The American Academy of Dermatology (AAD) has released updated guidelines on the management of atopic dermatitis with topical therapies in adults.

Developed by a multidisciplinary workgroup, strong recommendations were made for both prescription and nonprescription therapies in which the benefits clearly outweighed the potential risks. These included moisturizers, topical calcineurin inhibitors (pimecrolimus 1% cream and tacrolimus 0.03% or 0.1% ointment), topical costicosteroids, topical phosphodiesterase-4 inhibitors (crisaborole 2% ointment), and topical Janus kinase inhibitors (ruxolitinib 1.5% cream).

The experts also conditionally recommended bathing for the treatment and maintenance of atopic dermatitis and wet wrap therapy for adult patients with moderate to severe disease experiencing a flare.  

Due to the low certainty of evidence, the workgroup conditionally recommended against the use topical antimicrobials, antiseptics, and antihistamines. The experts noted that bleach baths or topical sodium hypochlorite may be suggested to reduce diseases severity in patients with moderate to severe atopic dermatitis and clinical signs of secondary bacterial infection.

“Atopic dermatitis is the most common type of eczema, and it can interfere with a person’s daily life without proper treatment,” said board-certified dermatologist Robert Sidbury, MD, MPH, FAAD, co-chair of the AAD’s Atopic Dermatitis Guideline Workgroup. “The guidelines provide evidence-based recommendations for dermatologists to use in caring for their adult atopic dermatitis patients with topical treatments, which have come a long way since the guidelines were last revised in 2014. This update reflects the latest advances in topical medications that are now available to help adults with atopic dermatitis.”

The full guidelines can be viewed here.


  1. American Academy of Dermatology issues updated guidelines for the management of atopic dermatitis in adults with topical therapies. News release. January 12, 2023.
  2. Sidbury R, Alikhan A, Bercovitch L, et al. Guidelines of care for the management of atopic dermatitis in adults with topical therapies. Published online January 11, 2023. Journal of the American Academy of Dermatology.