Frequent Versus Infrequent Bathing in Pediatric Atopic Dermatitis: A Randomized Clinical Trial

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Ivan D Cardona1, Erin E Kempe2, Christine Lary1

  • 1Department of Pediatrics, Maine Medical Center Research Institute, Portland, Maine.

The Journal of Allergy and Clinical Immunology. in Practice
|November 17, 2019
PubMed

Insights

Twice-daily soaking baths (wet method) significantly improved pediatric atopic dermatitis (AD) severity compared to twice-weekly baths (dry method). The wet method is a superior acute treatment for moderate-to-severe childhood AD.

Area of Science:

  • Dermatology
  • Pediatrics
  • Clinical Trials

Background:

  • Limited studies exist on bathing frequency for pediatric atopic dermatitis (AD).
  • Conflicting information on bathing practices causes parental frustration and confusion.

Purpose of the Study:

  • To compare the efficacy of twice-daily soaking baths with immediate moisturizer application (soak-and-seal, SS) versus twice-weekly SS baths for acute pediatric AD management.
  • To evaluate the "wet method" (WM) versus the "dry method" (DM) in managing moderate-to-severe pediatric AD.

Main Methods:

  • A randomized, single-blind, crossover trial involved 42 children (6 months to 11 years) with moderate-to-severe AD.
  • Participants alternated between twice-weekly (DM) and twice-daily (WM) SS baths over two 2-week periods.
  • The primary outcome was AD severity measured by the SCORing Atopic Dermatitis (SCORAD) index.

Main Results:

  • The wet method (WM) significantly decreased SCORAD by 21.2 points compared to the dry method (DM).
  • WM showed a greater than 30% SCORAD improvement versus DM.
  • Caregiver assessment (ADQ) also significantly improved with WM, decreasing by 5.8 points.

Conclusions:

  • Twice-daily soaking baths (wet method) are superior to twice-weekly baths (dry method) for acute management of moderate-to-severe pediatric AD.
  • The wet method effectively improves disease severity in children with AD.
Abstract

Keywords:
Atopic dermatitisBathingBathsEczema

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