CHICAGO Assume noncompliance when treating atopic dermatitis in teenage patients, said Dr. Jon M. Hanifin, a dermatologist at Oregon Health and Science University in Portland.
"Managing atopic dermatitis in teenagers is not for the faint of heart," said Dr. Hanifin, a specialist in atopic dermatitis who has served as a consultant for multiple pharmaceutical companies.
Dr. Hanifin shared some tips on treating atopic dermatitis (AD) in teenagers at the annual meeting of the Society for Pediatric Dermatology, including these:
▸ Keep the parents out of the room except for the start and end of the visit. "You have to get the parents out of the room to find out what's going on," he said.
▸ Ask the teens to call the office if the treatment isn't going well and encourage them to schedule their appointments.
▸ Offer psychiatric consultation. Some of these teens genuinely want some help other than their parents yelling at them.
▸ Don't shy away from systemic medications. Try methotrexate for moderate to severe cases of AD in adolescents because it is less expensive than cyclosporin, Dr. Hanifin said. He often starts teen atopic dermatitis patients with 2.5 mg of methotrexate for 4 of 7 days each week, which has been more effective than a once-weekly dose of 15 mg in many of his teen patients.
But clinicians must remember that making time for consistent AD care is rarely a priority for a busy teenager, he noted.