Emollient bath additives provide no meaningful benefit when used in addition to standard eczema care in children, finds a trial published in the BMJ.
Prescribing of bath additives in England costs the NHS more than £23 million annually. The authors of this new study say their findings may help guide decisions around effective prescribing in this area.
Although evidence supports the use of leave-on emollients and there is clinical consensus around soap substitutes, evidence on the benefits of emollient bath additives is lacking. Researchers, led by the University of Southampton, set out to determine both the clinical and cost effectiveness of including emollient bath additives in the management of eczema in children.
The trial included 482 children aged 1-11 years diagnosed with eczema recruited from 96 general practices in England and Wales. Participants were randomly assigned to receive bath additives or not, for 1 year. Eczema control was measured weekly for 16 weeks using the patient-oriented eczema measure (POEM), with scores of 0-7 indicating mild eczema and scores of 8-16 and 17-28 indicating moderate and severe disease.
The researchers found no statistically significant difference in weekly POEM scores between the 2 groups over the 16-week period. Mean POEM was 7.5 in the bath additives group and 8.4 in the no bath additives group. The POEM score in the no bath additives group was 0.41 points higher than in the bath additives group over 16 weeks, which is substantially lower than the minimal clinically important difference for POEM of 3 points. There were also no significant differences between the groups for additional measures, including eczema severity over 1 year, the number of eczema flare-ups, QoL, cost-effectiveness and adverse effects.
