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Bath oils still important for children with atopic dermatitis

By Nicole MacKee
An Australian expert has recommended that children with atopic dermatitis (AD) continue to be bathed daily with bath oils, despite a UK finding that emollient bath additives provide no benefit.

Professor Alan Cooper, Head of the Department of Dermatology at Sydney’s Royal North Shore Hospital, said both bath oils and leave-on emollients were important in managing AD in young children.

‘When atopic dermatitis is very uncomfortable, a little bit of oil in the bath can help to reduce stinging,’ Professor Cooper told Medicine Today. ‘We always recommend that young children get a wash every day.’

Professor Cooper was commenting on a randomised controlled trial that found no clinical benefit in using additive bath emollients.

The 12-month trial included 482 children (aged 1 to 11 years) with AD who were randomised to use emollient bath additives or no additives.

Both groups continued with standard AD management, including leave-on emollients and topical corticosteroids as required. Disease severity was evaluated using a patient-oriented eczema measure (POEM) score.

After controlling for baseline severity and confounders, the researchers found that POEM scores in the no bath additives group were 0.41 points higher than in the bath additives group (95% CI, -0.27 to 1.10), which did not reach the minimal clinically important difference of 3 points.

They also reported that only 36% of all participants had five or more baths a week.

Professor Cooper said the research showed that bath oils were beneficial in children aged 5 years and under and in those who bathed five or more times per week.

‘There is compelling logic and strong evidence that emollients play a vital role in the management of atopic dermatitis,’ Professor Cooper told Medicine Today.
BMJ 2018; 361: k1332.