‘Eczema’ is a dry, itchy, sometimes thickened, skin rash. It’s a common expression of ‘atopic dermatitis’, a hereditary tendency for skin to inflame. There are associated skin infections sometimes, because the skin’s barrier to bacteria is impaired. Babies and toddlers get this kind of eczema most often.
One of the ways to help is with an ‘emollient’, a non-cosmetic moisturizer. This keeps the skin flexible, less likely to crack, and less itchy.
And there are three kinds of emollients: the ones you rub on, the soap substitutes, and the kind you add to bathwater.
There is evidence that the first two of these work, but medical opinion has long been divided about how much the bath additives help. Amazingly, they’ve not been studied in clinical trials, even though, in the United Kingdom, they account for a third of the cost of eczema treatment overall.
To address this gap in practical knowledge, researchers in the UK recently recruited a group of some 500 children with eczema between the ages of 1 and 11, gave some of them standard eczema care with bath additives, and some of them standard care without bath additives. They did this for a year, measuring changes in eczema symptoms at fixed intervals.
They found that even after a year there was no significant difference in control of symptoms or in general comfort or quality of life. The children who used emollient bath additives in addition to standard treatments for eczema did not benefit more than treated children who used no additives.
This study, the first of its kind, suggests, doubtless to many parents’ surprise, that prescribers can stop recommending bath additives in treatment of children’s eczema.
1BMJ. 2018 May 3;361:k1332. doi: 10.1136/bmj.k1332
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