In this video blog, Lisa Swanson, MD , briefly discusses highlights from her Pearls in Pediatric Care lecture on November 10, 2024, at the 5th Annual Elevate-Derm West Conference at the Westin Kierland Resort in Scottsdale, AZ.
In this video
Speaking with PA Lisa Weiss, Dr. Swanson tackles the demand for "natural" atopic dermatitis options, noting these products aren't studied the way therapeutic agents are, which puts clinicians "in a bit of a tough spot." She walks through what the evidence shows: olive oil was found to worsen eczema, coconut oil is "neither pro nor con" (though it reduces staph aureus), and sunflower seed oil shows some benefit — the challenge being finding a clean preparation without "all sorts of other junk in them." She sees potential for CBD-containing products for itch and inflammation, likes discussing the dilute, European appeal of the aeron regimen, and looks forward to tapinarof ("based in worm poop, so it's natural") gaining approval down to age two for AD.
On diet, Dr. Swanson stresses that food is rarely the cause of eczema — kids with eczema have increased food allergy risk, but "98% of the time, the food allergy is not driving the eczema." Recent science actually flips the relationship: eczema appears to cause food allergy, as aerosolized food particles enter through the broken skin barrier, so the best way to reduce allergy risk is to treat the atopic dermatitis. She closes on vaccines and dupilumab: non-live vaccines are safe and effective, and while the label says avoid live vaccines, a recent allergy/immunology consensus statement found no immunologic reason for concern, supporting a comfortable, flexible conversation with families.
- Natural AD products lack rigorous study: olive oil may worsen eczema, coconut oil is neutral but reduces staph aureus, and sunflower seed oil shows benefit if you can find a clean preparation.
- Tapinarof (tapinarof), already approved for psoriasis, is anticipated down to age two for AD — and its "worm poop" origin makes it a natural-minded selling point.
- Food rarely drives eczema; avoid only true allergies, since pan-eliminating foods can increase allergy risk and compromise nutrition. Eczema appears to cause food allergy, not the reverse.
- Non-live vaccines (e.g., meningococcal, Tdap) are safe and effective on dupilumab.
- For live vaccines (MMR, varicella) on dupilumab, the label still says avoid, but personal experience plus a recent allergy/immunology consensus statement support reasonable options — often a one-month hiatus around vaccination.
