the Revolutionizing Atopic Dermatitis (RAD) 2026 Conference, held June 17-19, 2026, in Nashville, Tennessee.¹ Her session focused on what she described as an “explosion” of treatment options across several mechanisms of action.

Topical JAK, Aryl Hydrocarbon Receptor, And PDE4 Options Expand the Toolbox

Topical ruxolitinib, a JAK inhibitor, has shown efficacy data supporting US Food & Drug Administration (FDA) approval down to age 2 years, Stein Gold said.² The drug works well across body sites, though she recommends limiting use to 20% body surface area and avoiding long-term application.

Topical tapinarof, an aryl hydrocarbon receptor agonist, also performed well in pooled AD data, Stein Gold noted.³ The adverse event profile differs from what was seen in psoriasis: folliculitis occurs less frequently, and contact dermatitis rates do not exceed those of the vehicle alone.

Topical roflumilast, a phosphodiesterase 4 inhibitor dosed once daily, rounds out the newer nonsteroidal options.⁴ The drug is not yet approved for infants, but she said approval may come soon.

For adults with chronic hand eczema, Stein Gold pointed to delgocitinib, a pan-JAK inhibitor, as a needed addition. She called it a great tool for a condition that previously lacked strong treatment options.

Simplicity and Tolerability Drive Adherence in Pediatric AD

Asked about the biggest challenges in managing pediatric AD, Stein Gold emphasized keeping treatment regimens simple. She said that complex regimens strain the child, the parent, and the whole family; fewer steps set families up for success.

Tolerability is equally important, she added. A cream that stings or burns discourages continued use, particularly in children. Gold highlighted the favorable tolerability profiles across the newer nonsteroidal options.

“Although my section was really on top of therapy, I think it's critical to advance the systemic therapy as quickly as is indicated,” she concluded.

Editor’s note: Disclosures for Gold include AbbVie, Amgen, Arctis, Bristol Myers Squibb, Dermavant, Eli Lilly, Johnson & Johnson, Novartis, Pfizer, and UCB.

References

1. Gold L. Practice Pearls for Pediatric AD. Session presented at RAD 2026 in Nashville from June 17-19.

2. Smith T. FDA Approves Ruxolitinib Cream for Pediatric Patients with Atopic Dermatitis. HCPLive. Published September 18, 2026. Accessed on July 21, 2026. https://www.hcplive.com/view/fda-approves-ruxolitinib-cream-for-pediatric-patients-with-atopic-dermatitis.

3. Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024;91(3):457-465. doi:10.1016/j.jaad.2024.05.023

4. Smith T. Roflumilast Cream Receives FDA Approval for Atopic Dermatitis. HCPLive. Published July 9, 2024. Accessed July 21, 2026. https://www.hcplive.com/view/roflumilast-cream-receives-fda-approval-atopic-dermatitis