Systemic therapy is generally considered if you have moderate to severe disease with frequent or severe flares, says Tanya Evans, MD, a dermatologist and the medical director of the skin cancer program at the Melanoma Clinic at MemorialCare Saddleback Medical Center in Laguna Hills, California.
Newer oral therapies known as JAK inhibitors work by targeting specific inflammatory signaling pathways involved in AD. These medications can help reduce inflammation and itch more directly and often quicker than traditional treatments, Dr. Evans says. Options approved by the U.S. Food and Drug Administration include upadacitinib (Rinvoq) and abrocitinib (Cibinqo).
“New systemic therapies, especially JAK inhibitors, are transforming treatment for moderate to severe atopic dermatitis by offering rapid symptom relief and high efficacy,” explains Evans. “However, they require an understanding of whether you’re a good candidate, and ongoing monitoring to balance benefits with potential side effects.” She says these may include:
- Nausea
- High blood pressure
- Headache
- Diarrhea
- Increased risk of infections
It’s important to keep in mind that systemic therapies don’t replace good skin care, they work alongside it, says Bowles.
“Even when someone starts an oral medication, maintaining a gentle, consistent skin care routine remains essential to support the skin barrier and reduce irritation,” she says. “That includes regular moisturizing, avoiding harsh cleansers, and minimizing known triggers. The most effective approach is a layered one that addresses both internal inflammation and external barrier support.”
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