Over-The-Counter Drug Recommendations for Atopic Dermatitis

Jamie L. McConaha, PharmD, NCTTP, BCACP, CDE, considers the benefit of over-the-counter options for battling atopic dermatitis, such as the topical products CeraVe and Eucerin.

Peter Lio, MD: I’d like to shift to some of the OTC [over-the-counter] products themselves, and according to a 2021 Pharmacy Times® of “Pharmacists Over-the-Counter Recommendations” in the category of eczema care and relief products, CeraVe was the most recommended over-the-counter product, about 22% of the recommendations, followed by Eucerin 17%. Combined, these 2 options accounted for nearly 40% of all the recommendations in this category. Jamie, can you talk to us about why you think that is and what is the rationale behind utilizing moisturizers in the management of atopic dermatitis?

Jamie L. McConaha, PharmD, NCTTP, BCACP, CDE: Absolutely. It’s very interesting that those were the top 2 products recommended by pharmacists. I teach a dermatology course at Duquesne University, [Pittsburgh, PA] and I can tell you CeraVe products are extremely popular with students in the college. A lot of them use them because they see them on social media. There’s a lot of skincare regimens right now on platforms like TikTok, and they think this is great. There is actually evidence and science behind these products and why they work so well, so it is a good recommendation that I like to give the patients as well.

The rationale is we want to hydrate the skin. We see dry skin that’s very itchy in patients with atopic dermatitis. Both CeraVe as well as Eucerin products, they’re great at hydrating the skin, and the reason is because they contain ingredients that are humectants and occlusives. For example, CeraVe contains ceramides and we talked earlier about the pathophysiology and how there is a reduction in ceramides in the skin. That’s working to try and replenish those. It also contains hyaluronic acid, which is a humectant, and that works to attract and trap water, both from the environment, as well from the underlying skin, from the dermal layer.

They also contain emollients, so emollients are lipids or oils that help to fill in the crevices in the skin, and those are really great, as Shannon was just talking about for patient satisfaction. They love how they feel, gives a smooth appearance of the skin and they’re very patient friendly. Those are some of the reasons for both of those, so I listed some of the ingredients in CeraVe. In Eucerin, you see a lot of the same concepts but different ingredients. It has mineral oil, which is an occlusive, not only are we trapping that water but then we’re sort of keeping it in the skin and keeping that skin hydrated, as well as glycerin which again is a humectant agent.

Peter Lio, MD: It’s kind of overwhelming sometimes. When you walk into a pharmacy, there used to be there were shelves of options, now there’s aisles of skincare options sometimes. It is difficult to navigate that, and I’m really grateful that you guys can help steer patients to an appropriate one because it is true, the right product can make or break it. Some of my colleagues will say just pick a good moisturizer, whatever that may be, I’m a little pickier. That some moisturizers really do seem to be in that much better class and be able to help more. To me, if we can even prevent a little bit more disease, if we can bring it down that much more, that could potentially mean the difference between someone who is going to go on a systemic agent or who’s going to stay OK with their topical. It’s very important.

This transcript has been edited for clarity.

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