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Can prophylactic emollients prevent the development of atopic dermatitis?

Laura Adams

BSc MBBS MRCP (UK) Dermatology Registrar, Dermatology Department, University Hospitals of Derby and Burton NHS Foundation Trust

Anusha P Panthagani

MBChB, MRCP(Derm) Dermatology Registrar, Dermatology Department, University Hospitals of Derby and Burton NHS Foundation Trust

Esther Burden-Teh

BMBS, MRCP(Derm), PhD Clinical Lecturer and Dermatology Registrar, Dermatology Department, University Hospitals of Derby and Burton NHS Foundation Trust and Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham

Atopic eczema is a common disease with a high burden of morbidity. Onset most often occurs between 3-6 months of age. Skin barrier dysfunction precedes its development. Emollients are known to improve skin barrier function in individuals with eczema.

 

Two pilot studies published in 2014 suggested prophylactic application of emollients to infants might be preventative. A simple intervention such as this would be of great interest to both parents and clinicians. In this article the authors review the latest evidence in the form of two large randomised controlled trials, the BEEP and the PreventADALL study, alongside a recent Cochrane review on the topic. 

 

The article considers:

  • The role of the skin barrier in eczema development
  • Why might prophylactic emollients work?
  • What are the risks associated with using prophylactic emollients?
  • What is the current evidence?
  • What is the quality of that evidence?
  • What skincare advice should we give to the parents of a healthy infant?
Dermatology in practice 2021; 27(2): 32–34
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Dermatology in practice was previously supported by Wyeth from 2008 to 2010, by Wyeth and Serono in 2007, by Wyeth and Shire from 2005 to 2006, by Medlock Medical in 2004 and by SSL International from 2001 to 2003.

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