Mild and moderate atopic dermatitis (eczema) – a journey from flare to care ACG

Published on 27 February 2026

This ACE Clinical Guideline (ACG) provides guidance on diagnosis, severity assessment and management of mild and moderate atopic dermatitis (AD), including topical and non-pharmacological interventions in adults and children. The ACG also covers proactive therapy, systematic assessment of treatment response, and principles of management of secondary bacterial infection. Supplementary materials are available, including a drug table on topical anti-inflammatories and a photo repository.

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Mild and moderate atopic dermatitis (eczema) – a journey from flare to care (Feb 2026) [PDF]

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ACG survey and feedback

We invite all readers of the ACG to complete this survey. The survey aims to understand the impact of the guideline on clinical confidence, decision-making, and practice. Results will contribute to informing future guidelines and implementation support for you. Your responses will remain confidential and will be analysed in aggregate to safeguard your privacy. The survey takes approximately 10–15 minutes to complete and will remain open until 30 March 2026. We highly encourage you to complete the survey after reading the ACG.

ACG recommendations

1. Diagnose AD through history taking and clinical examination, focusing on key features such as skin itchiness, dryness, personal or family history of atopic diseases, disease chronicity, lesion morphology and distribution.

2. Assess AD severity based on extent, frequency and intensity of clinical manifestations, and patient- or caregiver-reported impact on quality of life.

3. Review potential triggers for AD and advise on how to minimise exposure.

4. For patients with mild or moderate AD, advise liberal moisturiser use as baseline therapy, and 

   • Prescribe topical corticosteroids (TCS) as first-line anti-inflammatory treatment for active lesions.  

   • If a non-steroidal alternative is required or preferred, consider topical calcineurin inhibitors (as second- line) or topical phosphodiesterase 4 inhibitors (as third-line). 

5. For patients with recurring AD flares (e.g. 2-3 flares/month), prescribe proactive therapy of topical anti-inflammatory treatments to areas of skin prone to flare recurrences.

6. For patients with inadequate treatment response, assess and address possible factors before modifying treatment.

7. Do not routinely give oral corticosteroids for AD, except as a short course for: 

   • Rescue therapy for acute, severe flares, or  

   • Bridging therapy to systemic treatment.

8. For secondary infection of AD, continue patient’s topical anti-inflammatory treatments alongside appropriate antimicrobial agents.

9. Avoid triple combination products of TCS, antibiotics and antifungals in AD patients with suspected or clinically evident bacterial infection.

ACG supplementary guides

Supplementary guide on atopic dermatitis diagnosis criteria, severity assessment tools and mitigation strategies (Feb 2026) [PDF] 

Drug table on topical anti-inflammatories (Feb 2026) [PDF] 

Atopic dermatitis photo repository (Feb 2026) [PDF] 

ACG references and Expert Group details

Mild and moderate atopic dermatitis references (Feb 2026) [PDF] 

Mild and moderate atopic dermatitis ACG EG composition and other details (Feb 2026) [PDF] 

ACG EtR framework

The Evidence-to-Recommendation (EtR) framework is a document that outlines the underpinning evidence and rationale for the recommendations in our ACGs. Download the EtR framework below to learn more about factors that have informed the strength of the ACG recommendations, including certainty of evidence, clinical benefit/risk balance, local resource implications, feasibility considerations, patient preferences and values, acceptability and other considerations.

Mild and moderate atopic dermatitis EtR framework with summary of findings (Feb 2026) [PDF]