Pearls in Mitigating Application Pain of Topical Nonsteroidal Agents

Steven Madsen; Kyla N. Price; Vivian Y. Shi; Peter A. Lio

doi:10.1159/000508771

Pearls in Mitigating Application Pain of Topical Nonsteroidal Agents

Steven Madsen, Kyla N. Price, Vivian Y. Shi, Peter A. Lio^*

^*Corresponding author for this work

Dermatology

Research output: Contribution to journal › Review article › peer-review

5 Scopus citations

Abstract

Background: Topical steroid-sparing agents (SSA), such as tacrolimus, pimecrolimus, and crisaborole, represent an important therapeutic option in the treatment of inflammatory dermatoses such as atopic dermatitis. While these agents lack the common side effects associated with topical corticosteroids, they all share application site pain as an important adverse effect. Summary: Based on the available evidence and our experience, we suggest the following 7 practical strategies for decreasing the pain associated with SSA use. (1) Use a topical corticosteroid for a few days to reduce inflammation before starting the SSA treatment. (2) Use SSAs strategically. (3) Apply moisturizer before applying SSAs. (4) Store moisturizers in the refrigerator. (5) Ask the patient to apply the SSA on a small test area before broader application. (6) Apply the SSA on dry rather than on damp skin. (7) Consider using aspirin when appropriate for the patient.

Original language	English (US)
Pages (from-to)	477-480
Number of pages	4
Journal	Dermatology
Volume	236
Issue number	5
DOIs	https://doi.org/10.1159/000508771
State	Published - Sep 1 2020

Funding

P.A.L. reports research grants/funding from the National Eczema Association, Regeneron/Sanofi Genzyme, and AbbVie; is on the speaker’s bureau for Regeneron/Sanofi Genzyme, Pfizer, and L’Oreal; and reports consulting/advisory boards for UCB, Der-mavant, Regeneron/Sanofi Genzyme, Dermira, Pfizer, LEO Pharmaceuticals, AbbVie, Kiniksa, Eli Lilly, Micreos, La Roche Po-say/L’Oreal, Pierre-Fabre, Johnson & Johnson, Unilever, Menlo Therapeutics, Theraplex, IntraDerm, Exeltis, AOBiome, Realm Therapeutics, Franklin Bioscience/Altus Labs, Verrica, TopMD, Arbonne, Amyris, and Burt’s Bees. V.Y.S. is a stock shareholder of Learn Health, and has served as an advisory board member, investigator, and/or received research funding from Sanofi Genzyme/ Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Menlo Therapeutics, Burt’s Bees, GpSkin, the National Eczema Association, Global Parents for Eczema Research, the Foundation for Atopic Dermatitis, and Skin Actives Scientific. There were no incentives or transactions, financial or otherwise, relevant to this manuscript. S.M. and K.N.P. have no conflicts of interest to declare.

Keywords

Inflammatory dermatoses
Pain
Topical nonsteroidal agents

ASJC Scopus subject areas

Dermatology

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10.1159/000508771

Cite this

@article{2e475f66729445a680ce79c4f5c5ea1e,

title = "Pearls in Mitigating Application Pain of Topical Nonsteroidal Agents",

abstract = "Background: Topical steroid-sparing agents (SSA), such as tacrolimus, pimecrolimus, and crisaborole, represent an important therapeutic option in the treatment of inflammatory dermatoses such as atopic dermatitis. While these agents lack the common side effects associated with topical corticosteroids, they all share application site pain as an important adverse effect. Summary: Based on the available evidence and our experience, we suggest the following 7 practical strategies for decreasing the pain associated with SSA use. (1) Use a topical corticosteroid for a few days to reduce inflammation before starting the SSA treatment. (2) Use SSAs strategically. (3) Apply moisturizer before applying SSAs. (4) Store moisturizers in the refrigerator. (5) Ask the patient to apply the SSA on a small test area before broader application. (6) Apply the SSA on dry rather than on damp skin. (7) Consider using aspirin when appropriate for the patient. ",

keywords = "Inflammatory dermatoses, Pain, Topical nonsteroidal agents",

author = "Steven Madsen and Price, {Kyla N.} and Shi, {Vivian Y.} and Lio, {Peter A.}",

note = "Funding Information: P.A.L. reports research grants/funding from the National Eczema Association, Regeneron/Sanofi Genzyme, and AbbVie; is on the speaker{\textquoteright}s bureau for Regeneron/Sanofi Genzyme, Pfizer, and L{\textquoteright}Oreal; and reports consulting/advisory boards for UCB, Der-mavant, Regeneron/Sanofi Genzyme, Dermira, Pfizer, LEO Pharmaceuticals, AbbVie, Kiniksa, Eli Lilly, Micreos, La Roche Po-say/L{\textquoteright}Oreal, Pierre-Fabre, Johnson & Johnson, Unilever, Menlo Therapeutics, Theraplex, IntraDerm, Exeltis, AOBiome, Realm Therapeutics, Franklin Bioscience/Altus Labs, Verrica, TopMD, Arbonne, Amyris, and Burt{\textquoteright}s Bees. V.Y.S. is a stock shareholder of Learn Health, and has served as an advisory board member, investigator, and/or received research funding from Sanofi Genzyme/ Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Menlo Therapeutics, Burt{\textquoteright}s Bees, GpSkin, the National Eczema Association, Global Parents for Eczema Research, the Foundation for Atopic Dermatitis, and Skin Actives Scientific. There were no incentives or transactions, financial or otherwise, relevant to this manuscript. S.M. and K.N.P. have no conflicts of interest to declare. Publisher Copyright: {\textcopyright} 2019 S. Karger AG, Basel. Copyright: All rights reserved.",

year = "2020",

month = sep,

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doi = "10.1159/000508771",

language = "English (US)",

volume = "236",

pages = "477--480",

journal = "Dermatology",

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T1 - Pearls in Mitigating Application Pain of Topical Nonsteroidal Agents

AU - Madsen, Steven

AU - Price, Kyla N.

AU - Shi, Vivian Y.

AU - Lio, Peter A.

N1 - Funding Information: P.A.L. reports research grants/funding from the National Eczema Association, Regeneron/Sanofi Genzyme, and AbbVie; is on the speaker’s bureau for Regeneron/Sanofi Genzyme, Pfizer, and L’Oreal; and reports consulting/advisory boards for UCB, Der-mavant, Regeneron/Sanofi Genzyme, Dermira, Pfizer, LEO Pharmaceuticals, AbbVie, Kiniksa, Eli Lilly, Micreos, La Roche Po-say/L’Oreal, Pierre-Fabre, Johnson & Johnson, Unilever, Menlo Therapeutics, Theraplex, IntraDerm, Exeltis, AOBiome, Realm Therapeutics, Franklin Bioscience/Altus Labs, Verrica, TopMD, Arbonne, Amyris, and Burt’s Bees. V.Y.S. is a stock shareholder of Learn Health, and has served as an advisory board member, investigator, and/or received research funding from Sanofi Genzyme/ Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Menlo Therapeutics, Burt’s Bees, GpSkin, the National Eczema Association, Global Parents for Eczema Research, the Foundation for Atopic Dermatitis, and Skin Actives Scientific. There were no incentives or transactions, financial or otherwise, relevant to this manuscript. S.M. and K.N.P. have no conflicts of interest to declare. Publisher Copyright: © 2019 S. Karger AG, Basel. Copyright: All rights reserved.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: Topical steroid-sparing agents (SSA), such as tacrolimus, pimecrolimus, and crisaborole, represent an important therapeutic option in the treatment of inflammatory dermatoses such as atopic dermatitis. While these agents lack the common side effects associated with topical corticosteroids, they all share application site pain as an important adverse effect. Summary: Based on the available evidence and our experience, we suggest the following 7 practical strategies for decreasing the pain associated with SSA use. (1) Use a topical corticosteroid for a few days to reduce inflammation before starting the SSA treatment. (2) Use SSAs strategically. (3) Apply moisturizer before applying SSAs. (4) Store moisturizers in the refrigerator. (5) Ask the patient to apply the SSA on a small test area before broader application. (6) Apply the SSA on dry rather than on damp skin. (7) Consider using aspirin when appropriate for the patient.

AB - Background: Topical steroid-sparing agents (SSA), such as tacrolimus, pimecrolimus, and crisaborole, represent an important therapeutic option in the treatment of inflammatory dermatoses such as atopic dermatitis. While these agents lack the common side effects associated with topical corticosteroids, they all share application site pain as an important adverse effect. Summary: Based on the available evidence and our experience, we suggest the following 7 practical strategies for decreasing the pain associated with SSA use. (1) Use a topical corticosteroid for a few days to reduce inflammation before starting the SSA treatment. (2) Use SSAs strategically. (3) Apply moisturizer before applying SSAs. (4) Store moisturizers in the refrigerator. (5) Ask the patient to apply the SSA on a small test area before broader application. (6) Apply the SSA on dry rather than on damp skin. (7) Consider using aspirin when appropriate for the patient.

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KW - Pain

KW - Topical nonsteroidal agents

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JF - Dermatology

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ER -

Pearls in Mitigating Application Pain of Topical Nonsteroidal Agents

Abstract

Funding

Keywords

ASJC Scopus subject areas

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