American Academy of Dermatology

The American Academy of Dermatology (AAD) is the main US professional body for dermatologists and the publisher of the Journal of the American Academy of Dermatology (JAAD). Its clinical guidelines on Atopic Dermatitis are the main US counterpart to NICE CG57. Alongside them it publishes patient pages, such as its toddler Bleach Baths recipe and child bathing advice (Soak and Seal: soak 10–15 minutes, apply moisturiser within 3 minutes). It also publishes member summaries of allergy guidance, including the NIAID 2017 early-peanut addendum (Dual-Allergen Exposure Hypothesis).

American Academy of Dermatology [regulates] Atopic Dermatitis American Academy of Dermatology [supports] Soak and Seal American Academy of Dermatology [supports] Bleach Baths

The 2014 four-part guideline (Eichenfield, Sidbury et al.) covers paediatric and adult atopic dermatitis of all severities. For 12 years it was the AAD’s guidance for children, until the AAD Pediatric Guideline 2026 replaced it. Part 2 (topical therapies) says moisturisers should be “an integral part” of treatment because strong evidence shows they reduce severity and the need for drugs. It suggests bathing and supports Wet Wrap Therapy for flares or stubborn disease, with caution about extra steroid absorption under wraps. It recommends Topical Corticosteroids once good skin care and emollients alone have failed, and it names under-treatment caused by Steroid Phobia as a problem. Topical Calcineurin Inhibitors are recommended for acute, chronic and maintenance treatment in adults and children. The guideline notes that Tacrolimus 0.03% and Pimecrolimus are labelled from age 2, and that the boxed warning should be discussed. Bleach baths with intranasal mupirocin “may be recommended” for moderate–severe AD with signs of secondary infection. No other topical anti-staphylococcal treatment is recommended, and topical antihistamines are not recommended.

American Academy of Dermatology [supports] Emollient Therapy American Academy of Dermatology [supports] Topical Calcineurin Inhibitors American Academy of Dermatology [supports] Wet Wrap Therapy Bleach Baths [treats] Infected Eczema

A new guideline series began in 2022 with comorbidities. The 2023 topical-therapy guideline (Sidbury, Chu et al.) is for adults only. It strongly recommends moisturisers, TCIs, TCS and topical PDE-4 and JAK inhibitors, and twice-weekly medium-potency TCS maintenance. It conditionally recommends bathing and wet wraps, and recommends against topical antimicrobials, antiseptics and antihistamines. The 2023/2024 phototherapy and systemic guideline (Davis et al., 11 recommendations, also adults only) strongly recommends Dupilumab, tralokinumab, abrocitinib, baricitinib and upadacitinib. It conditionally recommends Phototherapy, azathioprine, ciclosporin, methotrexate and mycophenolate, and recommends against systemic corticosteroids. A 2025 focused update adds strong recommendations for tapinarof and roflumilast creams, lebrikizumab and nemolizumab.

American Academy of Dermatology [supports] Topical Corticosteroids American Academy of Dermatology [supports] Dupilumab American Academy of Dermatology [supports] Phototherapy

Update (October 2026). On 7 April 2026 the AAD published its first guidelines written specifically for children, in two JAAD papers. One covers management (Davis, Sidbury et al., 27 recommendations), and the other covers primary prevention and comorbidities (Sidbury, Davis et al.). Its member guideline page now lists both under “Pediatric atopic dermatitis”. For toddlers, the main changes from 2014 are new strong recommendations for non-steroid creams with age floors: Crisaborole from 3 months, and roflumilast, Ruxolitinib Cream and tapinarof from 2 years. Dupilumab is strongly recommended from 6 months. There are conditional recommendations for bathing, Bleach Baths and Wet Wrap Therapy, and recommendations against topical antimicrobials on uninfected skin and against systemic steroids. Evidence for Oral Antihistamines was judged insufficient. The prevention paper conditionally recommends against probiotics, vitamin D and early food introduction for preventing AD. Full detail is in AAD Pediatric Guideline 2026. Co-chair Robert Sidbury died on 11 July 2025, after the manuscript was finalised (JAAD editorial note). The AAD has issued no specific position statement on Topical Steroid Withdrawal. Compare the joint UK statement by the British Association of Dermatologists and the National Eczema Society.

American Academy of Dermatology [part-of] AAD Pediatric Guideline 2026 American Academy of Dermatology [relates] NICE CG57 American Academy of Dermatology [relates] British Association of Dermatologists

Conflict (resolved 2026-10-03): An earlier round recorded that the AAD member page said the 2014 guidelines still applied to children, while search results pointed to a 2026 paediatric guideline. Re-checked 2026-10-03: the member page now lists the 2026 paediatric guidelines, and the full manuscript (AAD-hosted PDF) and PubMed abstracts (PMIDs 41949508, 41949509) were retrieved. The 2026 paediatric guideline supersedes 2014 for under-18s.

Connections

• Topical Corticosteroids — publishes TCS guidance, source: JAAD 2023
• Bleach Baths — patient dilution recipe (½ cup/full tub, 1 tsp/gallon toddler tub), source: AAD patient page
• Wet Wrap Therapy — conditional recommendation in 2023 topical guideline, source: JAAD 2023
• Bathing Frequency — up to once-daily 5–10 min baths; no fixed standard, source: Cardona review 2016
• Topical Steroid Withdrawal — no TSW-specific position statement found in round 3 searches, source: search 2026-10-03
• Dual-Allergen Exposure Hypothesis — summarises NIAID 2017 early-peanut addendum (severe eczema: test, then peanut at 4–6 months), source: AAD
• Food Allergy — NIAID 2010: evaluate <5s with moderate–severe AD only if uncontrolled or immediate reaction; no testing beyond peanut, source: AAD
• Atopic Dermatitis — publishes US guideline series 2014–2025, source: AAD guideline page
• Emollient Therapy — moisturisers strongly recommended, source: JAAD 2014 Part 2
• Topical Calcineurin Inhibitors — recommended in children; labelled ≥2 y, source: JAAD 2014 Part 2
• Soak and Seal — child bathing page, moisturise within 3 min, source: AAD patient page
• Dupilumab — strong recommendation (adults), source: AAD 2023/24 systemic guideline
• Phototherapy — conditional recommendation (adults), source: AAD 2023/24 systemic guideline
• Steroid Phobia — 2014 guideline flags under-treatment from steroid fear, source: JAAD 2014 Part 2
• NICE CG57 — UK counterpart guideline, source: NICE CG57
• Prebiotics and Synbiotics — probiotics/prebiotics not recommended for established AD, source: NCCIH digest
• Fragrance-Free Labelling — choose fragrance-free, not unscented, for children with eczema, source: AAD
• Hanifin-Rajka Criteria — AAD 2003 revised consensus criteria, source: Healio
• AAD Pediatric Guideline 2026 — publisher; first child-specific AD guidelines (April 2026), source: AAD member page; JAAD 2026