23 July 2026

Precision Medicine in Atopic Dermatitis: Progress and Future Prospects

Where precision medicine for eczema stands today

Atopic dermatitis (commonly called eczema) affects people in different ways, and researchers are working to match the right treatment to the right person. Christopher Bunick, MD, PhD, an associate professor of dermatology at Yale School of Medicine, recently talked about how close we are to that goal and what still needs to happen.

A quick plain-language picture

Scientists can now look at which genes are turned on or off in the skin and immune cells of people with atopic dermatitis. That has helped identify patterns linked to different types of the disease and to how some treatments work. But we’re not yet at the point where a simple test can tell a doctor, with strong confidence, which drug will work best for one particular person.

What gene expression profiling tells us — and what it doesn’t

Gene expression profiling means measuring which genes are active in skin or immune cells. This approach has been useful for spotting molecular patterns, such as disease driven by a type of immune response called Th2, or patterns that suggest someone might respond to JAK inhibitors (a class of drugs that reduce many inflammatory signals).

Those findings are a good step forward, but they don’t yet give a precise “pick this drug for this person” answer. As Dr. Bunick put it, the work so far points in the right direction, but more is needed before clinicians can reliably predict individual treatment responses.

Why more than genes matter

Gene activity is only part of the story. To reach true precision medicine, researchers need to understand how treatments change the immune system over time. That includes looking at:

Memory T cells — immune cells that “remember” past inflammation and can cause flares.
T-regulatory (T-reg) cells — cells that help calm the immune response.
Antigen-presenting cells — cells that show bits of foreign material to the immune system and can trigger inflammation.
Feedback loops in the immune system that can sustain or dampen disease activity.

To get a fuller picture, researchers are combining gene data with protein profiles (proteomics) and detailed studies of immune cells. Mapping these pieces together may reveal which biologic pathways to target for each person.

Current benchmarks and what’s under study

Right now, oral JAK inhibitors serve as an important benchmark in lab tests that measure lymphocyte (a type of white blood cell) activation, because these drugs broadly reduce many inflammatory signals called cytokines. New treatments are being compared against that level of immune suppression to see if they offer better or different benefits.

At the same time, attention is turning to therapies that act earlier in the immune response. That includes investigational drugs aimed at STAT6 and therapies that influence IL-2 signaling or boost T-reg cells. These approaches try to change how the immune system behaves at a higher level, which may help control the disease more durably or even modify how the condition behaves over time.

Bringing it all together

Progress in precision medicine for atopic dermatitis is likely to come from teamwork across labs and from combining different types of data. That means integrating transcriptomics (gene activity), proteomics (protein signals), cytokine biology, and detailed immunology. The goal is a fuller roadmap of the disease that helps clinicians choose treatments more confidently for each person.

What this means for you

These research directions are encouraging because they aim to match treatments to how an individual’s disease actually works. But for now, treatment decisions still rely on clinical judgment, patient history, and how someone responds over time. If you have eczema and are curious about new tests or drugs, talk with your dermatologist — they can explain whether a specific test or therapy is appropriate for you.

If you want to keep track of how your skin changes, taking photos over time or keeping a simple diary of flare triggers and treatments can help you and your doctor see patterns and measure progress.

When to see a doctor

See a dermatologist if your eczema is severe, getting worse, causing large or painful areas, bleeding, showing signs of infection (such as increasing redness, pus, warmth, or fever), or if over-the-counter treatments aren’t helping. For any rapidly changing or concerning skin problem, it’s best to seek medical advice promptly.

Quick disclaimer

This article explains current research and expert commentary and is not medical advice. Treatment choices should be discussed with your doctor or dermatologist.