Shared Decision-Making and New Treatments in Pediatric AD

Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine, met with Dermatology Times at the Revolutionizing Atopic Dermatitis (RAD) 2026 Conference to discuss the evolving landscape of pediatric atopic dermatitis (AD) care, including the need for pediatric-focused treatment guidance, shared decision-making, and expanded therapeutic options.

Lio highlighted that while recent guideline updates from the American Academy of Dermatology have provided important guidance for clinicians, pediatric patients remain an area where additional focus is needed. Many existing recommendations do not fully address the unique considerations of treating children, including age-specific approvals, safety concerns, and the broader impact of disease during critical periods of growth and development.

According to Lio, pediatric AD management requires consideration of factors beyond disease severity alone. Families often have significant concerns when systemic therapies are introduced, particularly regarding long-term treatment duration, potential adverse effects, effects on growth and development, and how treatment may affect a child’s daily life. These concerns can be more complex in young children, where decisions may involve years of ongoing management.

Lio emphasized the importance of educating families and supporting shared decision-making. Treating pediatric AD is a “juggling act,” as he describes, often involving balancing the perspectives of multiple stakeholders, including children, parents, and caregivers. He noted that even young children may have strong preferences about aspects of treatment, such as injections or the feel of topical products, and those preferences should be incorporated into the treatment plan.

He also discussed the challenges of navigating family dynamics, including differing opinions between caregivers. Lio stressed that clinicians should approach these conversations with the shared goal of improving the child’s health rather than trying to “win” a discussion. Establishing trust and collaboration can help families feel more comfortable with treatment decisions.

In terms of therapeutic advances, Lio expressed enthusiasm about the expanding availability of nonsteroidal topical therapies, many of which are now approved for younger pediatric patients. He noted that these options provide clinicians with additional tools to reduce reliance on topical corticosteroids while still effectively managing disease.

Although he remains cautious and thoughtful about steroid use, Lio emphasized that topical corticosteroids continue to play an important role when used appropriately. He also highlighted the transformative impact of systemic therapies, noting that patients who previously had limited treatment options are now achieving meaningful improvements in disease control and quality of life.

As pediatric AD treatment continues to evolve, Lio emphasized the importance of providing clinicians with evidence-based guidance that addresses the unique needs of children and their families. Want more insights from RAD 2026? Click here.