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Different types of emollients equally effective in childhood eczema

A recent head-to-head study comparing four types of emollients for childhood eczema found no difference in effectiveness between lotions, creams, gels, or ointments.

The authors of the paper, published in The Lancet Child and Adolescent Health (May 23, 2022) conclude that patients should be able to choose from a range of emollients so they can find one they are likely to use effectively.

A total of 550 children with eczema aged under 12 years were enrolled and randomized to use one of the four types of emollient as their primary moisturizer for 16 weeks. Parents of the children in the study completed diaries about the child’s eczema for one year.

Researchers also interviewed some of the parents to gain a more in-depth understanding of how they applied the emollients and what the parents thought of them. Each child also had an independent examination of their skin.

The investigators found that when used alongside other eczema treatments there was no difference in effectiveness between the four types of emollient. Skin reactions such as itching were common with all moisturizer types.

Participants had low awareness of the different types of emollients, and their preferences were generally based on how the moisturizers looked and felt. Some participants liked how lotions quickly soaked in whereas others preferred the “barrier” provided by ointments.

“A study of this type has been long overdue,” said the study’s lead author, Professor Matthew Ridd, PhD, from the Centre for Academic Primary Care at the University of Bristol, in a press release. “It has not been in the interest of the manufacturers to directly compare types of moisturizers in the way we have done in this trial. Our findings challenge conventions about how often moisturizers need to be applied, which types are less likely to cause problems and which patients should be recommended certain types. For example, ointments are often suggested for more severe eczema, yet they were found to be no better.”

Co-author Professor Hywel Williams, PhD, added: “Our study shows that one size does not fit all, and points to the need for doctors to make parents aware of the different emollient types and to help them choose which one is most likely to work for them.

“At last, we have evidence that supports the saying, ‘The best moisturizers are the ones the patient will use.”


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