Zest Health Guide to Topical Phosphodiesterase-4 (PDE4) Inhibitor

Living with eczema, psoriasis, or seborrheic dermatitis means your skin is sending signals it cannot turn off on its own. The redness, the itch, the plaques. Zoryve works by stepping in at the source of those signals and calming them down. It is steroid-free, works across a wide range of skin areas, and is approved for both adults and children.

This guide explains how Zoryve works, how to use it, and what to expect along the way.

What are Topical PDE4 Inhibitors?

Topical PDE4 inhibitors are a non-steroidal class of treatment for eczema and psoriasis. They work by blocking an enzyme called phosphodiesterase-4 (PDE-4), which drives the overactive immune response that causes skin inflammation.

By calming that immune response, PDE4 inhibitors help reduce the redness, itching, and plaque buildup that can make flares so hard to live with.

Topical PDE-4 Inhibitor:

• Zoryve (roflumilast) — available as a cream or foam

Getting Started: Using Topical PDE4 Inhibitors Safely

PDE4 stands for phosphodiesterase-4. PDE4 is an enzyme that drives the overactive immune response behind skin inflammation. When PDE4 is too active, it keeps inflammation going, which leads to the redness, itching, and plaque buildup that make flares so hard to live with.

Zoryve blocks that enzyme. When PDE4 is blocked, the immune response calms down and inflammation decreases. Zoryve is available as both a cream and a foam, and your Zest provider will recommend the right form for your skin and the areas being treated.

Zoryve is FDA-approved for:

• Plaque psoriasis. Adults and children 6 and older.
• Atopic dermatitis (eczema). Adults and children 2 and older.
• Seborrheic dermatitis. Adults and children 9 and older.

What Makes This Different

Zoryve does not contain steroids. It does not cause skin thinning or stretch marks. That makes it a strong option for sensitive areas where long-term steroid use may not be ideal, and for patients who want a steroid-free approach to managing their condition.

It can be used on sensitive areas like the face, neck, armpits, groin, genitals, and skin folds. It also works on the body, arms, legs, and persistent spots like elbows, knees, and thick plaques.

Application Tips:

A few simple habits will help you get the most from your treatment:

1. Wash your hands before and after applying, unless you are treating your hands.
2. Apply to clean, dry skin, unless your provider directs otherwise.
3. Apply a thin layer to affected areas only, once daily.
4. Gently rub in until fully absorbed.
5. You can still use a moisturizer to support your skin barrier. Check with your provider on timing.

How Much Should I Use?

We recommend using the Fingertip Unit (FTU) when you are getting started:

• This is the amount of cream squeezed from the tip of your finger to the first crease.
• 1 FTU covers about the size of the front and back of one adult hand.
• Precision: If you are treating a very small spot, adjust the amount accordingly.

Different body parts need different amounts. If you are only treating a small area, you will use less. Your provider can walk you through the right amount for your specific areas.

Getting Started

• Submit baseline photos of your skin condition for a severity assessment.
• No routine blood work is needed, but please share all current and past medications with your provider.
• Provide previous treatment records if requested.

What to Expect

• Early improvement. Many people begin to see changes within 2 to 4 weeks.
• Meaningful relief. Significant symptom improvement is often reported by the 8-week mark.
• Long-term maintenance. Once your skin clears, your provider may suggest a plan to help keep flares from coming back. This might include weekend therapy, applying the medication once or twice a week as a preventive step.

‍Safety and Side Effects

Zoryve does not cause skin thinning or stretch marks. Most side effects are mild and can include:

• Stinging or burning at the application site
• Diarrhea or nausea
• Headache

If any side effect feels significant or your skin is not improving as expected, reach out to your Zest care team. We want to hear from you.

Storing Your Medication

• Store at room temperature
• Keep tube or bottle tightly closed
• Keep out of reach of children
• Do not ingest medication
• Check expiration date before use

When to Contact Your Zest Team 

• No improvement after 8 weeks of treatment
• Signs of a severe allergic reaction or infection
• Unusual worsening redness, pain, or swelling, or other signs of skin infection (pus, warmth, fever)
• Any vision changes if using medication near your eyes

Have more questions? Contact your Zest care team by texting (865) 426-1746 or sending a message from your portal. You've got this, and we've got you.