Emerging Research Supports Nonsteroidal Therapies in Pediatric Dermatology
Key Takeaways:
- Historically, topical corticosteroids (TCS) have been used as first-line treatments for pediatric skin conditions, although they have a higher risk of side effects for children.
- Ongoing research in pediatric dermatology is focused on the impact of nonsteroidal topical therapies (NSTTs) on conditions such as atopic dermatitis (AD), psoriasis, alopecia areata (AA), vitiligo, and seborrheic dermatitis (SD).
- NSTTs have demonstrated promising safety and efficacy in clinical trials, suggesting a potential shift away from traditional TCS therapies.
Pediatric skin conditions like AD, psoriasis, AA, vitiligo, and SD are typically treated with TCS. However, the increased risk of side effects in children is associated with higher symptom burden and lower rates of treatment adherence.
Research on NSTTs has increased to develop more tolerable and effective treatments instead of common TCS therapies. Ongoing studies show promise for various NSTTs in pediatric dermatology.
Ongoing Research Demonstrates the Potential of NSTT
Tacrolimus, pimecrolimus, and crisaborole are NSTTs approved by the US Food and Drug Administration (FDA) to treat patients with AD. Recent studies evaluated the efficacy and safety of other drugs such as difamilast, ruxolitinib, roflumilast, delgocitinib, and tapinarof.
Common NSTTs for psoriasis include vitamin D analogues, calcineurin inhibitors, and anthralin. Ongoing studies are focused on new, innovative treatments to increase available therapies. Expanded use of ruxolitinib and tofacitinib is currently being evaluated.
Current research on AA therapies is also aimed at expanding treatment options. Ruxolitinib and tofacitinib show promising effectiveness in recent studies and case reports.
Vitiligo is usually treated with the NSTTs tacrolimus, pimecrolimus, and ruxolitinib. Although not yet approved by the FDA, roflumilast and latanoprost are being studied as additional treatment options.
Treatment for SD includes a wide array of NSTTs such as topical antifungal agents, calcineurin inhibitors, sulfacetamide, and pyrithione. Recent research also indicates roflumilast as an effective and safe long-term therapy.
Adjusting the Treatment Landscape in Pediatric Dermatology
A multitude of studies focus on the effect of NSTTs on various pediatric skin conditions, reflecting efforts to improve treatment options. This growing body of research anticipates a switch from traditional steroid therapies to safer nonsteroid alternatives.
The authors said, “Emerging research supports a shift away from TCS in pediatric dermatology, and current trials show promising results for a plethora of different NSTT.”
Reference
Gillespie J, Funk T, Dhossche J, Kenny L, Small A. Emerging topical nonsteroidal therapies in pediatric dermatology: atopic dermatitis, psoriasis, alopecia areata, vitiligo, and seborrheic dermatitis. Curr Opinion Pediatr. 2026;38(4):382-388. doi:10.1097/MOP.0000000000001580
