New evidence challenges use of bath emollients for children with eczema

Eczema (also known as atopic eczema or atopic dermatitis) is the commonest inflammatory skin condition in childhood, affecting around 20% of UK children and having a substantial impact on patients’ and families’ quality of life and National Health Service resources.1 The regular application of leave-on emollients is a cornerstone of treatment,2 based at least partly on evidence from intervention studies.

Little good evidence exists on the benefits of emollient bath additives,3 although the National Institute for Health and Care Excellence recommends regular use of “emollient wash products” for children with eczema.4 This is probably one of the reasons why emollient bath additives are commonly prescribed, costing the English NHS more than £17m a year in primary care alone.5 But do emollient bath additives really reduce the severity of eczema and improve quality of life, in conjunction with standard care?

To answer these important questions, Santer and colleagues (doi:10.1136/bmj.k1332) conducted a pragmatic randomised controlled trial (n=482) comparing standard care with …