Eczema

Prescribing Notes:

• All emollients (paraffin-based and paraffin-free) carry a risk of severe burns. Patients should avoid smoking or naked flames, as emollients can transfer to clothing, bedding, and dressings, where they dry, build up, and act as an accelerant if ignited. Though not flammable on skin, dried residues increase fire speed and intensity.
• Similar risks may occur with other skin products used widely or in large amounts. Clothing and bedding should be changed daily; washing at high temperatures reduces but does not remove residue.
• Resources are available for health and social care professionals to support the safe use of emollients see MHRA guidance.
• Content is available on the Dermatology Pathway pages of the Right Decision Service to provide an accessible resource for primary care practitioners to support the diagnosis and management of patients presenting with common skin conditions.
• General considerations on formulations:
  • Creams – less greasy, easier to apply, preferred cosmetically; useful for weeping lesions.
  • Gels – suitable for face and scalp.
  • Lotions – cooling; good for moist or hairy areas; alcohol-based lotions may sting on broken skin.
  • Ointments – greasy, less likely to sensitise; best for chronic dry lesions.
  • Absorption – creams and lotions absorb faster than ointments or gels.
• Rarely, severe adverse effects can occur on stopping treatment with topical corticosteroids, often after long-term continuous or inappropriate use of moderate to high potency products. To reduce the risks of these events, prescribe the topical corticosteroid of lowest potency needed and ensure patients know how to use it safely and effectively. See MHRA warning - Topical corticosteroids: information on the risk of topical steroid withdrawal reactions.
• Emollients with antiseptics should only be used in patients with infected eczema.
• Exacerbation of eczema may represent secondary bacterial or viral infection (eczema herpeticum). Appropriate swabs should be taken, and appropriate anti-infective therapy prescribed.
• As per the Scottish Government guidance document ‘Medicines - achieving value and sustainability in prescribing’ bath and shower emollient preparations should be reserved for situations where the use of regular emollient preparations is not sufficient (for example, in severe disease where combination of treatment modalities is required). In most cases regular emollient preparations are suitable for use as bath additives and soap substitutes.

Unlicensed / Special Manufacture Preparations

• The British Association of Dermatologists (BAD) list of preferred unlicensed dermatological preparations (‘Specials’) is available at the BAD website.

Corticosteroid creams

• Quantities are based on single daily application for 2 weeks in adults:

• Quantities are based on twice daily application for 1 week in adults:

Prescribing Notes:

• Most emollients (apart from white soft paraffin 50%/liquid paraffin 50%) may be used as soap substitutes (hand washing and in bath/shower) by firstly wetting the skin, washing with the cream or ointment, then rinsing off. Epimax products are considered body washes rather than soap substitutes so as to avoid contact with the eyes.
• It is more cost-effective to prescribe emollients in large pack sizes and products that come in pump dispensers may be more suitable for long term use in order to reduce the risk of microbial contamination.

Prescribing Notes:

• Most emollients (apart from white soft paraffin 50%/liquid paraffin 50%) may be used as soap substitutes (hand washing and in bath/shower) by firstly wetting the skin, washing with the cream or ointment, then rinsing off. Epimax products are considered body washes rather than soap substitutes so as to avoid contact with the eyes.
• It is more cost-effective to prescribe emollients in large pack sizes and products that come in pump dispensers may be more suitable for long term use in order to reduce the risk of microbial contamination.
• Epimax paraffin free ointment should not be applied to the face. See MHRA Drug Safety Update (July 2024) Epimax Ointment and Epimax Paraffin-Free Ointment: reports of ocular surface toxicity and ocular chemical injury.

Prescribing Notes:

• Preparations containing urea are suitable for the treatment of very dry or hyperkeratotic, scaling skin conditions.

Prescribing Notes:

• As per the Scottish Government guidance document ‘Medicines - achieving value and sustainability in prescribing’ bath and shower emollient preparations should be reserved for situations where the use of regular emollient preparations is not sufficient (for example, in severe disease where combination of treatment modalities is required).
• Most emollients (apart from white soft paraffin 50% / liquid paraffin 50%) may be used as soap substitutes for hand washing and in the bath or shower. First wet the skin, wash with the cream or ointment, then rinse off. Alternatively, emollients can be put on the skin before bathing or showering and then washed off to reduce stinging from broken areas.

Prescribing Notes:

• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.

Prescribing Notes:

• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.

Prescribing Notes:

• Palms of the hands and soles of the feet may require potent or very potent steroids.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.

Prescribing Notes:

• Palms of the hands and soles of the feet may require potent or very potent steroids.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Patients prescribed very potent topical corticosteroids should be reviewed regularly (at least monthly) and the preparation should not be prescribed on repeat prescription except on specialist advice.

Prescribing Notes:

• Do not routinely offer either topical or oral antibiotic if not systemically unwell. Take skin swabs if there are clinical signs of infection. If an oral antibiotic is appropriate for empirical treatment see recommendations for cellulitis.
• Increasing concerns about the development of resistance have led to topical antibiotic therapy being discouraged.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Guidance on the treatment of skin infections including impetigo can be found in the Infections chapter of the formulary.

Prescribing Notes:

• Long term use of products containing antibacterials and antifungals increases the likelihood of resistance and sensitisation. Normally products are used for a short period only, usually 7 days.
• Topical antimicrobials have limited evidence of benefit but may be appropriate if the infection is localised and not severe.
• The risk of antimicrobial resistance increases with repeated courses.
• The presence of bacteria may be a result of colonisation and not necessarily infection.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• The potency of the steroid should be stepped up or stepped down depending on the severity of symptoms.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Palms of the hands and soles of the feet may require potent or very potent steroids.

Prescribing Notes:

• Long term use of products containing antibacterials and antifungals increases the likelihood of resistance and sensitisation. Normally products should be used for a short period only, usually 7 days.
• Topical antimicrobials have limited evidence of benefit but may be appropriate if the infection is localised and not severe.
• The risk of antimicrobial resistance increases with repeated courses.
• The presence of bacteria may be a result of colonisation and not necessarily infection.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Palms of the hands and soles of the feet may require potent or very potent steroids.

Prescribing Notes:

• Long term use of products containing antibacterials and antifungals increases the likelihood of resistance and sensitisation. Normally products should be used for a short period only, usually 7 days.
• Topical antimicrobials have limited evidence of benefit but may be appropriate if the infection is localised and not severe.
• The risk of antimicrobial resistance increases with repeated courses.
• The presence of bacteria may be a result of colonisation and not necessarily infection.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Palms of the hands and soles of the feet may require potent or very potent steroids.

Prescribing Notes:

• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Potassium permanganate soaks are not suitable for dry skin conditions and may leave a brown stain on skin, nails and the bath or vessel holding the solution.
• The British Association of Dermatologists (BAD) have developed guidance on safe use of potassium permanganate soaks and an information leaflet for patients which can be found on their website.

Prescribing Notes:

• Ichthammol has anti-inflammatory properties and can be a useful addition to emollients and corticosteroid therapy.
• For zinc paste and ichthammol bandages refer to local wound formulary.
• When ichthammol preparations are introduced as an add-on therapy there is increased absorption of topical corticosteroids, therefore the potency of concurrent steroid therapy may require reduction.

Prescribing Notes:

• Topical tacrolimus 0.03% is restricted for the treatment of moderate to severe atopic eczema in adults and children aged 2 years and older that has not been controlled by topical corticosteroids where there is a serious risk of important adverse effects from further topical corticosteroid use, particularly irreversible skin atrophy.
• Tacrolimus 0.1% ointment is a treatment option for moderate to severe atopic eczema in adults and adolescents aged 16 years and older that has not been controlled by topical corticosteroids where there is a serious risk of important adverse effects from further topical corticosteroid use, particularly irreversible skin atrophy. Review need of preventative therapy after 1 year.
• Tacrolimus 0.1% ointment can also be used for the prevention of flares in patients aged 16 years and over with moderate to severe atopic eczema in accordance with the licensed indications.
• Tacrolimus should be initiated only by physicians (including GP’s) with a special interest and experience in dermatology.

Prescribing Notes:

Methotrexate

• Methotrexate can be prescribed, for severe atopic eczema unresponsive to conventional therapy. 
• To avoid prescribing, dispensing and administration errors only the 2.5mg strength of methotrexate tablets should be prescribed and dispensed. Measures have been implemented to prompt healthcare professionals to record the day of the week for intake and to remind patients of the dosing schedule and the risks of overdose due to continued reports of inadvertent overdose. For further advice see MHRA Drug Safety Update (September 2020).
• Regular monitoring of full blood count, renal function and liver function should be undertaken in line with local protocols.

Ciclosporin

• Ciclosporin can be prescribed, for atopic dermatitis where conventional therapy is ineffective or inappropriate. Preparations should be prescribed by brand name only due to differences in bioavailability.
• The formulary choice for ciclosporin is Capsorin (10mg capsules must be prescribed as Neoral).
• Patients on ciclosporin should be regularly monitored for adverse effects including hypertension and renal impairment.

Azathioprine

• Azathioprine can be prescribed for severe refractory eczema. It is contraindicated if there is absent or very low thiopurine methyltransferase (TPMT) activity.

Alitretinoin

• Alitretinoin is accepted for use in adults with severe hand eczema unresponsive to treatment with potent topical corticosteroids. It should be dispensed by a hospital-based pharmacy. It is teratogenic. Prescription of alitretinoin for women of childbearing is only possible if adequate contraception is undertaken (Pregnancy prevention programme). Refer to MHRA Drug Safety Update (June 2019).

Mycophenolate mofetil

• Mycophenolate mofetil can be prescribed, for patients with moderate to severe eczema where other preferred treatment options are contraindicated or subtherapeutic.

Prescribing Notes:

• All emollients (paraffin-based and paraffin-free) carry a risk of severe burns. Patients should avoid smoking or naked flames, as emollients can transfer to clothing, bedding, and dressings, where they dry, build up, and act as an accelerant if ignited. Though not flammable on skin, dried residues increase fire speed and intensity.
• Similar risks may occur with other skin products used widely or in large amounts. Clothing and bedding should be changed daily; washing at high temperatures reduces but does not remove residue.
• Resources are available for health and social care professionals to support the safe use of emollients see MHRA guidance.
• Content is available on the Dermatology Pathway pages of the Right Decision Service to provide an accessible resource for primary care practitioners to support the diagnosis and management of patients presenting with common skin conditions.
• General considerations on formulations:
  • Creams – less greasy, easier to apply, preferred cosmetically; useful for weeping lesions.
  • Gels – suitable for face and scalp.
  • Lotions – cooling; good for moist or hairy areas; alcohol-based lotions may sting on broken skin.
  • Ointments – greasy, less likely to sensitise; best for chronic dry lesions.
  • Absorption – creams and lotions absorb faster than ointments or gels.
• Rarely, severe adverse effects can occur on stopping treatment with topical corticosteroids, often after long-term continuous or inappropriate use of moderate to high potency products. To reduce the risks of these events, prescribe the topical corticosteroid of lowest potency needed and ensure patients know how to use it safely and effectively. See MHRA warning - Topical corticosteroids: information on the risk of topical steroid withdrawal reactions.
• Emollients with antiseptics should only be used in patients with infected eczema.
• Exacerbation of eczema may represent secondary bacterial or viral infection (eczema herpeticum). Appropriate swabs should be taken, and appropriate anti-infective therapy prescribed.
• As per the Scottish Government guidance document ‘Medicines - achieving value and sustainability in prescribing’ bath and shower emollient preparations should be reserved for situations where the use of regular emollient preparations is not sufficient (for example, in severe disease where combination of treatment modalities is required). In most cases regular emollient preparations are suitable for use as bath additives and soap substitutes.

Unlicensed / Special Manufacture Preparations

• The British Association of Dermatologists (BAD) list of preferred unlicensed dermatological preparations (‘Specials’) is available at the BAD website.

Corticosteroid creams

Quantities are based on single daily application for 2 weeks. Estimates are based on the number of adult finger tips units (FTUs) of cream to treat the area. 2 FTUs are about the same as 1g of topical steroid.

(*) Qty = Estimated prescribable quantity of corticosteroid cream/ointment.

Quantities are based on twice daily application for 1 week in a child 12-18 years; smaller quantities will be required for children under 12 years.

Prescribing Notes:

• Most emollients (apart from white soft paraffin 50%/liquid paraffin 50%) may be used as soap substitutes (hand washing and in bath/shower) by firstly wetting the skin, washing with the cream or ointment, then rinsing off. Epimax products are considered body washes rather than soap substitutes so as to avoid contact with the eyes.
• It is more cost-effective to prescribe emollients in large pack sizes and products that come in pump dispensers may be more suitable for long term use in order to reduce the risk of microbial contamination.

Prescribing Notes:

• Most emollients (apart from white soft paraffin 50%/liquid paraffin 50%) may be used as soap substitutes (hand washing and in bath/shower) by firstly wetting the skin, washing with the cream or ointment, then rinsing off. Epimax products are considered body washes rather than soap substitutes so as to avoid contact with the eyes.
• It is more cost-effective to prescribe emollients in large pack sizes and products that come in pump dispensers may be more suitable for long term use in order to reduce the risk of microbial contamination.
• Epimax paraffin free ointment should not be applied to the face. See MHRA Drug Safety Update (July 2024) Epimax Ointment and Epimax Paraffin-Free Ointment: reports of ocular surface toxicity and ocular chemical injury.

Prescribing Notes:

• Preparations containing urea are suitable for the treatment of very dry or hyperkeratotic, scaling skin conditions.

Prescribing Notes:

• As per the Scottish Government guidance document ‘Medicines - achieving value and sustainability in prescribing’ bath and shower emollient preparations should be reserved for situations where the use of regular emollient preparations is not sufficient (for example, in severe disease where combination of treatment modalities is required).
• Most emollients (apart from white soft paraffin 50% / liquid paraffin 50%) may be used as soap substitutes for hand washing and in the bath or shower. First wet the skin, wash with the cream or ointment, then rinse off. Alternatively, emollients can be put on the skin before bathing or showering and then washed off to reduce stinging from broken areas.

Prescribing Notes:

• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.

Prescribing Notes:

• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.

Prescribing Notes:

• Palms of the hands and soles of the feet may require potent or very potent steroids.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required. The occlusive effect of ointments increases penetration of the corticosteroid.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.

Prescribing Notes:

• Do not routinely offer either topical or oral antibiotic if not systemically unwell. Take skin swabs if there are clinical signs of infection. If an oral antibiotic is appropriate for empirical treatment see recommendations for cellulitis.
• Increasing concerns about the development of resistance have led to topical antibiotic therapy being discouraged.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Guidance on the treatment of skin infections including impetigo can be found in the Infections chapter of the formulary.

Prescribing Notes:

• Long term use of products containing antibacterials and antifungals increases the likelihood of resistance and sensitisation. Normally products are used for a short period only, usually 7 days.
• Topical antimicrobials have limited evidence of benefit but may be appropriate if the infection is localised and not severe.
• The risk of antimicrobial resistance increases with repeated courses.
• The presence of bacteria may be a result of colonisation and not necessarily infection.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• The potency of the steroid should be stepped up or stepped down depending on the severity of symptoms.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Palms of the hands and soles of the feet may require potent or very potent steroids.

Prescribing Notes:

• Long term use of products containing antibacterials and antifungals increases the likelihood of resistance and sensitisation. Normally products should be used for a short period only, usually 7 days.
• Topical antimicrobials have limited evidence of benefit but may be appropriate if the infection is localised and not severe.
• The risk of antimicrobial resistance increases with repeated courses.
• The presence of bacteria may be a result of colonisation and not necessarily infection.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Palms of the hands and soles of the feet may require potent or very potent steroids.

Prescribing Notes:

• Long term use of products containing antibacterials and antifungals increases the likelihood of resistance and sensitisation. Normally products should be used for a short period only, usually 7 days.
• Topical antimicrobials have limited evidence of benefit but may be appropriate if the infection is localised and not severe.
• The risk of antimicrobial resistance increases with repeated courses.
• The presence of bacteria may be a result of colonisation and not necessarily infection.
• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Water-miscible corticosteroid creams are suitable for moist areas e.g. axillae or groin or for weeping lesions.
• Ointments are generally chosen for dry, lichenified or scaly lesions or where a more occlusive effect is required.
• Gloves should be worn during, or hands washed after, application of large quantities of steroid preparations.
• Palms of the hands and soles of the feet may require potent or very potent steroids.

Prescribing Notes:

• For more information see NICE NG190 ‘Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing’.
• Potassium permanganate soaks are not suitable for dry skin conditions and may leave a brown stain on skin, nails and the bath or vessel holding the solution.
• The British Association of Dermatologists (BAD) have developed guidance on safe use of potassium permanganate soaks and an information leaflet for patients which can be found on their website.

Prescribing Notes:

• Ichthammol has anti-inflammatory properties and can be a useful addition to emollients and corticosteroid therapy.
• For zinc paste and ichthammol bandages refer to local wound formulary.
• When ichthammol preparations are introduced as an add-on therapy there is increased absorption of topical corticosteroids, therefore the potency of concurrent steroid therapy may require reduction.

Prescribing Notes:

• Topical tacrolimus 0.03% is restricted for the treatment of moderate to severe atopic eczema in adults and children aged 2 years and older that has not been controlled by topical corticosteroids where there is a serious risk of important adverse effects from further topical corticosteroid use, particularly irreversible skin atrophy.
• Pimecrolimus is restricted to the treatment of moderate atopic eczema on the face and neck in children aged 2 to 16 years that has not been controlled by topical corticosteroids where there is a serious risk of important adverse effects from further topical corticosteroid use, particularly irreversible skin atrophy. 
• Tacrolimus or pimecrolimus should be initiated only by physicians (including GP’s) with a special interest and experience in dermatology.

Prescribing Notes:

Methotrexate

• Methotrexate can be prescribed, for severe atopic eczema unresponsive to conventional therapy. 
• To avoid prescribing, dispensing and administration errors only the 2.5mg strength of methotrexate tablets should be prescribed and dispensed. Measures have been implemented to prompt healthcare professionals to record the day of the week for intake and to remind patients of the dosing schedule and the risks of overdose due to continued reports of inadvertent overdose. For further advice see MHRA Drug Safety Update (September 2020).
• Regular monitoring of full blood count, renal function and liver function should be undertaken in line with local protocols.

Ciclosporin

• Ciclosporin can be prescribed, for atopic dermatitis where conventional therapy is ineffective or inappropriate. Preparations should be prescribed by brand name only due to differences in bioavailability.
• The formulary choice for ciclosporin is Capsorin (10mg capsules and liquid formulation must be prescribed as Neoral).
• Patients on ciclosporin should be regularly monitored for adverse effects including hypertension and renal impairment.

Azathioprine

• Azathioprine can be prescribed for severe refractory eczema. It is contraindicated if there is absent or very low thiopurine methyltransferase (TPMT) activity.

Prescribing Notes:

• Lebrikizumab is available for the treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older with a body weight of at least 40kg who are candidates for systemic therapy. Use is restricted to patients who have had an inadequate response to an existing systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable and where a biologic would otherwise be offered.
• Dupilumab is available for the treatment of moderate-to-severe atopic dermatitis for patients aged 6 months and over who are candidates for systemic therapy. Use is restricted to patients who have had an inadequate response to existing systemic immunosuppressants such as ciclosporin, or in whom such treatment is considered unsuitable.
• Tralokinumab is available for treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy. Use is restricted to patients who have had an inadequate response to an existing systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable.

Prescribing Notes:

• Abrocitinib is available for the treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy. Use is restricted to patients who have not responded to, or have lost response to, at least one systemic immunosuppressant therapy, or in whom these are contraindicated or not tolerated.
• Upadicitinib is available for the treatment of moderate to severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy. Use is restricted to patients who have had an inadequate response to at least one conventional systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable.