Treatments for Atopic Dermatitis in Children
Treatments for
Atopic Dermatitis
Understanding Atopic Dermatitis (Eczema)
Atopic Dermatitis (AD) is a chronic skin condition that causes recurrent itchy, inflamed plaques on the skin. It is not life-threatening, but it can significantly impact a child’s quality of life, leading to sleep disturbances, discomfort, and increased risk of infections.
AD is caused by a combination of genetic, immune, and environmental factors that result in skin barrier dysfunction and excessive inflammation. Children with AD often experience flare-ups triggered by allergens, irritants, weather changes, or stress.
Prevalence and Impact
- AD affects 13-25% of children and 2-10% of adults.
- Studies show a higher prevalence in Black children (19.3%) compared to White children (16.1%).
- Children with severe AD may experience greater social and emotional distress due to itching, visible skin changes, and sleep disruption.
Available Treatments for Atopic Dermatitis
There is no permanent cure for atopic dermatitis, but effective treatments can help control symptoms and reduce flare-ups.
First-Line Treatments: Topical Therapies
For mild to moderate cases, treatment usually starts with topical therapies:
- Topical corticosteroids – Reduce inflammation and itching.
- Topical calcineurin inhibitors (Tacrolimus, Pimecrolimus) – Help control flares.
- Non-steroid topicals:
– Crisaborole (for mild to moderate AD, 3 months+)
– Ruxolitinib cream (for mild to moderate AD, 12 years+)
– Roflumilast 0.15% cream (for mild to moderate AD, 6 years+)
– Tapinaroff 1% cream (for mild to moderate AD, 2 years+) - Phototherapy – Light therapy for patients who do not respond to creams.
Meet Our Medical Director
Dr. Mercedes E. Gonzalez is a board-certified pediatric dermatologist. After graduating from Emory University, she earned her degree at Rutgers–New Jersey Medical School in 2004. Always drawn to working with children, she accepted the prestigious pediatrics program at the Morgan Stanley Children’s Hospital of New York–Columbia University where she solidified her interest in treating skin disorders. She then completed a dermatology residency followed by a clinical fellowship in pediatric dermatology at the top-ranked New York University (NYU) Department of Dermatology.
Her gentle, child-friendly bedside manner, combined with her broad knowledge of childhood skin diseases and their treatments, make her the preferred pediatric dermatologist in Miami. In addition to practicing medicine, Dr. Gonzalez currently serves as a clinical assistant professor at The FIU Herbert Wertheim School of Medicine and The Phillip Frost Department of Dermatology at Miller School of Medicine.
Dr. Gonzalez serves as the principal investigator on numerous clinical trials and has a special interest in severe skin diseases in children. She lectures regularly at dermatology conferences and to medical students and residents and is the co-editor of 3 dermatology textbooks, including the recently published 2nd edition of Goodheart’s Same Site Differential Diagnosis, and has published over 50 journal articles.
When to Consider Systemic Medications
Children with moderate to severe AD may need systemic (whole-body) treatments when:
- Topical treatments no longer work and flares continue.
- Itching and skin discomfort interfere with sleep, school, or daily activities.
- The treatment regimen is burdensome or ineffective.
- The child has other allergic conditions (asthma, food allergies).
Systemic Treatments for Moderate to Severe Atopic Dermatitis in Children
There are two main types of systemic treatments: biologics (injectables) and oral medications.
Biologic Therapies (Injectable Monoclonal Antibodies)
Dupilumab (Dupixent)
- Blocks IL-4 and IL-13, which drive inflammation.
- Approved for children 6 months and older.
Tralokinumab
For 12 years+; clinical trials ongoing for younger children
- Targets IL-13, a key cytokine in AD.
Lebrikizumab
For 12 years+; under investigation
- Also blocks IL-13.
Nemolizumab
For 12 years+; under investigation
- Blocks IL-31, the main driver of itching.
Amlitelimab
For 12-17 years; under investigation
- Targets OX40L, which regulates immune responses earlier in the inflammation pathway.
Oral Systemic Therapies
Upadacitinib (Rinvoq)
For 12 years+; clinical trials for younger children
- A JAK1 inhibitor that reduces inflammation inside immune cells.
Abrocitinib
For 12 years+; under investigation
- Another JAK1 inhibitor designed to control AD inflammation.
Clinical Trials for Atopic Dermatitis
Systemic treatments are recommended when topical creams and standard therapies are no longer effective, or when AD significantly impacts a child’s life.
Why Enroll in a Clinical Trial?
- Early access to promising new treatments before they are FDA-approved.
- No cost for participation, and compensation for travel-related expenses.
- Expert care from board-certified pediatric dermatologists.
- Contribute to future treatments that could help other children with AD.
Current Ongoing Trials at Pediatric Skin Research
We currently have four active clinical trials for pediatric patients with mild to severe AD:
| Clinical Trial | Age Group | Medication | Type of Treatment |
|---|---|---|---|
| Tralokinumab | 2-11 years | IL-13 antibody | Subcutaneous injection |
| Upadacitinib vs Dupilumab | 6-11 years | JAK1 inhibitor vs IL-4/IL-13 | Oral vs Injection |
| Amlitelimab | 12-17 years | OX40L antibody | Subcutaneous injection |
| Roflumilast Cream | 3-24 months | PDE4 inhibitor | Topical cream |
Eligibility for Clinical Trials
Each study has specific age and symptom requirements. In general, participants must:
- Have a confirmed diagnosis of moderate to severe AD.
- Have at least 10% of their body covered by AD (for systemic treatment trials).
- Meet weight requirements (e.g., Amlitelimab requires ≥25 kg).
- Be willing to follow study protocols (regular clinic visits, follow-up assessments).
Request An Appointment
To request an appointment, please fill out the contact form below. Our team will get back to you as soon as possible to confirm your appointment and answer any questions you may have. We look forward to assisting you.
