Integrative Care in Atopic Dermatitis

How complementary strategies can support biologic therapy without replacing evidence-based treatment

Atopic dermatitis (AD) care has changed dramatically in the biologic era, but better options have not eliminated the need for thoughtful adjunctive strategies. In this opening conversation, Cynthia Trickett, MPAS, PA-C, and Peter Lio, MD, begin with the clinical reality many dermatology providers know well: even when biologics are appropriate, effective, and well tolerated, patients may still need more support to control itch, inflammation, barrier dysfunction, sleep disruption, and the day-to-day burden of disease. As Dr Lio puts it, integrative care is not about replacing conventional medicine with “something crazy.” It is about “taking the best of both worlds and putting them together in a coordinated way.”

Dr Lio outlines what integrative medicine can mean in AD, from mind-body approaches and botanicals to barrier support, microbiome-directed strategies, and other adjunctive tools that may help patients who are already using topical therapies or systemic agents. The conversation also grounds these approaches in the larger biologic landscape, including IL-4/IL-13, IL-13, and IL-31 pathway targeting, while acknowledging that these therapies, however transformative, are not perfect fits for every patient. Part 1 closes where clinical practice often begins—with the need to layer treatment thoughtfully, safely, and with the patient’s goals and comfort in mind.