Lio Highlights Advances in Topical Dermatology Therapies

In an interview with Dermatology Times, Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, discussed the central role of topical therapies in modern dermatologic practice. Lio emphasized that despite the surge of systemic and biologic treatments, topicals continue to define the core of dermatology.

“Topical therapy is so important to me and it’s near and dear to my heart,” Lio stated. He explained that companies investing in topical formulations demonstrate a deep commitment to the specialty, noting the scientific and economic challenges associated with their development. “The people who really love dermatology, the companies that are truly invested in dermatology, they will make a topical because it's really hard,” he said. “It’s expensive, it’s difficult, and the money that a company can make from a topical is nowhere near what they can make.”

Lio highlighted several notable advancements in topical therapy, particularly for atopic dermatitis, an area of personal and professional focus. He cited the expansion of indications for several agents to include younger age groups. Among them is topical roflumilast, a phosphodiesterase-4 (PDE4) inhibitor, now approved for patients as young as 2 years old. Similarly, topical ruxolitinib, a JAK inhibitor, and tapinarof, an aryl hydrocarbon receptor agonist, have also received approvals down to age 2.^1-3

According to Lio, these developments represent important milestones in pediatric dermatology, expanding safe, effective, and targeted options for children with inflammatory skin disease. “We’re getting comfortable with these new treatments,” he noted, emphasizing their growing adoption and favorable tolerability profiles.

Beyond efficacy, Lio underscored the educational and emotional impact of topicals, which empower patients through direct engagement in their own skin care. He views the continued advancement of topical agents as both a scientific achievement and a reaffirmation of dermatology’s patient-centered roots.

As innovation in dermatologic therapeutics continues to evolve, Lio’s remarks underscore a key message: while systemic and biologic drugs capture attention, the art and science of topicals remain foundational to the specialty’s identity and future.

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References

1. Eichenfield LF, Serrao R, Prajapati VH, et al. Efficacy and safety of once-daily roflumilast cream 0.05% in pediatric patients aged 2-5 years with mild-to-moderate atopic dermatitis (INTEGUMENT-PED): A phase 3 randomized controlled trial. Pediatr Dermatol. 2025;42(2):296-304. doi:10.1111/pde.15840
2. Eichenfield LF, Stein Gold LF, Simpson EL, et al. Efficacy and safety of ruxolitinib cream in children aged 2 to 11 years with atopic dermatitis: Results from TRuE-AD3, a phase 3, randomized double-blind study. J Am Acad Dermatol. 2025;93(3):689-698. doi:10.1016/j.jaad.2025.05.1385
3. Hoy SM. Tapinarof cream 1%: Pediatric first approval. Paediatr Drugs. 2025;27(3):383-391. doi:10.1007/s40272-025-00689-3