For many Filipinos living with atopic dermatitis (AD), the constant itch and inflammation are more than a physical burden — they affect daily life, confidence, and mental well-being. Managing this chronic skin condition effectively requires not just reducing symptoms but also restoring the skin barrier and improving overall quality of life (QoL). While traditional first-line therapies such as topical corticosteroids (TCS) remain essential, newer, safer alternatives like crisaborole two percent ointment are offering patients more options, especially for long-term care.

Crisaborole two percent ointment is a non-steroidal anti-inflammatory medication approved for treating mild-to-moderate atopic dermatitis in patients as young as three months old in countries like the US and Canada. In Australia, it is approved for children aged two years and older. Unlike topical corticosteroids or topical calcineurin inhibitors (TCIs), crisaborole works by inhibiting phosphodiesterase-4 (PDE4), an enzyme that contributes to inflammation in the skin. By blocking this enzyme, crisaborole helps reduce both itch (pruritus) and redness without the side effects commonly associated with steroids.

The goals of treating AD are clear: reduce inflammation, alleviate itch, repair the skin barrier, and improve patients’ overall quality of life. Many Filipino patients are wary of using corticosteroids for extended periods due to potential side effects, such as skin thinning (atrophy) and hormone disruption. This is where crisaborole two percent ointment steps in as a game-changer.

Crisaborole has no boxed warning, no limitations on duration of use, and does not cause skin atrophy. This makes it especially useful for sensitive areas such as the face, neck, and skin folds, where long-term steroid use is not ideal. For patients whose AD is resistant to TCS or those who experience adverse effects from steroids, crisaborole offers a safer alternative either as monotherapy or as part of an alternating regimen with TCIs.

An essential aspect of AD management is restoring and maintaining the skin barrier, which helps protect against environmental triggers and infections. The main base of crisaborole two percent ointment, is white petrolatum, a well-known skin protectant. White petrolatum has been shown to:

• Enhance antimicrobial peptides: Helps the skin fight off infections.

• Promote skin barrier markers: Encourages skin cell differentiation and repair.

• Thicken the stratum corneum: Strengthens the outermost layer of the skin.

• Reduce inflammation: Decreases T-cell infiltration, which is associated with inflammatory flare-ups.

By combining crisaborole’s anti-inflammatory properties with the barrier-repairing benefits of white petrolatum, this ointment not only soothes current flare-ups but also helps prevent future episodes.

Clinical trials have demonstrated the efficacy and safety of crisaborole two percent ointment. In large-scale studies, over 30 percent of patients achieved clear or nearly clear skin after four weeks of treatment, with many reporting reduced itching within just a few days. Adverse effects were minimal, with only mild burning or stinging reported by a small percentage of patients.

For Filipino patients, who often deal with flare-ups exacerbated by hot, humid weather and pollution, a treatment that is non-greasy and has a favorable safety profile is particularly valuable.

Current dermatological guidelines now recognize crisaborole two percent ointment as a potential first-line treatment option for both acute flare-ups and maintenance therapy of mild-to-moderate AD. For patients seeking alternatives to steroids, crisaborole provides a safe and effective option to manage symptoms while preserving skin integrity.

While crisaborole two percent ointment is a promising addition to the AD treatment toolkit, its cost may be higher than generic corticosteroids. However, as more patients and healthcare providers become aware of its benefits, insurance coverage, and accessibility may improve in the Philippines. Consulting with a dermatologist can help patients determine the most suitable treatment plan based on their needs and budget.

In the ongoing battle against atopic dermatitis, crisaborole two percent ointment represents not just a new medication, but a step forward in providing safer, more versatile options for patients. For Filipino families affected by this condition, it offers renewed hope for healthier, more comfortable skin and a better quality of life.