Treatment Selection, Adherence, and Misconceptions in Pediatric Atopic Dermatitis

Linda Stein Gold, MD, director of dermatology clinical research at Henry Ford Health, previously discussed the expanding list of nonsteroidal topical therapies for pediatric atopic dermatitis (AD) from her session at the Revolutionizing Atopic Dermatitis (RAD) 2026 Conference, held June 17-19, 2026, in Nashville, Tennessee. ^1,2 In the second part of her interview with HCPLive, she addressed how clinicians should choose among those options, along with adherence strategies and common misconceptions among patients and parents.

Selecting Therapy by Age and Body Surface Area: Atopic Dermatitis Care

Most of the newer topical options are US Food & Drug Administration (FDA) approved down to age 2 years, Stein Gold said, giving clinicians a wide range of choices for younger patients. None of the newer molecules are approved yet for children under 2 years.

Drug selection often comes down to body surface area, Stein Gold explained. Ruxolitinib carries a narrower indication limited to 20% body surface area, so clinicians would likely avoid it in patients with more extensive disease. Other molecules can be used broadly across the face, trunk, and other sites.

Not every drug works for every patient. Stein Gold recommended picking an option clinicians are comfortable with and switching to another mechanism of action if the first does not work.

Simplifying Regimens Supports Adherence to Atopic Dermatitis Treatment

Stein Gold noted that adherence in pediatric AD starts before treatment even begins since a prescription that is never picked up from the pharmacy cannot help a patient. Once home, patients are more likely to continue treatment if they see improvement quickly and without stinging or burning. She also noted that consistency drives outcomes.

“Don't give them 15 different things to do because then they'll do nothing,” she said. “If you can give them 1 thing…once…or twice a day, that's really the best option.”

Addressing Parental Misconceptions of Pediatric AD

One of the most common misconceptions Stein Gold encounters is that parents search for a single cause of their child's AD, often asking, “What can I eliminate? What food can I get rid of? Is it my fault? What can I do so that my child isn't suffering?”

“It's so much more complicated than that,” Stein Gold continued. “I really advise them that restricting the child's diet is not generally a good thing. There are food allergies, and we have to avoid those, but just a general restrictive diet is never a good thing. This is something that we have the tools to get under control, and it's really a matter of having the child appropriately diagnosed and then sticking with the treatment regimen.”

References

1. Stein Gold L. New Nonsteroidal Options Are Reshaping Pediatric Atopic Dermatitis Care. HCPLive. Published July 21, 2026. Accessed July 22, 2026. https://www.hcplive.com/view/new-nonsteroidal-options-reshaping-pediatric-atopic-dermatitis-care

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