Treating atopic dermatitis during pregnancy often raises concerns for both the mother and the physician. This summary of recent guidance can be used to determine appropriate care.
- Class II or III steroids can be used as first-line therapy. If more than 200 g/month is needed, then consider adding narrowband UVB therapy.
- Topical Tacrolimus (Protopic) can be used off-label as a first-line therapy.
- Chlorhexidine and oher topical antiseptics (excluding Triclosan) can be used in pregnancy to prevent skin infections.
- Aminoglycoside topical antibiotics should be avoided.
- Cyclosporine off-label is a first-line systemic therapy when needed.
- Systemic corticosteroids is a second-line therapy. If necessary use should be limited to 0.5 mg/kg per day for up to two to three weeks.
- Azathioprine should not be used during pregnancy.
- Dupixent (and its biosimilars) should be avoided until more safety data is available.