What Patients Do With the Prescription

Clear instructions for a topical corticosteroid don’t determine how it gets used at home, and patients don’t always say when they’ve decided otherwise. In a survey of 1,500 adults and caregivers of children with atopic dermatitis, psoriasis, or seborrheic dermatitis, a substantial share reported using their TCS less often than prescribed, often because of concerns about adverse effects. Many had not raised those concerns with their clinician. Tina Bhutani, MD, the study’s first author, considers what that silence means in practice, and how clinicians might draw concerns out before they quietly reshape a treatment plan.