Peter Lio, MD 

Discussing Current Treatment Options for Atopic Dermatitis, With Peter Lio, MD

 interview, Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine, spoke about the rapid and recent evolution of atopic dermatitis therapy options following his session presentation at the 

Revolutionizing Atopic Dermatitis (RAD) Conference

In this presentation, he and his fellow panelists highlighted both the growing number of therapeutics available as well as the increasingly personalized approach to patient care. In his discussion with 

, Lio pointed to the modern eczema treatment landscape as one of the most exciting periods in atopic dermatitis management.

“I am a big nerd for topical therapy, and I'm just so grateful that we have so many wonderful new non-steroidal options, many of which are now approved down to age two,” Lio said.

With several treatments US Food and Drug Administration (FDA)-approved for children as young as 2 years of age, Lio believes clinicians have more opportunities to manage this condition while reducing reliance on topical corticosteroids. Although he stressed that steroids remain an important component of treatment, he added that the availability of effective non-steroidal alternatives allows providers to implement such treatments more strategically.

In his interview, Lio also reflected on the transformative impact of newer systemic drugs. Having practiced through an era when many individuals living with moderate-to-severe disease had limited options for therapy, he described the current moment as a dramatic shift in care. According to Lio, therapies that were unavailable just a few years ago are now helping patients achieve levels of disease control that previously seemed unattainable, fundamentally changing expectations for long-term outcomes.

In his look ahead, Lio expressed notable interest in the growing body of literature around addressing patients’ skin microbiome. He described microbiome-targeted medications as being a promising frontier in the atopic dermatitis management space, pointing to emerging approaches such as selective antimicrobial sprays. He also noted topical probiotics and prebiotic interventions as potential supporters to a healthy microbial balance.

Disclosures: Relevant disclosures for Lio include AbbVie, Almirall, Arbonne, ASLAN Pharmaceuticals, Dermavant, Eli Lilly and Company, Galderma, Johnson & Johnson, L’Oreal, LEO Pharma, Pfizer, Regeneron/Sanofi Genzyme and others.

Lio P, Eichenfield L. Session 8: Anticipated Updates in Pediatric AD Guidelines (AAD 2026 Release). Session presented at: 2026 Revolutionizing Atopic Dermatitis Conference; June 17-19, 2026; Nashville, TN.

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This segment of Lio's RAD Conference interview in Nashville highlights the growing number of therapeutics and an increasingly personalized approach.

Upcoming AAD Pediatric Guidelines and Tips for Kids in Dermatology, With Peter Lio, MD

New AAD Pediatric Guidelines and Tips for Kids in Dermatology, With Peter Lio, MD

’s editorial team spoke on-site with Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine, following his session presented at the 

Revolutionizing Atopic Dermatitis (RAD) Conference 2026

Lio, whose presentation focused on the development of pediatric-specific guidance and the considerations that distinguish care of younger patients from the treatment of adults with atopic dermatitis, highlighted the unique challenges of managing atopic dermatitis in children.

“We are lucky that we have had some really great guideline updates in the last couple of years, and then some even further updates in the adult guidelines just in the last year, because things are moving so quickly,” Lio said. “But there's a gap, because they often do not really focus on pediatrics, and that's important because the rules do not always apply equally.”

 interview, Lio noted that the rapid evolution of the atopic dermatitis treatment landscape has led to several important guideline updates. He emphasized the lack of current recommendations centered on non-adult populations, noting the need for tailored guidance specifically for pediatric patients. A major theme of Lio’s discussion was the long-term perspective required when treating children with atopic dermatitis. Unlike adult patients, families of young children often have questions about how long treatment may be needed and what long-term implications systemic therapies could carry.

Additionally, concerns related to development, growth, school performance, and potential adverse effects commonly represent a notable concern in treatment discussions. Due to this fact, he believes clinicians in dermatology must be prepared to address not only the immediate benefits and risks of medications and management strategies but also broader questions about the future course of therapy.

Lio also highlighted the importance of shared decision-making in pediatric dermatology, noting caring for children with atopic dermatitis can often be a balancing act involving everyone, including patients and their caregivers. Even very young children may have strong views related to treatment preferences, particularly when it comes to injections, topicals, or general drug tolerability. Parents can also diverge on their views regarding the same topics.

Lio highlighted his own view suggesting the successful management of one’s disease often depends on the use of a collaborative approach designed to keepsthe child’s well-being at the center of decision-making. Open communication and help to families navigating questions surrounding safety, efficacy, and long-term care, was described as key for clinicians. They can build trust and improve treatment adherence.

Peter Lio, MD, spoke at the RAD 2026 conference about the upcoming AAD pediatric guidelines for atopic dermatitis.

How Online-Informed Patients Are Changing Dermatology Visits

In recent years, the rise of the “online-informed” patient has transformed visits to 

 practices, with clinicians increasingly encountering patients who greet them armed with TikTok skincare advice, Reddit-informed treatment data, AI-generated differential diagnoses, and screenshots from ChatGPT inquiries. In this feature, interviews between 4 leaders in dermatology and 

highlight this trend as being simultaneously empowering to patients and potentially hazardous.

David Cotter, MD, PhD, assistant clinical professor at the University of Nevada, spoke with 

 in 1 such interview, describing the phenomenon as a double-edged sword. Cotter noted digitally informed individuals often arrive more prepared to discuss disease states and treatment options. He described access to online tools as encouraging earlier intervention, particularly for conditions such as skin cancer or acne, where delays in care may hurt patient outcomes. Cotter pointed to teledermatology and online educational content as especially valuable among those without access to specialists.

However, Cotter also warned against inaccurate online information, noting its ability to lead patients astray, particularly when individuals rely on unverified influencers or AI tools lacking training. He described seeing patients delay appropriate care following treating autoimmune skin disease as fungal infections based on online recommendations. Cotter also raised concerns over increasingly aggressive self-treatment trends, ranging from excessive tween skincare routines involving multiple active ingredients to do-it-yourself cosmetic filler injections promoted on social media platforms and Reddit forums. In Cotter’s view, dermatologists must lean into the digital era by understanding the online content patients consume.

Raj Chovatiya, MD, PhD, clinical associate professor of medicine at Rosalind Franklin University Chicago Medical School and founder and director of the Center for Medical Dermatology + Immunology Research in Chicago, Illinois, similarly highlighted online self-education as an inevitable development, noting the widespread availability of search engines and large language models (LLMs) making patient self-research a permanent fixture. Chovatiya noted these tools may help patients recognize symptoms and connect with appropriate specialists, but only when they understand their limitations.

Chovatiya described dermatology’s visual nature as amplifying the impact of social media, especially for stigmatized diseases such as hidradenitis suppurativa (HS). He did acknowledge online communities can reduce shame and encourage earlier care-seeking, though they may also expose patients primarily to severe disease presentations that generate unnecessary fear. Chovatiya recalled a patient of his who extensively self-treated what she believed were refractory warts after consulting AI tools, only to later discover she had chronic inflammatory eczema. By the time she presented to clinic, her skin barrier had been significantly damaged by chemical peels and other at-home interventions.

Kathryn Celeste Durham, MD, a board-certified dermatologist practicing in Fort Worth, Texas, at US Dermatology Partners, echoed that ambivalence. With 20 years of clinical experience, Durham said patient self-education is broadly positive, as she values patients feeling empowered and informed about their conditions, but described mounting frustration when AI tools generate diagnoses that contradict her own clinical assessment.

Durham identified skin cancer as the area of greatest concern, explaining that diagnosing lesions involves far more than visual pattern recognition. Texture, feel, history, and chronology all factor into clinical judgment in ways that images and symptom checkers cannot replicate. She described seborrheic keratoses as a frequent driver of patient anxiety amplified by online searches, where broad symptom matching commonly steers individuals toward worst-case conclusions. She also described some patients’ resistance to standard surgical treatment for confirmed cancers in favor of holistic alternatives discovered online.

Durham pointed to perioficial dermatitis as a case study in how well-intentioned self-research can worsen outcomes. Because the condition can resemble both acne and eczema at different stages, patients frequently self-treat with topical steroids sourced from prior prescriptions or online recommendations, an approach potentially exacerbating the condition and complicating clinical management.

On the positive end, Durham described a significant rise in numbers of patients with acne who arrive already familiar with such products as retinoids and tretinoin, a development she attributed largely to online skincare communities. Durham also said targeted digital advertising has meaningfully expanded awareness of biologic treatments for psoriasis and other conditions, particularly among younger patients who do not engage with traditional broadcast media. She noted that growing disease awareness has translated into more patients actively seeking diagnoses and treatment.

When patients arrive with social media screenshots or online forum discussions, Durham urged acknowledgment over dismissal, suggesting the need for clinicians to validate patients’ attempts to engage with their own care before gently redirecting toward a more accurate diagnosis or treatment plan.

Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, described the current AI era as a significant acceleration of the patient self-research trend that began with widespread internet access. While he acknowledged AI systems can produce misinformation and occasionally dangerous confabulations, Lio noted his own cautious optimism as that patients are arriving more educated and engaged.

Lio additionally argued against clinicians feeling threatened by informed patients, framing education in this or any manner as central to medical care rather than a challenge to clinical authority. In his practice, he welcomes patients who bring in influencer videos, research papers, or chatbot outputs, as these materials allow for higher-level conversations earlier in the treatment process. He cautioned, however, that oversimplified online narratives can create unrealistic expectations.

Durham expressed cautious optimism about the trajectory of AI-assisted patient research, noting tools like ChatGPT, when implemented appropriately, can provide a useful on-ramp to professional care. On the inquiry of whether cliniciasns should build their own digital presence to counter unverified health content, Durham acknowledged the growing necessity while flagging its issues. She framed the challenge as a matter of balance: dermatologists need a presence in the digital space where their patients are increasingly turning for health information, but the profession’s primary obligation remains availability and care in the clinic.

Overall, the experts painted a complicated picture of the benefits and drawbacks of the online-informed patient. The 4 leaders in the field made their views regarding better-informed questions and increased access clear, along with their opinions of the potential negative aspects of misinformation and delayed diagnoses. Their statements help to paint a picture of the cross-section of the clinician viewpoints surrounding the ubiquity of access to information through Internet and AI use.

Chovatiya, Lio, Durham, and Cotter had no relevant disclosures of note.

Livingston R. AI Tools Improve Patient Knowledge of and Confidence in Optometric Information. HCPLive. June 26, 2025. Accessed May 18, 2026. 

https://www.hcplive.com/view/ai-tools-improve-patient-knowledge-of-and-confidence-in-optometric-information

Sayres R and Liu Y. Patient Awareness of Dermatologic Conditions Using AI, With Rory Sayres, PhD, and Yun Liu, PhD. HCPLive. April 23, 2026. Accessed May 18, 2026. 

https://www.hcplive.com/view/patient-awareness-dermatologic-conditions-using-ai-rory-sayres-phd-yun-liu-phd

Stein Gold L, Zirwas M, Lio P, et al. Assessing Severity of Atopic Dermatitis. HCPLive. April 30, 2023. Accessed May 18, 2026. 

https://www.hcplive.com/view/assessing-severity-of-atopic-dermatitis

As dermatology patients enter clinical visits with information from social media, online forums, and AI inquiries, clinicians are juggling new concerns.

Topical Steroid Withdrawal: Inside the Controversy Over TSW in Dermatology

Topical steroid withdrawal (TSW) is a controversial topic in the field of 

, precisely because it exposes the fault lines between patient experience and clinical consensus. Long discussed in patient communities found online, a wider acknowledgement of TSW has largely remained unseen.

TSW is often a contested diagnosis, recognized by some dermatologists as a distinct entity but dismissed by others as simply a severe or undertreated atopic dermatitis flare. Many patients who have recognized a distinction between a typical flare and a result of withdrawal from topical corticosteroids have highlighted distinct symptoms of this condition, including what is commonly referred to as ‘elephant skin.’

Additional features may be present, including sharp, “sleeve-like” demarcations at wrists and ankles, temperature dysregulation, chronic exfoliation, and neuropathic sensations described among patients reporting TSW may raise red flags for clinicians, particularly when seen alongside long-term, escalating steroid use. However, a stalemate between patient and dermatologist can arise in which patients insist steroids have impacted them, and clinicians describe their atopic dermatitis as merely uncontrolled.

In this video feature, 3 experts with recently published research on the topic of TSW were consulted on the controversy surrounding TSW, its lack of acceptance, and the ways for clinicians to recognize the condition. These experts included Peter A. Lio, MD, a clinical assistant professor of Dermatology & Pediatrics at Northwestern University Feinberg School of Medicine, Ian Myles, MD, MPH, the chief medical research officer of the US Public Health Service Commissioned Corps, and Anish Maskey, PhD, an assistant professor of Microbiology & Immunology at Touro College of Osteopathic Medicine, Montana.

The 3 dermatology experts converged on several key points in their separate interviews, noting the high efficacy of topical steroids and general safety for most patients. Additionally, prolonged and escalating use of topical corticosteroids without reassessment is a common risk factor of TSW. Lastly, they pointed to patient communities, especially those found online, as largely helpful and instrumental in highlighting TSW for clinicians who may not be aware of TSW’s distinction from eczema.

Throughout the feature, Lio, Miles, and Maskey agree on the path forward, lying not in polarization but in transparency, understanding, and new research taking patient-reported suffering seriously without discarding scientific rigor. While definitions remain imperfect, the experts agree about the existence of increasing acknowledgement of TSW and its impacts on patients. Bridging the gap between many patients’ beliefs and the views of wary physicians may be less about choosing sides than about restoring faith in the medical community’s commitment to patients while new evidence grows.

Check out the feature video posted above to discover more about the views of these 3 experts on this topic.

Lio P. Addressing Doubts About Topical Steroid Withdrawal (TSW), with Peter Lio, MD. HCPLive. June 10, 2025. Accessed December 12, 2025. 

https://www.hcplive.com/view/addressing-doubts-about-topical-steroid-withdrawal-tsw-peter-lio-md

Ahuja K, Lio P. Pediatric Topical Steroid Withdrawal Syndrome: What Is Known, What Is Unknown. Pediatr Dermatol. 2025 Mar-Apr;42(2):311-317. doi: 10.1111/pde.15799. Epub 2024 Nov 4. PMID: 39496222; PMCID: PMC11950796.

Shobnam N, Ratley G, Myles IA, et al. Topical Steroid Withdrawal Is a Targetable Excess of Mitochondrial NAD. J Invest Dermatol. 2025 Aug;145(8):1953-1968.e14. doi: 10.1016/j.jid.2024.11.026. Epub 2025 Mar 14. PMID: 40088241; PMCID: PMC12286752.

Maskey AR, Sasaki A, Li XM, et al. Breaking the cycle: a comprehensive exploration of topical steroid addiction and withdrawal. Front Allergy. 2025 Mar 31;6:1547923. doi: 10.3389/falgy.2025.1547923. PMID: 40230788; PMCID: PMC11994697.

Topical steroid withdrawal (TSW) remains a contentious issue in dermatology, with a divide between patient experiences and clinical consensus. Some dermatologists recognize TSW as distinct from atopic dermatitis flares, while others do not. Symptoms include "elephant skin," sharp demarcations, and neuropathic sensations. Experts agree on the efficacy of topical steroids but caution against prolonged use without reassessment. Patient communities play a crucial role in raising awareness. Bridging the gap between patient beliefs and clinical views requires transparency, understanding, and research that respects patient-reported experiences.

Topical steroid withdrawal remains a controversial topic in the dermatology field, given the lack of necessary data. 

Peter Lio, MD

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