Treatment Adherence in Pediatric Atopic Dermatitis

Families managing pediatric atopic dermatitis face significant adherence challenges, with twice-daily medication regimens representing the primary obstacle to consistent treatment success. Parents struggle to remember and implement complex treatment schedules that require morning and evening applications, especially when rushing to prepare children for school or managing busy evening routines. Once-daily formulations like roflumilast and tapinarof offer substantial advantages by allowing families to establish single, consistent daily routines that integrate more easily with existing habits like teeth brushing or bedtime rituals.

Children with atopic dermatitis benefit from simplified treatment regimens that reduce the complexity of managing multiple medications for different body areas and time schedules. Traditional approaches often involve prescribing different strength steroids for various body locations with varying application schedules, creating confusion and reducing adherence rates. Modern nonsteroidal medications allow families to use single products safely across multiple body areas, dramatically simplifying treatment plans and improving the likelihood of consistent use.

Patients who cannot maintain daily topical medication routines may be better candidates for systemic treatments that require less frequent dosing, highlighting the importance of honest discussions about realistic adherence expectations. Health care providers should assess each family’s capacity for topical medication management before selecting treatment approaches, as even the most effective topical therapy provides no benefit if not used consistently. Recognition of adherence limitations allows for appropriate escalation to systemic options when topical treatments, regardless of their theoretical effectiveness, prove impractical for individual families to implement successfully.