Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials.
Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol 2024;91(3):457-465.
Study type: RCT ×2 (phase 3, n=813, ages ≥2; industry-sponsored) · Added to this library August 23, 2026
What the researchers did
Not a herb — the FDA-approved (Dec 2024) topical AhR-agonist drug for eczema, included as the pharmaceutical analogue of indigo's mechanism.
What they found
EASI75 in 56–59% vs 21–23% on vehicle; the authors describe the mechanism as down-regulating Th2 cytokines, up-regulating skin-barrier components, reducing oxidative stress.
Why it matters
Indirubin is an aryl-hydrocarbon-receptor ligand. Western medicine just approved, with a patent, the receptor action Qing Dai ointment has been delivering for centuries.
Relates to the patterns: Blood Heat · Heat-Toxin
This summary is educational and does not replace care from your child's pediatrician. Evidence tiers matter: a finding in cells or animals is a reason a treatment could work, not proof that it does.
More in Qing Dai Gao
Efficacy and safety of indigo naturalis ointment in Treating Atopic Dermatitis: A randomized clinical trial.
Lin YK, Chang SH, Yang CY, See LC, Lee BH, Shih IH. Efficacy and safety of indigo naturalis ointment in Treating Atopic Dermatitis: A randomized clinical trial. J Ethnopharmacol 2020;250:112477.
Study type: RCT (double-blind, vehicle-controlled; ages 6–65; NCT02669888)
What: Refined indigo naturalis oil (Lindioil) twice daily vs vehicle for 6 weeks in 48 people with atopic dermatitis, including children from age 6.
Found: Eczema severity (EASI) fell 49.9% on indigo vs 19.6% on vehicle (p=0.024); superior on every secondary endpoint including itch and quality of life; no significant adverse events.
Why it matters: The first randomized trial of a topical Qing Dai preparation in eczema itself — the "clear Heat, cool Blood" ointment beat its own base oil, with pediatric participants included.
Efficacy and safety of indigo naturalis oil extract (Lindioil ointment) for the treatment of atopic dermatitis: a randomized, crossover, evaluator-blinded, controlled trial.
Yang CY, et al. Efficacy and safety of indigo naturalis oil extract (Lindioil ointment) for the treatment of atopic dermatitis: a randomized, crossover, evaluator-blinded, controlled trial. Front Pharmacol 2025;16:1546589.
Study type: RCT (crossover vs tacrolimus, n=22 adults)
What: Indigo ointment head-to-head against tacrolimus, a standard prescription immunosuppressant cream.
Found: Tacrolimus reduced severity more (−71% vs −41% EASI), but caused local side-effects in 61% of users vs 10% for indigo; indigo also reduced S. aureus colonisation toward healthy-skin levels and shifted the skin microbiome back toward normal.
Why it matters: Honest comparison: the pharmaceutical is stronger, the herb is far gentler — and only the herb showed the antimicrobial, microbiome-restoring action. Different tools for different lesions.
Comparison of indirubin concentrations in indigo naturalis ointment for psoriasis treatment: a randomized, double-blind, dosage-controlled trial.
Lin YK, et al. Comparison of indirubin concentrations in indigo naturalis ointment for psoriasis treatment: a randomized, double-blind, dosage-controlled trial. Br J Dermatol 2018;178(1):124-131.
Study type: RCT (dose-ranging)
What: Four concentrations of indirubin (indigo's key active) in psoriasis, to find the dose-response.
Found: Highest dose: PASI severity down 69%, with 57% of patients reaching PASI75 and 30% PASI90; no severe adverse events over 20 weeks.
Why it matters: A clean dose-response curve is pharmacology's signature that the active is real — indirubin behaves like a drug because it is one.
Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis.
Lin YK, et al. Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis. Arch Dermatol 2008;144(11):1457-64.
Study type: RCT (intra-patient, vehicle-controlled, n=42)
What: Crude indigo ointment vs its own base, on matched plaques of the same patients, 12 weeks.
Found: 74% of patients reached clearance or near-clearance on the treated side; severity scores halved relative to control.
Why it matters: Published in the American Medical Association's dermatology journal — the moment topical Qing Dai entered the Western evidence base.