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Effectiveness of a standardized skin care regimen to prevent atopic dermatitis in infants at risk for atopy: a
J Kottner1,2, K Hillmann2, A Fastner1
1Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Berlin, Germany.
Insights
Daily emollient therapy starting at birth did not prevent atopic dermatitis (AD) in infants. A standardized skincare routine did not impact AD development or skin barrier function.
Area of Science:
- Dermatology
- Pediatrics
- Clinical Trials
Background:
- Early life emollient application is hypothesized to enhance skin barrier function and prevent atopic dermatitis (AD) in predisposed infants.
- Pilot studies suggested daily emollient therapy from birth could reduce AD incidence.
Purpose of the Study:
- To evaluate a standardized infant skincare regimen's effectiveness in preventing AD development.
- Comparison against a non-structured skincare approach in infants with atopic predisposition.
Main Methods:
- A prospective, randomized, pragmatic trial involved 160 infants.
- Intervention group received daily leave-on emollient (21% lipid content); control group used parental preference skincare.
- Study included a 52-week intervention and a 52-week follow-up to age two years.
Main Results:
- Cumulative AD incidence was 10.6% at one year and 19.5% at two years, with no significant difference between groups.
- Skin barrier parameters remained comparable between the standardized care and control groups.
- Infants in the control group exhibited higher AD severity and poorer quality of life.
Conclusions:
- Regular emollient application in the first year of life does not prevent atopic dermatitis.
- Standardized skincare regimens do not impede skin barrier development or cause adverse effects.
Background:
It has been proposed that regular emollient application in early life could enhance skin barrier function and prevent atopic dermatitis (AD) especially in predisposed infants. This hypothesis was supported by evidence from exploratory and pilot trials showing protective effects in terms of reduced cumulative atopic dermatitis incidence with the use of daily emollient therapy starting immediately after birth.
Objectives:
To investigate the effectiveness of a standardized skin care regimen for infants on the development of AD compared to not structured skin care regimen in infants with atopic predisposition.
Methods:
Prospective, parallel group, randomized, pragmatic, investigator-blinded intervention trial including 160 infants with 52 weeks intervention and 52 weeks follow up phase up to the age of two years. Infants were randomly assigned to receive a standardized skin care regimen including once daily leave-on product application (lipid content 21%) or skin care as preferred by the parents.
Results:
Using the intention to treat approach, the cumulative AD incidence was 10.6% after one year, and 19.5% after two years in the total sample. There were no statistical significant differences between intervention and control groups. Skin barrier parameters between the intervention and control groups were comparable. AD severity was higher and quality of life was more affected in the control group.
Conclusions:
Regular emollient application during the first year of life does not prevent the development of atopic dermatitis. A standardized skin care regimen does not delay skin barrier development or causes side effects.
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