Emollients Fail to Protect Against Eczema
The regular application of an emollient on the skin of babies in their first year of life does not prevent eczema, according to results from two large clinical trials. n the Preventing Atopic Dermatitis and Allergies in Children, or PreventADALL (NCT02449850), study, Skjerven and his colleagues recruited expectant mothers during a routine ultrasound appointment. Participants were excluded if there were more than two fetuses, if infants were born before 35 weeks of gestation, or if infants were born with severe disease. The day after delivery, 2397 infants were randomized to one of four groups: 575 to a skin intervention, 642 to a food intervention, 583 to both the skin and food interventions, and 597 to no intervention. For the skin intervention, babies were bathed in water with liquid paraffin and trilaureth-4-phosphate oil and their faces were covered with Ceridal cream. Compliance was defined as an oil bath and cream application at least 3.5 days a week for 16 of 25 weeks. All babies were breast-fed, but those in the food-intervention groups were introduced to peanut, milk, wheat, and egg between 3 and 6 months.
@dipanwita At 12 months, 2172 infants were assessed for atopic dermatitis, the primary outcome of the study; 224 participants were lost to follow-up and one withdrew consent. The results were not as expected. At 12 months, atopic dermatitis was more common in infants who received either the skin or food intervention than in infants who received both or neither intervention (11.1% vs 9.0% vs 5.3% vs 8.1%; P = .003). Numbers were similar in the four groups for the secondary outcome of possible atopic dermatitis (16.5% vs 16.0% vs 10.8% vs 15.9%). The development of atopic dermatitis was not delayed or prevented with early skin-barrier enhancement or with complementary food introduction, said Skjerven. In fact, the interventions "possibly enhanced" the onset of atopic dermatitis