Vehicle Matters: Selecting Topicals for Pediatric Atopic Dermatitis

The vehicle feel of a topical is crucial for treatment adherence in pediatric atopic dermatitis. Dr. Golant notes most parents prefer creams over ointments. Ointments can stain clothes and furniture and are difficult on hair-bearing sites. She engages in shared decision-making, asking about vehicle preferences. Dr. Eichenfield cites decades of data showing patients prefer creams, while dermatologists historically would prefer ointments. Modern non-steroidal creams like roflumilast address this preference. He explains its water-based cream formulation is designed to penetrate the skin's lipid layer effectively. Both experts stress that a vehicle the family will actually use is central to long-term management success in this chronic inflammatory disease. Dr. Eichenfield offers practical scripting: plan for 4 weeks of once-daily use per trial data, then adjust frequency based on control.