{"id":875,"date":"2026-08-25T13:30:00","date_gmt":"2026-08-25T05:30:00","guid":{"rendered":"https:\/\/eczema.skinmedical.com.hk\/treatment-step2\/"},"modified":"2026-08-28T17:04:44","modified_gmt":"2026-08-28T09:04:44","slug":"treatment-step2","status":"publish","type":"page","link":"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step2\/","title":{"rendered":"Step 2: Proactive maintenance"},"content":{"rendered":"<div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-30 vce-row-equal-height vce-row-content--top\" id=\"el-620964cb\" data-vce-do-apply=\"all el-620964cb\"><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-auto vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-76b8937f\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-76b8937f\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-76b8937f\"><div class=\"vce vce-separator-container vce-separator--align-center vce-separator--style-solid\" id=\"el-9f06d3cb\" data-vce-do-apply=\"margin el-9f06d3cb\"><div class=\"vce-separator vce-separator--color-bfc0c1 vce-separator--width-100 vce-separator--thickness-1\" data-vce-do-apply=\"border padding background  el-9f06d3cb\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-30 vce-row-equal-height vce-row-content--top\" id=\"el-0d55ac2e\" data-vce-do-apply=\"all el-0d55ac2e\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-22-12p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-d8452c1a\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-d8452c1a\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-d8452c1a\"><div class=\"vce-single-image-container vce-single-image--align-center\"><div class=\"vce vce-single-image-wrapper\" id=\"el-03873137\" data-vce-do-apply=\"all el-03873137\"><figure><div class=\"vce-single-image-figure-inner\" style=\"width: 400px;\"><div class=\"vce-single-image-inner vce-single-image--absolute\" style=\"width: 100%; padding-bottom: 66.75%;\"><img loading=\"lazy\" decoding=\"async\" class=\"vce-single-image\"  width=\"400\" height=\"267\" srcset=\"https:\/\/eczema.skinmedical.com.hk\/wp-content\/uploads\/2024\/05\/photo-1586282091736-c2f9a8af8772-320x214.jpg 320w, https:\/\/eczema.skinmedical.com.hk\/wp-content\/uploads\/2026\/08\/photo-1586282091736-c2f9a8af8772-400x267.jpg 400w\" src=\"https:\/\/eczema.skinmedical.com.hk\/wp-content\/uploads\/2026\/08\/photo-1586282091736-c2f9a8af8772-400x267.jpg\" data-img-src=\"https:\/\/eczema.skinmedical.com.hk\/wp-content\/uploads\/2024\/05\/photo-1586282091736-c2f9a8af8772.jpg\" data-attachment-id=\"312\"  alt=\"\" title=\"\" \/><\/div><\/div><figcaption hidden=\"\"><\/figcaption><\/figure><\/div><\/div><\/div><\/div><\/div><div class=\"vce-col vce-col--md-77-86p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last\" id=\"el-d39a7722\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-d39a7722\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-d39a7722\"><div class=\"vce-text-block\"><div class=\"vce-text-block-wrapper vce\" id=\"el-4edfca25\" data-vce-do-apply=\"all el-4edfca25\"><h2><strong><span style=\"color: #756464;\"><span style=\"color: #756464;\">Evidence-based treatment<\/span><\/span><\/strong><\/h2>\n<p><span style=\"color: #756464;\"><span style=\"font-size: 15pt;\">The framework is a treatment ladder, and every level continues the one beneath it. Emollients never stop.<\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-10 vce-row-equal-height vce-row-content--top\" id=\"el-434d66e6\" data-vce-do-apply=\"all el-434d66e6\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-auto vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-99ad4372\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-99ad4372\" vce-box-shadow=\"el-99ad4372\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-99ad4372\"><div class=\"vce-text-block\"><div class=\"vce-text-block-wrapper vce\" id=\"el-0261f7a3\" data-vce-do-apply=\"all el-0261f7a3\"><div style=\"text-align: center;\" align=\"center\">\n<table style=\"border-collapse: collapse; width: 93%; margin-right: calc(7%); border: medium none currentcolor;\">\n<tbody>\n<tr>\n<td style=\"color: #efefef; background-color: #efefef; border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><span style=\"color: #756464; font-size: 16px;\"><strong><span style=\"font-family: 'Google Sans', sans-serif;\">Step<\/span><\/strong><\/span><\/td>\n<td style=\"color: #efefef; background-color: #efefef; border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px;\"><strong><span style=\"font-family: 'Google Sans', sans-serif;\">Treatment<\/span><\/strong><\/span><\/td>\n<td style=\"color: #efefef; background-color: #efefef; border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px;\"><strong><span style=\"font-family: 'Google Sans', sans-serif;\">Indication<\/span><\/strong><\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><a href=\"https:\/\/eczema.skinmedical.com.hk\/en\/evidence-based-treatment\/\" target=\"_blank\" rel=\"noopener\"><span style=\"color: #756464; font-size: 16px;\"><span style=\"font-family: 'Google Sans', sans-serif;\"><strong>Foundation<\/strong><\/span><\/span><\/a><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Emollients, bathing practice, trigger avoidance<\/span><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Everyone, always<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><a href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step1\/\" target=\"_blank\" rel=\"noopener\"><span style=\"color: #756464; font-size: 16px;\"><span style=\"font-family: 'Google Sans', sans-serif;\"><strong>Step 1<\/strong><\/span><\/span><\/a><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Topical corticosteroids; topical calcineurin inhibitors<\/span><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Mild-to-moderate; flare treatment<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><a href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step2\/\"><span style=\"color: #756464; font-size: 16px;\"><span style=\"font-family: 'Google Sans', sans-serif;\"><strong>Step 2<\/strong><\/span><\/span><\/a><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Proactive maintenance twice weekly; non-steroidal topicals (PDE4 inhibitors, topical JAK, tapinarof)<\/span><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Recurrent flares at the same sites<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><a href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step3\/\" target=\"_blank\" rel=\"noopener\"><span style=\"color: #756464; font-size: 16px;\"><span style=\"font-family: 'Google Sans', sans-serif;\"><strong>Step 3<\/strong><\/span><\/span><\/a><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\"><strong>Narrowband UVB phototherapy<\/strong><\/span><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Moderate disease inadequately controlled by topicals; useful steroid-sparing option<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><a href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step4\/\" target=\"_blank\" rel=\"noopener\"><span style=\"color: #756464; font-size: 16px;\"><span style=\"font-family: 'Google Sans', sans-serif;\"><strong>Step 4<\/strong><\/span><\/span><\/a><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Conventional systemics: ciclosporin, methotrexate, azathioprine, mycophenolate<\/span><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Moderate-to-severe<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 17.3819%;\"><a href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step5\/\" target=\"_blank\" rel=\"noopener\"><span style=\"color: #756464; font-size: 16px;\"><span style=\"font-family: 'Google Sans', sans-serif;\"><strong>Step 5<\/strong><\/span><\/span><\/a><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; width: 40.867%; text-align: center;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Biologics; oral JAK inhibitors<\/span><\/td>\n<td style=\"border: 0.75pt solid #c4c7c5; text-align: center; width: 41.7646%;\"><span style=\"color: #756464; font-size: 16px; font-family: 'Google Sans', sans-serif;\">Moderate-to-severe inadequately controlled by the above<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-10 vce-row-equal-height vce-row-content--top\" id=\"el-2588139a\" data-vce-do-apply=\"all el-2588139a\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-10p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-58ca2ef6\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-58ca2ef6\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-58ca2ef6\"><div class=\"vce-single-image-container vce-single-image--align-center\"><div class=\"vce vce-single-image-wrapper\" id=\"el-8c2a91c2\" data-vce-do-apply=\"all el-8c2a91c2\"><figure><div class=\"vce-single-image-figure-inner\" style=\"width: 100px;\"><div class=\"vce-single-image-inner vce-single-image--absolute\" style=\"width: 100%; padding-bottom: 100%;\"><img decoding=\"async\" class=\"vce-single-image\" src=\"https:\/\/eczema.skinmedical.com.hk\/wp-content\/uploads\/2026\/08\/eczema_icon_step2.png\" data-img-src=\"https:\/\/eczema.skinmedical.com.hk\/wp-content\/uploads\/2026\/08\/eczema_icon_step2.png\" data-attachment-id=\"705\" alt=\"\u6fd5\u75b9 \u6cbb\u7642 \u9999\u6e2f\" title=\"eczema_icon_step2\"><\/div><\/div><figcaption hidden=\"\"><\/figcaption><\/figure><\/div><\/div><\/div><\/div><\/div><div class=\"vce-col vce-col--md-90p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last\" id=\"el-8c144a01\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-8c144a01\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-8c144a01\"><div class=\"vce-text-block\"><div class=\"vce-text-block-wrapper vce\" id=\"el-94f4cda8\" data-vce-do-apply=\"all el-94f4cda8\"><h2><span style=\"color: #756464;\">Step 2: Proactive maintenance <span style=\"font-size: 16pt;\">(the step most often skipped)<\/span><\/span><\/h2><\/div><\/div><div class=\"vce-text-block\"><div class=\"vce-text-block-wrapper vce\" id=\"el-7f3d5de7\" data-vce-do-apply=\"all el-7f3d5de7\"><p><span style=\"color: #756464;\">This is the difference between eczema that recurs every few weeks and eczema that stays quiet.<\/span><\/p><p><span style=\"color: #756464;\"><br><span style=\"color: #756464;\">Once a flare has cleared, apply a topical anti-inflammatory -&nbsp; a calcineurin inhibitor or an appropriate-potency steroid -<strong> twice weekly to the sites that usually flare<\/strong>, even though the skin looks normal. Continue emollients daily everywhere.<\/span><\/span><\/p><p><span style=\"color: #756464;\"><span style=\"color: #756464;\"><br><span style=\"color: #756464;\">Randomised evidence shows this roughly halves the flare rate and substantially extends the time between flares, while using less total steroid than repeatedly treating flares reactively. Most patients are never told to do it.<br><\/span><\/span><\/span><\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-10 vce-row-equal-height vce-row-content--top\" id=\"el-27ea57a3\" data-vce-do-apply=\"all el-27ea57a3\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-auto vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-168ef6a7\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-168ef6a7\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-168ef6a7\"><div class=\"vce-text-block\"><div class=\"vce-text-block-wrapper vce\" id=\"el-f16edc80\" data-vce-do-apply=\"all el-f16edc80\"><p><span style=\"color: #756464;\"><strong>On steroid phobia, plainly<\/strong>. Fear of topical steroids is the most common reason atopic dermatitis remains uncontrolled, and it is particularly prevalent among Chinese patients and parents. The concern is understandable but disproportionate. Skin thinning occurs with prolonged use of potent steroids on delicate sites, not with appropriate, targeted courses. Meanwhile, undertreated eczema causes real harm: sleep loss, infection, thickened skin, and lasting pigmentation. The correct approach is not avoidance but appropriate use \u2014 the right potency, on the right site, for long enough, followed by a maintenance plan.<\/span><\/p><p><span style=\"color: #756464;\"><br><span style=\"color: #756464;\"><strong>Topical steroid withdrawal<\/strong>, widely discussed online, is a recognised but uncommon phenomenon associated with prolonged high-potency use, especially on the face. It is not a reason to avoid appropriate treatment, and any patient worried about it should discuss it rather than simply stopping.<\/span><\/span><\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-10 vce-row-equal-height vce-row-content--top\" id=\"el-df5139e0\" data-vce-do-apply=\"all el-df5139e0\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-auto vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-b0f02020\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-b0f02020\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-b0f02020\"><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-30 vce-row-content--top\" id=\"el-426b32f3\" data-vce-do-apply=\"all el-426b32f3\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-20p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-01b0780a\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-01b0780a\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-01b0780a\"><div class=\"vce-features vce-var-icon vce-features--style-filled-circle vce-features--size-small\" style=\"--iconAlignment: center; --iconColor: rgb(255, 255, 255); --iconColorHover: #fff; --shapeColor: rgb(175, 163, 150); --shapeColorHover: rgb(218, 218, 218); --linkColorHover: rgb(157,146,134);\"><div id=\"el-6793d838\" class=\"vce vce-features-icon-wrapper\" data-vce-do-apply=\"all el-6793d838\"><a class=\"vce-features--icon vce-icon\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step1\/\" title=\"\u7b2c\u4e00\u7d1a: \u5916\u7528\u6297\u708e\u6cbb\u7642\" target=\"_blank\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 769 769\"><path stroke-width=\"25\" d=\"M565.755 696.27h-360l-180-311.77 180-311.77h360l180 311.77z\"><\/path><\/svg><span class=\"vce-icon-container vcv-ui-icon-dripicons vcv-ui-icon-dripicons-brush\"><\/span><\/a><\/div><\/div><div class=\"vce-google-fonts-heading vce-google-fonts-heading--align-center vce-google-fonts-heading--color-b-62-61-61--45--5C00FF--FF7200 vce-google-fonts-heading--font-family-Sanchez\"><div id=\"el-544d6e35\" class=\"vce-google-fonts-heading-wrapper\"><div class=\"vce-google-fonts-heading--background vce\" data-vce-do-apply=\"border background  padding margin el-544d6e35\"><h2 class=\"vce-google-fonts-heading-inner\" style=\"font-size: 20px; letter-spacing: 2px; font-weight: 400; font-style: normal;\"><a class=\"vce-google-fonts-heading-link\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step1\/\" title=\"Step 1: Topical anti-inflammatory treatment\" target=\"_blank\">Step 1: Topical anti-inflammatory treatment<\/a><\/h2><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-col vce-col--md-20p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first\" id=\"el-6114e512\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-6114e512\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-6114e512\"><div class=\"vce-features vce-var-icon vce-features--style-filled-circle vce-features--size-small\" style=\"--iconAlignment: center; --iconColor: rgb(255, 255, 255); --iconColorHover: #fff; --shapeColor: rgb(175, 163, 150); --shapeColorHover: rgb(218, 218, 218); --linkColorHover: rgb(157,146,134);\"><div id=\"el-00cfab29\" class=\"vce vce-features-icon-wrapper\" data-vce-do-apply=\"all el-00cfab29\"><a class=\"vce-features--icon vce-icon\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step2\/\" title=\"\u7b2c\u4e8c\u7d1a: \u4e3b\u52d5\u7dad\u6301\u6cbb\u7642\" target=\"_blank\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 769 769\"><path stroke-width=\"25\" d=\"M565.755 696.27h-360l-180-311.77 180-311.77h360l180 311.77z\"><\/path><\/svg><span class=\"vce-icon-container vcv-ui-icon-batch vcv-ui-icon-batch-plus\"><\/span><\/a><\/div><\/div><div class=\"vce-google-fonts-heading vce-google-fonts-heading--align-center vce-google-fonts-heading--color-b-62-61-61--45--5C00FF--FF7200 vce-google-fonts-heading--font-family-Sanchez\"><div id=\"el-d2f5223b\" class=\"vce-google-fonts-heading-wrapper\"><div class=\"vce-google-fonts-heading--background vce\" data-vce-do-apply=\"border background  padding margin el-d2f5223b\"><h2 class=\"vce-google-fonts-heading-inner\" style=\"font-size: 20px; letter-spacing: 2px; font-weight: 400; font-style: normal;\"><a class=\"vce-google-fonts-heading-link\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step2\/\" title=\"Step 2: Proactive maintenance \" target=\"_blank\">Step 2: Proactive maintenance <\/a><\/h2><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-col vce-col--md-20p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first\" id=\"el-0b7fd39c\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-0b7fd39c\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-0b7fd39c\"><div class=\"vce-features vce-var-icon vce-features--style-filled-circle vce-features--size-small\" style=\"--iconAlignment: center; --iconColor: rgb(255, 255, 255); --iconColorHover: #fff; --shapeColor: rgb(175, 163, 150); --shapeColorHover: rgb(237, 237, 237); --linkColorHover: rgb(157,146,134);\"><div id=\"el-f0d5b737\" class=\"vce vce-features-icon-wrapper\" data-vce-do-apply=\"all el-f0d5b737\"><a class=\"vce-features--icon vce-icon\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step3\/\" title=\"\u7b2c\u4e09\u7d1a: \u7a84\u983b NB-UVB \u5149\u7642\" target=\"_blank\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 769 769\"><path stroke-width=\"25\" d=\"M565.755 696.27h-360l-180-311.77 180-311.77h360l180 311.77z\"><\/path><\/svg><span class=\"vce-icon-container vcv-ui-icon-dripicons vcv-ui-icon-dripicons-vibrate\"><\/span><\/a><\/div><\/div><div class=\"vce-google-fonts-heading vce-google-fonts-heading--align-center vce-google-fonts-heading--color-b-62-61-61--45--5C00FF--FF7200 vce-google-fonts-heading--font-family-Sanchez\"><div id=\"el-280d7516\" class=\"vce-google-fonts-heading-wrapper\"><div class=\"vce-google-fonts-heading--background vce\" data-vce-do-apply=\"border background  padding margin el-280d7516\"><h2 class=\"vce-google-fonts-heading-inner\" style=\"font-size: 20px; letter-spacing: 2px; font-weight: 400; font-style: normal;\"><a class=\"vce-google-fonts-heading-link\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step3\/\" title=\"Step 3: NB-UVB Phototherapy\" target=\"_blank\">Step 3: NB-UVB Phototherapy<\/a><\/h2><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-col vce-col--md-20p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first\" id=\"el-744660a3\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-744660a3\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-744660a3\"><div class=\"vce-features vce-var-icon vce-features--style-filled-circle vce-features--size-small\" style=\"--iconAlignment: center; --iconColor: rgb(255, 255, 255); --iconColorHover: #fff; --shapeColor: rgb(175, 163, 150); --shapeColorHover: rgb(237, 237, 237); --linkColorHover: rgb(157,146,134);\"><div id=\"el-b106ead4\" class=\"vce vce-features-icon-wrapper\" data-vce-do-apply=\"all el-b106ead4\"><a class=\"vce-features--icon vce-icon\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step4\/\" title=\"\u7b2c\u56db\u7d1a: \u50b3\u7d71\u7cfb\u7d71\u6027\u6cbb\u7642\" target=\"_blank\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 769 769\"><path stroke-width=\"25\" d=\"M565.755 696.27h-360l-180-311.77 180-311.77h360l180 311.77z\"><\/path><\/svg><span class=\"vce-icon-container vcv-ui-icon-mfglabs vcv-ui-icon-mfglabs-link\"><\/span><\/a><\/div><\/div><div class=\"vce-google-fonts-heading vce-google-fonts-heading--align-center vce-google-fonts-heading--color-b-62-61-61--45--5C00FF--FF7200 vce-google-fonts-heading--font-family-Sanchez\"><div id=\"el-bc532a45\" class=\"vce-google-fonts-heading-wrapper\"><div class=\"vce-google-fonts-heading--background vce\" data-vce-do-apply=\"border background  padding margin el-bc532a45\"><h2 class=\"vce-google-fonts-heading-inner\" style=\"font-size: 20px; letter-spacing: 2px; font-weight: 400; font-style: normal;\"><a class=\"vce-google-fonts-heading-link\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step4\/\" title=\"Step 4: Conventional systemic treatment\" target=\"_blank\">Step 4: Conventional systemic treatment<\/a><\/h2><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-col vce-col--md-20p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last\" id=\"el-b8a2cc3b\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-b8a2cc3b\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-b8a2cc3b\"><div class=\"vce-features vce-var-icon vce-features--style-filled-circle vce-features--size-small\" style=\"--iconAlignment: center; --iconColor: rgb(255, 255, 255); --iconColorHover: #fff; --shapeColor: rgb(175, 163, 150); --shapeColorHover: rgb(237, 237, 237); --linkColorHover: rgb(157,146,134);\"><div id=\"el-fab22dc1\" class=\"vce vce-features-icon-wrapper\" data-vce-do-apply=\"all el-fab22dc1\"><a class=\"vce-features--icon vce-icon\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step5\/\" title=\"\u7b2c\u4e94\u7d1a: \u751f\u7269\u88fd\u5291\u8207\u53e3\u670d JAK \u6291\u5236\u5291\" target=\"_blank\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 769 769\"><path stroke-width=\"25\" d=\"M565.755 696.27h-360l-180-311.77 180-311.77h360l180 311.77z\"><\/path><\/svg><span class=\"vce-icon-container vcv-ui-icon-dripicons vcv-ui-icon-dripicons-pulse\"><\/span><\/a><\/div><\/div><div class=\"vce-google-fonts-heading vce-google-fonts-heading--align-center vce-google-fonts-heading--color-b-62-61-61--45--5C00FF--FF7200 vce-google-fonts-heading--font-family-Sanchez\"><div id=\"el-a084e1d7\" class=\"vce-google-fonts-heading-wrapper\"><div class=\"vce-google-fonts-heading--background vce\" data-vce-do-apply=\"border background  padding margin el-a084e1d7\"><h2 class=\"vce-google-fonts-heading-inner\" style=\"font-size: 20px; letter-spacing: 2px; font-weight: 400; font-style: normal;\"><a class=\"vce-google-fonts-heading-link\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step5\/\" title=\"Step 5: Biologics and oral JAK inhibitors\" target=\"_blank\">Step 5: Biologics and oral JAK inhibitors<\/a><\/h2><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vce-row-container\" data-vce-boxed-width=\"true\"><div class=\"vce-row vce-row--col-gap-30 vce-row-equal-height vce-row-content--top\" id=\"el-5ad9753f\" data-vce-do-apply=\"all el-5ad9753f\"><div class=\"vce-content-background-container\"><\/div><div class=\"vce-row-content\" data-vce-element-content=\"true\"><div class=\"vce-col vce-col--md-auto vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last vce-col--md-first vce-col--lg-first vce-col--xl-first\" id=\"el-fd3a422a\"><div class=\"vce-col-inner\" data-vce-do-apply=\"border margin background  el-fd3a422a\"><div class=\"vce-col-content\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding el-fd3a422a\"><div class=\"vce-text-block\"><div class=\"vce-text-block-wrapper vce\" id=\"el-43bc31bf\" data-vce-do-apply=\"all el-43bc31bf\"><p><span style=\"color: #756464; font-size: 12pt;\">Reference:<\/span><\/p>\n<ol>\n \t<span style=\"color: #756464; font-size: 12pt;\">\n<li><span style=\"color: #756464; font-size: 12pt;\">Davis DMR, Drucker AM, Alikhan A, et al. AAD guidelines of care for the management of atopic dermatitis in adults with topical therapies. J Am Acad Dermatol. 2023.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Sidbury R, Alikhan A, Bercovitch L, et al. AAD guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies. J Am Acad Dermatol. 2023.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Guidelines Development Panel of the Hong Kong College of Paediatricians. Management of Atopic Dermatitis in Children: 2020 Review. HK J Paediatr. 2021;26:42-57. \u2014 the key local reference; cite this prominently.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Wollenberg A, Kinberger M, Arents B, et al. EuroGuiDerm guideline on atopic eczema. J Eur Acad Dermatol Venereol. (most recent update).<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">National Institute for Health and Care Excellence. Atopic eczema in under 12s: diagnosis and management. CG57.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Leung R, Wong G, Lau J, et al. Prevalence of asthma and allergy in Hong Kong schoolchildren: an ISAAC study. Eur Respir J 1997.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Childhood Wheeze, Allergic Rhinitis, and Eczema in Hong Kong: ISAAC Study from 1995 to 2015. \u2014 source of the 21-year local trend data.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology 1993;186:23-31.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Efficacy and Safety of Lebrikizumab in Combination With Topical Corticosteroids in Adolescents and Adults With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial (ADhere). JAMA Dermatol.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">ARCADIA 1 and ARCADIA 2 \u2014 two identically designed pivotal phase III trials enrolling more than 1,700 patients, evaluating nemolizumab administered subcutaneously every four weeks versus placebo with background topical corticosteroids.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Sanofi. Press release: decision not to submit amlitelimab in atopic dermatitis for global regulatory reviews. Paris, 24 July 2026.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Simpson EL, Bieber T, Guttman-Yassky E, et al. Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis (SOLO 1 and SOLO 2). N Engl J Med. 2016.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Chalmers JR, et al. BEEP trial: daily emollient during the first year of life for preventing atopic dermatitis. Lancet. 2020. \u2014 the negative prevention trial cited in the article.<\/span><\/li>\n<li><span style=\"color: #756464; font-size: 12pt;\">Hong Kong Drug Office, Department of Health \u2014 verify local registration status of every systemic agent named.<\/span><\/li>\n<\/span><\/ol>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Evidence-based treatment The framework is a treatment ladder, and every level continues the one beneath it. Emollients never stop. Step Treatment Indication Foundation Emollients, bathing practice, trigger avoidance Everyone, always Step 1 Topical corticosteroids; topical calcineurin inhibitors Mild-to-moderate; flare treatment Step 2 Proactive maintenance twice weekly; non-steroidal topicals (PDE4 inhibitors, topical JAK, tapinarof) Recurrent flares&hellip; <a class=\"more-link\" href=\"https:\/\/eczema.skinmedical.com.hk\/en\/treatment-step2\/\">Continue reading <span class=\"screen-reader-text\">Step 2: Proactive maintenance<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-875","page","type-page","status-publish","hentry","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Step 2: Proactive maintenance<\/title>\n<meta name=\"description\" content=\"This is the 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