From the Guidelines
Alternatives to mild strength topical corticosteroids, such as fluid inline acetonide 0.025%, include topical calcineurin inhibitors like pimecrolimus 1% cream, which is recommended for adults with mild-to-moderate atopic dermatitis 1. When considering alternatives to mild strength topical corticosteroids, it's essential to evaluate the specific skin condition, location on the body, and individual factors like age and treatment history.
- Topical calcineurin inhibitors, such as pimecrolimus (Elidel) and tacrolimus (Protopic), are effective options for conditions like eczema and dermatitis, as they suppress the immune response in the skin without causing skin thinning 1.
- Other alternatives include crisaborole ointment, a topical PDE-4 inhibitor, which is recommended for adults with mild-to-moderate atopic dermatitis 1.
- Moisturizers containing ceramides or colloidal oatmeal can also be beneficial for mild skin conditions.
- It's crucial to consult with a healthcare provider to determine the most appropriate alternative for a specific condition, as they can help weigh the benefits and risks of each option and recommend the best course of treatment 1. Key considerations include the potential for steroid-related side effects, such as skin atrophy, telangiectasia, or tachyphylaxis, and the need for prescription non-steroidal options for long-term use or specific concerns like facial rashes.
- The most recent and highest quality study recommends pimecrolimus 1% cream for adults with mild-to-moderate atopic dermatitis, making it a viable alternative to mild strength topical corticosteroids 1.
From the FDA Drug Label
CLINICAL STUDIES Three randomized, double-blind, vehicle-controlled, multi-center, Phase 3 studies were conducted in 589 pediatric patients ages 3 months-17 years old to evaluate ELIDEL ® (pimecrolimus) Cream 1% for the treatment of mild to moderate atopic dermatitis
- Alternative to mild strength topical corticosteroid: Pimecrolimus (ELIDEL) Cream 1% can be considered as an alternative for the treatment of mild to moderate atopic dermatitis 2.
- Key points:
- Pimecrolimus Cream 1% is used for the treatment of mild to moderate atopic dermatitis.
- It can be applied twice daily to affected areas.
From the Research
Alternatives to Mild Strength Topical Corticosteroids
- Pimecrolimus cream 1% has been shown to be an effective alternative to triamcinolone acetonide paste in the treatment of symptomatic oral lichen planus 3, 4
- Tacrolimus 0.1% ointment may not be as effective as triamcinolone acetonide 0.1% ointment in inhibiting the atopy patch test reaction in patients with atopic dermatitis 5
- Fluocinolone acetonide 0.01% in peanut oil has been found to be an effective alternative to topical corticosteroid agents in ointment, cream, and lotion forms in children with atopic dermatitis, including those with peanut allergic sensitivity 6
- A moderately potent topical steroid, such as 0.02% triamcinolone acetonide cream, can be used to treat childhood phimosis, with successful retraction achieved in 84% of patients after 6 weeks of application 7
Key Findings
- Pimecrolimus cream 1% has been shown to have a better therapeutic response compared to triamcinolone acetonide 0.1% oral paste in subjects with symptomatic oral lichen planus 4
- Fluocinolone acetonide 0.01% in peanut oil is well tolerated and does not cause adrenal suppression or adverse local effects in children with atopic dermatitis, including those with peanut allergic sensitivity 6
- The use of a moderately potent topical steroid, such as 0.02% triamcinolone acetonide cream, can effect comparable improvements in foreskin retractability after 6 weeks of treatment in boys with phimosis 7