Emollients and moisturisers for eczema

Area of Science:

• Dermatology
• Evidence-based medicine
• Clinical trials

Background:

• Eczema (atopic dermatitis) is a chronic inflammatory skin condition characterized by dry skin, intense itching, and lesions.
• Moisturisation is a cornerstone of eczema management, but its efficacy remains debated.
• This review assesses the evidence for moisturiser effectiveness in treating eczema.

Purpose of the Study:

• To evaluate the effects of various moisturisers on eczema symptoms and treatment outcomes.
• To compare moisturiser use against no moisturiser, vehicle, or placebo.
• To assess the impact of moisturisers on disease severity, itching, flares, and adverse events.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) included in the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS databases up to December 2015.
• Inclusion criteria: RCTs involving participants with eczema.
• Data extraction and analysis followed standard Cochrane methodology, assessing risk of bias and synthesizing outcomes including participant-assessed disease severity, satisfaction, investigator-assessed severity, flares, and adverse events.

Main Results:

• Moisturiser use, compared to no moisturiser, showed a trend towards reduced eczema severity (SCORAD) but did not meet minimal important difference, though it reduced flares and topical corticosteroid use.
• Specific formulations like Atopiclair demonstrated moderate-quality evidence for improving participant-assessed disease severity and reducing itching and flares.
• Overall, moisturisers were perceived as more effective in reducing eczema and itch, leading to lower investigator-assessed disease severity and fewer flares, with no significant increase in adverse events when compared to control.

Conclusions:

• Most moisturisers demonstrate some beneficial effects in managing eczema, particularly when used in conjunction with active treatments.
• Moisturiser application can prolong time to flare, reduce flare frequency, and decrease the need for topical corticosteroids.
• Current evidence does not reliably indicate that one specific type of moisturiser is superior to another for eczema treatment.