PHARMACOTHERAPY AND EVIDENCE BASED MEDICINE: Edited by Enrico Compalati and Derek ChuEvidence-based management of eczema: five things that should be done more and five things that should be droppedOlabi, Bayannea; Williams, Hywel C.bAuthor Information aBiosciences Institute, Newcastle University, Newcastle bCentre of Evidence-Based Dermatology at the University of Nottingham, United Kingdom Correspondence to Hywel C. Williams, DSc, FMedSci, Centre of Evidence-Based Dermatology, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, United Kingdom. Tel: +44 115 82 31048; fax: +44 115 82 31046; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: August 2021 - Volume 21 - Issue 4 - p 386-393 doi: 10.1097/ACI.0000000000000750 Buy Metrics Abstract Purpose of review We provide readers with an evidence-informed opinion on current treatments for eczema (atopic dermatitis) with the intention of improving patient care. We suggest five treatment aspects that should be promoted and five that should be demoted. Evidence sources include key randomized controlled trials and systematic reviews. Recent findings Under-treatment of eczema can be countered by more aggressive use of topical therapies including the ‘get control then keep control’ regimen, and systemics for severe disease, supplemented with good patient education. Topical corticosteroids should be used once daily rather than twice daily. Topical calcineurin inhibitors are useful for sensitive sites. There is little evidence to support the continued use of oral antihistamines, oral or topical antistaphylococcal treatments for infected eczema or probiotics for treating eczema. Nonpharmacological treatments including silk clothing, ion-exchange water softeners and emollient bath additives have not been shown to benefit eczema patients. Despite promising pilot studies, large trials suggest that emollients from birth do not prevent eczema and may result in harms such as increased skin infections and food allergy. Summary New evidence-based insights on existing and newer treatments allow clinicians the opportunity to change their practice in a way that enhances patients’ quality of life. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.