Elaine Siegfried, MD, Highlights Evolving Pediatric AD Care and Remaining Treatment Gaps

At the Revolutionizing Atopic Dermatitis (RAD) 2026 Conference, Elaine Siegfried, MD, a professor of pediatrics and dermatology at Saint Louis University School of Medicine, discussed advances and ongoing challenges in the management of pediatric atopic dermatitis (AD), emphasizing the importance of individualized treatment approaches, early intervention, and recognition of vulnerable patient populations.

Siegfried noted that treatment selection should begin with an assessment of disease severity, followed by consideration of additional factors that affect a child and family’s quality of life. These factors include sleep disruption, daily functioning, and the overall burden of disease on the household.

“The most important thing that’s happened in the last couple of decades is that children are included,” Siegfried said, highlighting a major shift in clinical research. Historically, pediatric patients were often excluded from clinical trials, limiting available evidence for treatment decisions. Increasing inclusion of children in studies has helped generate more robust data to guide pediatric AD management, although pediatric data continue to follow adult trial results by several years.

Despite recent progress, Siegfried identified children younger than 6 months as a significant unmet need. AD commonly presents during early infancy, yet treatment options for this population remain limited, with topical corticosteroids often representing the primary therapeutic option. She emphasized the need for additional research and approved therapies for this age group.

Siegfried described a stepwise approach to pediatric AD management, beginning with appropriate topical care and evaluation of over-the-counter products being used by families. For patients who require escalation beyond topical corticosteroids, clinicians must consider steroid-sparing therapies and systemic treatments. However, barriers such as cost, access, treatment tolerability, and disease severity can all contribute to inadequate control with topical therapies.

She also emphasized the importance of evaluating children with AD beyond their skin symptoms. Pediatric patients with moderate to severe disease, particularly those with poor growth, may represent a vulnerable subset requiring additional assessment. Siegfried encouraged dermatology providers to monitor growth curves routinely and consider laboratory evaluation in children with concerning clinical features, including markedly elevated total immunoglobulin E levels or significant eosinophilia.

Looking ahead, Siegfried anticipates that the increasing availability of nonsteroidal therapies will change the role of topical corticosteroids in AD care over the next decade. However, she noted that education will be essential, given the longstanding use, affordability, and familiarity of corticosteroids among patients and providers.

While disease modification and long-term remission remain areas of active investigation, Siegfried said emerging data examining outcomes both during and after treatment are promising. Continued research, she noted, will be critical to improving long-term outcomes for children living with AD.

More conference coverage can be found here.