How should topical corticosteroids be used for maintaining control in patients with atopic dermatitis?

Topical corticosteroids are commonly used in the management of atopic dermatitis, particularly for maintaining control of this chronic condition. The recommendation to use them twice weekly for maintenance therapy reflects the goal of reducing symptoms while minimizing potential side effects associated with long-term use of these medications.

Using topical corticosteroids twice a week allows for effective control of inflammation and itching without the risks associated with daily application, which could lead to skin atrophy or other adverse effects. This approach balances the need for ongoing treatment with the importance of preventing potential complications from prolonged steroid use.

The strategy aligns with contemporary guidelines that suggest a proactive approach to managing atopic dermatitis, where patients can apply the medication at a lower frequency to maintain skin health and prevent flare-ups while avoiding over-reliance on the medication.

Daily application may lead to unnecessary side effects, and using topical corticosteroids only during flare-ups does not provide a stable approach for managing a chronic condition like atopic dermatitis. Similarly, applying them only when symptoms are bothersome does not effectively prevent flare-ups or manage the condition in a systematic manner. The twice weekly strategy, therefore, represents an evidence-based approach to maintaining skin control in atopic dermatitis.