The study Best Emollients for Eczema found that no type of moisturizer is better than another. This study, the world’s first to directly compare different types of moisturizers, emphasizes the importance of patient education and choice when deciding which moisturizers to use for children with eczema. The results of the National Institute for Health and Care Research (NIHR) funded study are published in: The Lancet Child and Adolescent Health and British Journal of General Practice Today [24 May]†
Moisturizers (also called emollients) are recommended for one in five children with eczema (also known as atopic eczema/dermatitis), which causes dry and itchy skin. Over 100 different moisturizers are prescribed in the NHS, costing more than £100 million a year. Lack of research in this area means that NHS guidelines differ widely in what is recommended, leading to confusion and waste.
In the study, led by the Universities of Bristol, Nottingham and Southampton, 550 children with eczema under the age of 12 were randomized to receive one of four types of moisturizing cream (lotion, cream, gel or ointment) as their main moisturizer for 16 weeks. to use. Parents kept journals about their child’s eczema for a year, and some were interviewed to get an in-depth look at how they used the moisturizers and what they thought of them. All children also underwent an independent skin examination.
When used alongside other eczema treatments, there was no difference in effectiveness of the four types of moisturizer used in the study. Skin reactions such as itching or redness were common with all types of moisturizers. Awareness of the different types of moisturizers was low and users had different preferences based on how the moisturizers look and feel. For example, some people liked how lotions absorb quickly, while others preferred the “barrier” provided by ointments.
Such an investigation has been a long time coming. It has not been in the manufacturers interest to directly compare types of moisturizing creams as we did in this trial. Our findings challenge conventions about how often moisturizers should be applied, which types are less likely to cause problems, and which types should be recommended to patients. For more severe eczema, for example, ointments are often recommended, but they turned out to be no better.”
Professor Matthew Ridd, General Practitioner and Study Leader of the University of Bristol’s Center for Academic Primary Care
Hayley, Abriarna’s mother who took part in the trial, said: “The trial helped us find an emollient that we had never used before, which helped keep Abriarna’s skin in good condition for the longest time. eczema often requires a different emollient for different purposes, for example, Abriarna has a regular daily moisturizer, which we found during the trial, she has an emollient for days when her eczema is agitated and then an emollient to soak in. wash and use after hand washing.”
Tiffany Barrett, pharmacist and co-investigator added: “The prescribing of moisturizers by the NHS is governed by locally agreed formulas. These formulas are based on both cost and perceived effectiveness. What this study does is emphasize the importance of having the four main types of moisturizers available on formulas for children with eczema so that the right product can be used at the right time.”
Professor Hywel Williams, consultant dermatologist and co-investigator at the University of Nottingham, explains: “Along with anti-inflammatory treatments such as topical corticosteroids, emollients are a really important part of treating eczema in children as they prevent flare-ups and improve the skin’s appearance. help calm and improve the quality of life of children and their caregivers.
“Our research shows that one size doesn’t fit everyone, pointing to the need for doctors to make parents aware of the different types of emollients and help them choose which one is most likely to work for them. Finally, we have evidence that supports it.” saying, ‘The best moisturizers are the ones the patient will use.'”
Professor Nick Levell, NIHR National Specialty Lead for Dermatology, said: “About one in five children develop eczema and the scratching and sleep loss affect school performance and exhaust children and their parents. This study confirms that parental and patient preference is very important. is important when choosing a moisturizer to treat eczema Some people prefer ointments but others like gels, creams or lotions No option is best As reactions to moisturizing creams are common it is important that the NHS has a offers a wide choice to help parents find something that soothes and soothes their child’s fiery skin.”
Further research is needed to determine whether these findings apply to adolescents and adults with eczema and those with other dry skin conditions.
Ridd, MJ, et al. (2022) Effectiveness and safety of lotion, cream, gel and ointment emollients for eczema in children: a pragmatic, randomized phase 4 superiority trial. The Lancet Child and Adolescent Health† doi.org/10.1016/S2352-4642(22)00146-8†
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