In what order should topical medications be used for a 9-year-old with atopic dermatitis?

For a 9-year-old with atopic dermatitis, the order of application of topical medications is significant in managing the condition effectively. The recommended sequence typically involves starting with the least potent medications and progressing to more potent treatments if necessary, especially during flares.

In this case, hydrocortisone cream is often used as an initial treatment due to its relatively mild potency and suitability for sensitive skin, such as that of a child. Following this, triamcinolone acetonide ointment, which is a medium-potency corticosteroid, can be applied next to address more significant inflammation or flaring. Finally, crisaborole, a non-steroidal topical medication, is used as a long-term management option or for maintenance therapy after the acute phase has been controlled. This order not only minimizes potential side effects associated with stronger topical corticosteroids but also gives a structured approach to treatment where the skin can be calmed first before applying more potent agents.

Thus, this particular sequence aligns with best practices for managing atopic dermatitis in children, balancing efficacy and safety considerations and facilitating a stepwise approach to treatment where patients can benefit from a gradual intensification of therapy as needed.