OBJECTIVES : To document national and local guidelines for the treatment of atopic dermatitis (AD) in the United Kingdom and describe how guidelines have changed in the past 10 years.

METHODS : PubMed, Medline, EMBASE, NICE, NIHR Centre for Reviews and Dissemination (CRD), Bielefeld Academic Search Engine (BASE), Google scholar and Google search databases, local treatment guidance from CCGs and NHS trust websites were searched to identify relevant records.

RESULTS : 497 records were identified. 428 were excluded with no relation to AD/not treatment guidelines. 69 full texts were screened (n=64 excluded: non-UK/not treatment guideline) leaving 5 national guidelines in the final analysis from: NICE (Treatment of AD in children <12 years, published in 2007); the Scottish intercollegiate guidelines network SIGN (Treatment of AD in adults and children, published in 2011) and 3 NICE technology appraisals for topical corticosteroids (TA81), topical calcineurin inhibitors (TA82), and dupilumab solution for injection (TA534), published in 2004, 2004 and 2018 respectively. 13 local CCG guidelines for adult and paediatric AD are available online and are consistent with national guidelines recommending a stepped treatment plan and referral to community or secondary clinical care for severe/difficult to treat AD. No comprehensive NICE or British Association of Dermatologists (BAD) treatment guidelines for adults with AD were found.

CONCLUSIONS : There is a paucity of comprehensive, standardised and integrated national and local treatment guidelines for AD in the UK. Available guidelines describe siloed primary care AD management and there is a lack of clarity for treatment in secondary care. Recent advances in AD treatment have failed to prompt guideline updates. This work has highlighted the need for rigorously developed evidence-based national guidelines to aid effective diagnosis and management, optimise patient care and reduce variations in clinical practice.