Crisaborole: Application Pain and Prevention

Madison Anzelc1, *, Craig G. Burkhart2, 3
1 Department of Medicine, Medical Researcher, Division of Dermatology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
2 Department of Medicine, University of Toledo, Toledo, Ohio
3 Ohio University of Osteopathic Medicine, Athens, Ohio

© 2019 Anzelc and Burkhart.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Medicine, Division of Dermatology, University of Toledo College of Medicine and Life Sciences, 110 Ottawa Street, Unit 5A, Toledo, Ohio 43604; Tel: 330-814-2181; Fax: 330-689-1093;
E-mail: Madison.anzelc@rockets.utoledo.edu


In 2016, a new drug, crisaborole, was developed and approved, for the first time in 15 years, as an effective treatment for Atopic Dermatitis (AD). Crisaborole is a topical phosphodiesterase 4 (PDE4) inhibitor, which alleviates AD symptoms, such as pruritis, inflammation, and flares. Similar to other topical treatments like corticosteroids and calcineurin inhibitors, crisaborole has been found to cause pain during application. The pain felt during a topical application can be attributed to many possible causes, such as increased sensitivity to pain-provoking and itch-provoking stimuli, prior inflammation, prior damage, and hypersensitized skin of the patient to which the topical cream is applied. Crisaborole has been reported to be effective, yet the application site pain is a major road bump in the effective treatment of some patients. Some possible ways to circumvent this pain are letting the epidermis soothe and heal before starting crisaborole, starting this treatment modality before the skin has a chance to become irritated and inflamed, and numbing the area with an ice pack prior to topical crisaborole application. Overall, crisaborole has been an effective treatment modality, but further research is necessary to allow for safe use of this life-changing AD topical medication.

Keywords: Crisaborole, Application pain, Atopic dermatitis, Pain prevention, PDE4 inhibitor, Topical treatment.