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Meta-Analysis
. 2017 Feb 6;2(2):CD012119.
doi: 10.1002/14651858.CD012119.pub2.

Emollients and moisturisers for eczema

Esther J van Zuuren  1 , Zbys Fedorowicz  2 , Robin Christensen  3 , Adriana Lavrijsen  1 , Bernd WM Arents  4
Affiliations
Meta-Analysis

Emollients and moisturisers for eczema

Esther J van Zuuren et al. Cochrane Database Syst Rev. .

Abstract

Background: Eczema is a chronic skin disease characterised by dry skin, intense itching, inflammatory skin lesions, and a considerable impact on quality of life. Moisturisation is an integral part of treatment, but it is unclear if moisturisers are effective.

Objectives: To assess the effects of moisturisers for eczema.

Search methods: We searched the following databases to December 2015: Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, the GREAT database. We searched five trials registers and checked references of included and excluded studies for further relevant trials.

Selection criteria: Randomised controlled trials in people with eczema.

Data collection and analysis: We used standard Cochrane methodological procedures.

Main results: We included 77 studies (6603 participants, mean age: 18.6 years, mean duration: 6.7 weeks). We assessed 36 studies as at a high risk of bias, 34 at unclear risk, and seven at low risk. Twenty-four studies assessed our primary outcome 'participant-assessed disease severity', 13 assessed 'satisfaction', and 41 assessed 'adverse events'. Secondary outcomes included investigator-assessed disease severity (addressed in 65 studies), skin barrier function (29), flare prevention (16), quality of life (10), and corticosteroid use (eight). Adverse events reporting was limited (smarting, stinging, pruritus, erythema, folliculitis).Six studies evaluated moisturiser versus no moisturiser. 'Participant-assessed disease severity' and 'satisfaction' were not assessed. Moisturiser use yielded lower SCORAD than no moisturiser (three studies, 276 participants, mean difference (MD) -2.42, 95% confidence interval (CI) -4.55 to -0.28), but the minimal important difference (MID) (8.7) was unmet. There were fewer flares with moisturisers (two studies, 87 participants, RR 0.40, 95% CI 0.23 to 0.70), time to flare was prolonged (median: 180 versus 30 days), and less topical corticosteroids were needed (two studies, 222 participants, MD -9.30 g, 95% CI -15.3 to -3.27). There was no statistically significant difference in adverse events (one study, 173 participants, risk ratio (RR) 15.34, 95% CI 0.90 to 261.64). Evidence for these outcomes was low quality.With Atopiclair (three studies), 174/232 participants experienced improvement in participant-assessed disease severity versus 27/158 allocated to vehicle (RR 4.51, 95% CI 2.19 to 9.29). Atopiclair decreased itching (four studies, 396 participants, MD -2.65, 95% CI -4.21 to -1.09) and achieved more frequent satisfaction (two studies, 248 participants, RR 2.14, 95% CI 1.58 to 2.89), fewer flares (three studies, 397 participants, RR 0.18, 95% CI 0.11 to 0.31), and lower EASI (four studies, 426 participants, MD -4.0, 95% CI -5.42 to -2.57), but MID (6.6) was unmet. The number of participants reporting adverse events was not statistically different (four studies, 430 participants, RR 1.03, 95% CI 0.79 to 1.33). Evidence for these outcomes was moderate quality.Participants reported skin improvement more frequently with urea-containing cream than placebo (one study, 129 participants, RR 1.28, 95% CI 1.06 to 1.53; low-quality evidence), with equal satisfaction between the two groups (one study, 38 participants, low-quality evidence). Urea-containing cream improved dryness (investigator-assessed) more frequently (one study, 128 participants, RR 1.40, 95% CI 1.14 to 1.71; moderate-quality evidence) with fewer flares (one study, 44 participants, RR 0.47, 95% CI 0.24 to 0.92; low-quality evidence), but more participants in this group reported adverse events (one study, 129 participants, RR 1.65, 95% CI 1.16 to 2.34; moderate-quality evidence).Three studies assessed glycerol-containing moisturiser versus vehicle or placebo. More participants in the glycerol group noticed skin improvement (one study, 134 participants, RR 1.22, 95% CI 1.01 to 1.48; moderate-quality evidence), and this group saw improved investigator-assessed SCORAD (one study, 249 participants, MD -2.20, 95% CI -3.44 to -0.96; high-quality evidence), but MID was unmet. Participant satisfaction was not addressed. The number of participants reporting adverse events was not statistically significant (two studies, 385 participants, RR 0.90, 95% CI 0.68 to 1.19; moderate-quality evidence).Four studies investigated oat-containing moisturisers versus no treatment or vehicle. No significant differences between groups were reported for participant-assessed disease severity (one study, 50 participants, RR 1.11, 95% CI 0.84 to 1.46; low-quality evidence), satisfaction (one study, 50 participants, RR 1.06, 95% CI 0.74 to 1.52; very low-quality evidence), and investigator-assessed disease severity (three studies, 272 participants, standardised mean difference (SMD) -0.23, 95% CI -0.66 to 0.21; low-quality evidence). In the oat group, there were fewer flares (one study, 43 participants, RR 0.31, 95% CI 0.12 to 0.7; low-quality evidence) and less topical corticosteroids needed (two studies, 222 participants, MD -9.30g, 95% CI 15.3 to -3.27; low-quality evidence), but more adverse events were reported (one study, 173 participants; Peto odds ratio (OR) 7.26, 95% CI 1.76 to 29.92; low-quality evidence).All moisturisers above were compared to placebo, vehicle, or no moisturiser. Participants considered moisturisers more effective in reducing eczema (five studies, 572 participants, RR 2.46, 95% CI 1.16 to 5.23; low-quality evidence) and itch (seven studies, 749 participants, SMD -1.10, 95% CI -1.83 to -0.38) than control. Participants in both treatment arms reported comparable satisfaction (three studies, 296 participants, RR 1.35, 95% CI 0.77 to 2.26; low-quality evidence). Moisturisers led to lower investigator-assessed disease severity (12 studies, 1281 participants, SMD -1.04, 95% CI -1.57 to -0.51; high-quality evidence) and fewer flares (six studies, 607 participants, RR 0.33, 95% CI 0.17 to 0.62; moderate-quality evidence), but there was no difference in adverse events (10 studies, 1275 participants, RR 1.03, 95% CI 0.82 to 1.30; moderate-quality evidence).Topical active treatment combined with moisturiser was more effective than active treatment alone in reducing investigator-assessed disease severity (three studies, 192 participants, SMD -0.87, 95% CI -1.17 to -0.57; moderate-quality evidence) and flares (one study, 105 participants, RR 0.43, 95% CI 0.20 to 0.93), and was preferred by participants (both low-quality evidence). There was no statistically significant difference in number of adverse events (one study, 125 participants, RR 0.39, 95% CI 0.13 to 1.19; very low-quality evidence). Participant-assessed disease severity was not addressed.

Authors' conclusions: Most moisturisers showed some beneficial effects, producing better results when used with active treatment, prolonging time to flare, and reducing the number of flares and amount of topical corticosteroids needed to achieve similar reductions in eczema severity. We did not find reliable evidence that one moisturiser is better than another.

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Conflict of interest statement

Esther J van Zuuren: nothing to declare. Zbys Fedorowicz: nothing to declare. Adriana Lavrijsen: nothing to declare. Robin Christensen: nothing to declare. Bernd Arents: nothing to declare. Matthew Ridd (referee of the protocol): "I am chief investigator on a feasibility trial comparing four commonly used emollients in children with eczema (not yet published but likely to be included in this review). I have recently submitted an application for funding to take this study to a full trial." Sandra Lawton (referee of the protocol): "I have received an honorarium for speaking at meetings from Genus, Almirall, and Thornton & Ross Ltd, and for reviewing an educational programme for Bayer."

Figures

1
1
Study flow diagram
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
4
4
Funnel plot of comparison 5: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), outcome: 5.5 Change in disease severity as assessed by the investigators
1.1
1.1. Analysis
Comparison 1: Moisturisers versus no treatment (i.e. no moisturiser), Outcome 1: Change from baseline in SCORAD
1.2
1.2. Analysis
Comparison 1: Moisturisers versus no treatment (i.e. no moisturiser), Outcome 2: Number of participants experiencing a flare
1.3
1.3. Analysis
Comparison 1: Moisturisers versus no treatment (i.e. no moisturiser), Outcome 3: Rate of flare
1.4
1.4. Analysis
Comparison 1: Moisturisers versus no treatment (i.e. no moisturiser), Outcome 4: Amount of topical steroids used
1.5
1.5. Analysis
Comparison 1: Moisturisers versus no treatment (i.e. no moisturiser), Outcome 5: Change from baseline in quality of life
2.1
2.1. Analysis
Comparison 2: Atopiclair versus vehicle, Outcome 1: Number of participants who experienced good improvement to total resolution
2.2
2.2. Analysis
Comparison 2: Atopiclair versus vehicle, Outcome 2: Change from baseline in itch measured on a VAS
2.3
2.3. Analysis
Comparison 2: Atopiclair versus vehicle, Outcome 3: Number of participants reporting an adverse event
2.4
2.4. Analysis
Comparison 2: Atopiclair versus vehicle, Outcome 4: Change from baseline in EASI
2.5
2.5. Analysis
Comparison 2: Atopiclair versus vehicle, Outcome 5: Number of participants experiencing a flare
3.1
3.1. Analysis
Comparison 3: Urea‐containing moisturiser versus vehicle, Outcome 1: Change from baseline in skin capacitance
4.1
4.1. Analysis
Comparison 4: Glycerin cream versus placebo cream, Outcome 1: Number of participants reporting an adverse event
5.1
5.1. Analysis
Comparison 5: Oat‐containing cream versus vehicle or no treatment, Outcome 1: Change in disease severity as assessed by the investigators (SCORAD and EASI)
5.2
5.2. Analysis
Comparison 5: Oat‐containing cream versus vehicle or no treatment, Outcome 2: Change from baseline in quality of life
6.1
6.1. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 1: Number of participants who experienced improvement
6.2
6.2. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 2: Change from baseline in itch
6.3
6.3. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 3: Number of participants who expressed treatment satisfaction
6.4
6.4. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 4: Number of participants reporting an adverse event
6.5
6.5. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 5: Change in disease severity as assessed by the investigators
6.6
6.6. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 6: Number of participants experiencing a flare
6.7
6.7. Analysis
Comparison 6: All moisturisers versus vehicle, placebo or no treatment (no moisturiser), Outcome 7: Change from baseline in quality of life
7.1
7.1. Analysis
Comparison 7: Evening primrose oil versus placebo oil, Outcome 1: Change from baseline in TEWL
7.2
7.2. Analysis
Comparison 7: Evening primrose oil versus placebo oil, Outcome 2: Change from baseline in skin hydration
8.1
8.1. Analysis
Comparison 8: Licochalcone versus hydrocortisone acetate (HCA) 1%, Outcome 1: Change from baseline in itch (VAS)
8.2
8.2. Analysis
Comparison 8: Licochalcone versus hydrocortisone acetate (HCA) 1%, Outcome 2: Change from baseline in SCORAD
8.3
8.3. Analysis
Comparison 8: Licochalcone versus hydrocortisone acetate (HCA) 1%, Outcome 3: Change from baseline in TEWL
9.1
9.1. Analysis
Comparison 9: Advabase versus MPA cream twice weekly and emollient, Outcome 1: Rate of flare
10.1
10.1. Analysis
Comparison 10: Vehicle + daily moisturiser versus fluticasone propionate (FP) + daily moisturiser, Outcome 1: Number of participants reporting an adverse event
10.2
10.2. Analysis
Comparison 10: Vehicle + daily moisturiser versus fluticasone propionate (FP) + daily moisturiser, Outcome 2: Number of participants experiencing a flare
10.3
10.3. Analysis
Comparison 10: Vehicle + daily moisturiser versus fluticasone propionate (FP) + daily moisturiser, Outcome 3: Rate of flare
11.1
11.1. Analysis
Comparison 11: Active treatment in combination with a moisturiser versus active treatment only, Outcome 1: Change in disease severity as assessed by the investigators
11.2
11.2. Analysis
Comparison 11: Active treatment in combination with a moisturiser versus active treatment only, Outcome 2: Change in quality of life IDQOL
11.3
11.3. Analysis
Comparison 11: Active treatment in combination with a moisturiser versus active treatment only, Outcome 3: Change in quality of life DFI
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Giordano‐Labadie 2006 {published data only}
    1. Giordano Labadie F, Cambazard F, Guillet C, Combemale P, Mengeaud V. Interest of a moisturizer milk containing oat rhealba extracts in atopic dermatitis. In: 20th World Congress of Dermatology Paris 1st- 5th of July. P0203 edition. 2002.
    1. Giordano-Labadie F, Cambazard F, Guillet G, Combemale P, Mengeaud V. Evaluation of a new moisturizer (Exomega milk) in children with atopic dermatitis. Journal of Dermatological Treatment 2006;17(2):78-81. [PMID: ] - PubMed
Glazenburg 2009 {published data only}
    1. Glazenburg EJ, Wolkerstorfer A, Gerretsen AL, Mulder PG, Oranje AP. Efficacy and safety of fluticasone propionate 0.005% ointment in the long-term maintenance treatment of children with atopic dermatitis: differences between boys and girls? Pediatric Allergy and Immunology 2009;20(1):59-66. [PMID: ] - PubMed
    1. Glazenburg EJ, Wolkerstorfer A, Gerretsen AL, Oranje AP. Twice weekly topical fluticasone propionate delays the time to relapse in children with chronic atopic dermatitis. Journal of the European Academy of Dermatology and Venereology : JEADV 2003;17(Suppl 3):184.
Grimalt 2007 {published data only}
    1. Grimalt R, Cambazard F. Evaluation of the corticosteroid-sparing effect of a new emollient in 162 atopic infants. In: 4th European Association of Dermatology and Venereology (EADV) Spring Symposium Saariselka, Lapland, Finland. February 9-12th. 2006:P-009.
    1. Grimalt R, Mengeaud V, Cambazard F, Study IG . The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology 2007;214(1):61-7. [PMID: ] - PubMed
    1. Josse M, Mengeaud V, Durosier V, Sibaud V, Grimalt R, Cambazard F. Evaluation of the Corticosteroid-Sparing Effect of an Emollient Milk in a Large Population of Infants Affected by Atopic Dermatitis. Journal of Investigative Dermatology 2005;125(3):612.
Hagströmer 2001 {published data only}
    1. Hagströmer L, Nyrén M, Emstesam L. Urea and sodium chloride in moisturisers for dry atopic skin: A double-blind, randomised, placebo-controlled study. Journal of the European Academy of Dermatology and Venereology : JEADV 1999;12(Suppl 2):S160.
    1. Hagströmer L, Nyrén M, Emtestam L. Do urea and sodium chloride together increase the efficacy of moisturisers for atopic dermatitis skin? A comparative, double-blind and randomised study. Skin Pharmacology and Applied Skin Physiology 2001;14(1):27-33. [PMID: ] - PubMed
    1. Hagströmer L, Nyrén M, Emtestam L. Moisturisers for dry atopic skin: a double-blind, randomised, placebo-controlled study. Contact Dermatitis 2000;42(Suppl):52.
Hagströmer 2006 {published data only}
    1. Hagströmer L, Kuzmina N, Lapins J, Talme T, Emtestam L. Biophysical assessment of atopic dermatitis skin and effects of a moisturizer. Clinical and Experimental Dermatology 2006;31(2):272-7. [PMID: ] - PubMed
Hamada 2008 {published data only}
    1. Hamada M, Gyoutoku T, Sato S, Matsuda T, Kinukawa N, Furue M. The usefulness of camellia oil spray for treatment of atopic dermatitis. Nishinihon Journal of Dermatology 2008;70(2):213-8.
Hanifin 1998 {published data only}
    1. Hanifin JM, Hebert AA, Mayes S, Paller A, Sheretz EF, Wagner Aetal. Bilateral regimen comparison of desonide lotion, 0.05% vs desonide lotion, 0.05% plus a moisturizing cream in patients with atopic dermatitis. In: Australasian Journal of Dermatology. Vol. 38. 1997:233.
    1. Hanifin JM, Hebert AA, Mays SR, Paller A, Sherertz EF, Wagner AM, et al. Effects of a low-potency corticosteroid lotion plus a moisturizing regimen in the treatment of atopic dermatitis. Current Therapeutic Research, Clinical and Experimental 1998;59(4):227-33.
Hanifin 2002 {published data only}
    1. Glazenburg EJ, Meer JB. Safety of fluticasone propionate. Journal of the European Academy of Dermatology and Venereology : JEADV 2002;16(Suppl 1):P2-34.
    1. Hanifin J, Berth-Jones J. Consensus from 4 studies—use of twice weekly fluticasone propionate can maintain remission in moderate to severe atopic dermatitis. Journal of Investigative Dermatology 2003;121(1):199.
    1. Hanifin J, Gupta AK, Rajagopalan R. Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. British Journal of Dermatology 2002;147(3):528-37. [PMID: ] - PubMed
Harper 1995 {published data only}
    1. Harper J. Double-blind comparison of an antiseptic oil-based bath additive (Oilatum Plus) with regular Oilatum (Oilatum emollient) for the treatment of atopic eczema. In: Lever R, Levy J, editors(s). The Bacteriology of Eczema. Round Table Series 37 edition. Vol. 37. London: The Royal Society of Medicine Press Ltd, 1995:42-7.
Hlela 2015 {published data only}
    1. Hlela C, Lunjani N, Gumedze F, Kakande B, Khumalo NP. Affordable moisturisers are effective in atopic eczema: A randomised controlled trial. South African Medical Journal 2015;105(9):780-4. - PubMed
Janmohamed 2014 {published data only}
    1. Janmohamed SR, Gutermuth J, Oranje AP. The wet-wrap method with diluted corticosteroids versus emollients in children with atopic dermatitis-a prospective, randomized, double-blind, placebo controlled trial. Journal of Investigative Dermatology 2015;135(S2):S38. - PubMed
    1. Janmohamed SR, Oranje AP, Devillers AC, Rizopoulos D, Praag MC, Van Gysel, et al. The proactive wet-wrap method with diluted corticosteroids versus emollients in children with atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled trial. Journal of the American Academy of Dermatology 2014;70(6):1076-82. [PMID: ] - PubMed
Jirabundansuk 2014 {published data only}
    1. Jirabundansuk P, Ophaswongse S, Udompataikul M. Comparative trial of moisturizer containing spent grain wax, Butyrospermum parkii extract, Argania spinosa kernel oil vs. 1% hydrocortisone cream in the treatment of childhood atopic dermatitis. Journal of the Medical Association of Thailand 2014;97(8):820-6. [PMID: ] - PubMed
Kircik 2009 {published data only}
    1. Kircik L. Skin barrier function and hydration effects of hydrolipid cream alone and in combination in the treatment of mild to moderate atopic dermatitis: Investigator-blinded, split-body, pilot study results. Journal of the American Academy of Dermatology 2009;62(3 Suppl 1):AB67.
Kircik 2014 {published data only}
    1. Kircik LH. Effect of skin barrier emulsion cream vs a conventional moisturizer on transepidermal water loss and corneometry in atopic dermatitis: a pilot study. Journal of Drugs in Dermatology 2014;13(12):1482-4. [PMID: 25607793] - PubMed
Korting 2010 {published data only}
    1. Korting HC, Schöllmann C, Cholcha W, Wolff L, Collaborative SG . Efficacy and tolerability of pale sulfonated shale oil cream 4% in the treatment of mild to moderate atopic eczema in children: a multicentre randomized vehicle-controlled trial. Journal of the European Academy of Dermatology and Venereology : JEADV 2010;24(10):1176-82. [PMID: ] - PubMed
Larregue 1996 {published data only}
    1. Larregue M, Devaux J, Audebert C, Gelmetti DR. A double-blind controlled study on the efficacy and tolerability of 6% ammonium lactate cream in children with atopic dermatitis. Nouvelles Dermatologiques 1996;15(10):720-1.
Laumann 2006 {published data only}
    1. Laumann A, Lai S, Lucky AW, Schlessinger J, Jarratt M Jones TM, et al. The efficacy and safety of MimyX Cream in reducing the risk of relapse in atopic dermatitis. Journal of Investigative Dermatology 2006;126(Suppl 1s):45.
Lodén 2001 {published data only}
    1. Lodén M, Andersson AC, Andersson C, Frödin T, Oman H, Lindberg M. Instrumental and dermatologist evaluation of the effect of glycerine and urea on dry skin in atopic dermatitis. Skin Research and Technology 2001;7(4):209-13. [PMID: ] - PubMed
Lodén 2002 {published data only}
    1. Lodén M, Andersson AC, Anderson C, Bergbrant IM, Frödin T, Ohman H, et al. A double-blind study comparing the effect of glycerin and urea on dry, eczematous skin in atopic patients. Acta Dermato-Venereologica 2002;82(1):45-7. [PMID: ] - PubMed
Marseglia 2014 {published data only}
    1. Marseglia A, Licari A, Agostinis F, Barcella A, Bonamonte D, Puviani M, et al. Local rhamnosoft, ceramides and L-isoleucine in atopic eczema: a randomized, placebo controlled trial. Pediatric Allergy and Immunology 2014;25(3):271-5. [PMID: ] - PMC - PubMed
Miller 2011 {published data only}
    1. Miller DW, Clark AR, Fleischer AB, Yentzer BA, Koch SB. An over the counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild to moderate atopic dermatitis. Journal of the American Academy of Dermatology 2011;64(2 Suppl 1):AB57. - PubMed
    1. Miller DW, Koch SB, Yentzer BA, Clark AR, O'Neill JR, Fountain J, et al. An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial. Journal of Drugs in Dermatology 2011;10(5):531-7. [PMID: ] - PubMed
Msika 2008 {published data only}
    1. Msika C, De Belilovsky C, Menu F, Baudouin C, Chadoutaud B. Natural PPAR-alpha agonist and atopic dermatitis: From research to clinical efficacy. Contact Dermatitis 2010;63(Suppl 1):68.
    1. Msika P, De Belilovsky C, Chadoutaud IB, Nicolas JF. New Natural PPAR-a agonist for childhood atopic dermatitis: Dermocorticoid-sparing and quality of life improvement. Journal of Investigative Dermatology 2006;126(Suppl 3):S102.
    1. Msika P, De Belilovsky C, Chadoutaud IB, Nicolas JF. New natural PPAR-a agonist for childhood atopic dermatitis: Dermocorticoid- sparing and quality of life improvement. Journal of the American Academy of Dermatology 2007;56(2):AB67.
    1. Msika P, De Belilovsky C, Menu F, Baudouin C, Chadoutaud B. Natural PPAR-alpha agonist and Atopic dermatitis: From research to clinical efficacy. Journal of Investigative Dermatology 2010;130(10):2524.
    1. Msika P, De Belilovsky C, Menu F, Baudouin C, Chadoutaud B. Natural PPAR-alpha agonist and atopic dermatitis: From research to clinical efficacy. Journal of Investigative Dermatology 2010;130(Suppl 1):S54.
Namazova‐Baranova 2012 {published data only}
    1. Namazova-Baranova L, Vishneva E, Levina J, Torshkhoeva R, Alekseeva A, Efendieva K, et al. Combined therapy of atopic dermatitis in children. Allergy 2012;67(Suppl 96):181-2.
    1. Namazova-Baranova LS, Vishneva EA, Torshhoeva RM, Dzagoeva ZN, Alexeeva AA, Levina JG, et al. Non-steroidal topical medications in the treatment of atopic dermatitis in children. Pediatric Pharmacology [Pediatricheskaya farmakologiya] 2012;9(1):66-70.
Nebus 2009 {published data only}
    1. Nebus J, Nystrand G, Fowler J, Wallo W. A daily oat-based skin care regimen for atopic skin. Journal of the American Academy of Dermatology 2009;62(3 Suppl 1):AB67.
Nho 2014 {published data only}
    1. Kim YS, Jung YL, Youm JK, Park JH, Bae YI, Lee SH. The effects of peroxisome proliferator activated receptor α (PPARα) activator on patients with facial erythema. Korean Journal of Dermatology 2014;52(8):608-14.
    1. Nho Y, Kim H, Jung Y, Kim S, Kim Y, Lee Setal. A combination of PPARα activator and ceramide improves red face originated from variable skin diseases. Journal of Investigative Dermatology 2014;134(S1):S95.
Noh 2011 {published data only}
    1. Noh S, Jung JY, Park WS, Koh HJ, Lee KH. The Steroid-sparing Effect of an Emollient APDDR-0801 in Patients with Atopic Dermatitis. Korean Journal of Dermatology 2011;49(3):227-33.
Nuñez 2013 {published data only}
    1. Nuñez C, Hogan D, Humphrey M, Zhang P, Lisante T, Doshi U. A colloidal oatmeal OTC cream is as clinically effective as a prescription barrier repair cream for the management of mild to moderate atopic dermatitis in African American children. Journal of the American Academy of Dermatology 2013;68(4 Suppl 1):AB73.
Park 2014 {published data only}
    1. Park SB, Im M, Lee Y, Lee JH, Lim J, Park YH, et al. Effect of emollients containing vegetable-derived lactobacillus in the treatment of atopic dermatitis symptoms: split-body clinical trial. Annals of Dermatology 2014;26(2):150-5. [PMID: ] - PMC - PubMed
Patrizi 2008 {published data only}
    1. Patrizi A, Capitanio B, Neri I, Giacomini F, Sinagra JL, Raone B, et al. A double-blind, randomized, vehicle-controlled clinical study to evaluate the efficacy and safety of MAS063DP (ATOPICLAIR[trademark]) in the management of atopic dermatitis in paediatric patients. Pediatric Allergy and Immunology 2008;19(7):619-25. [PMID: ] - PubMed
Patrizi 2014 {published data only}
    1. Bianchi P, Theunis J, Casas C, Villeneuve C, Patrizi A, Phulpin C, et al. Effects of a New Emollient-Based Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis. Pediatric Dermatology 2016;33(2):165-71. [PMID: ] - PMC - PubMed
    1. Bianchi P, Villeneuve C, Theunis J, Casas C, Patrizi A, Bacquey A, et al. Evaluation of a novel emollient balm containing Aquaphilus dolomiae extract in atopic dermatitis children: Effect on clinical parameters, skin barrier and microflora. Journal of Investigative Dermatology 2014;134(Suppl 1):S96.
    1. Patrizi A, Bacquey A, Schmitt AM, Decoster CJ, Phulpin C, Theunis J, et al. Clinical and biometrologic evaluation of a novel emollient balm containing an Aquaphilus dolomiae extract in 1-to 4-year-old children suffering from atopic dermatitis: International,multicenter, randomized versus control group study. Journal of the American Academy of Dermatology 2014;70(5 Suppl 1):AB62.
Peltonen 2014 {published data only}
    1. Peltonen JM, Pylkkänen L, Jansén CT, Volanen I, Lehtinen T, Laihia JK, et al. Three randomised phase I/IIa trials of 5% cis-urocanic acid emulsion cream in healthy adult subjects and in patients with atopic dermatitis. Acta Dermato-Venereologica 2014;94(4):415-20. [PMID: ] - PubMed
Peserico 2008 {published data only}
    1. Peserico A, Städtler G, Sebastian M, Fernandez RS, Vick K, Bieber T. Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study. British Journal of Dermatology 2008;158(4):801-7. [PMID: ] - PubMed
Pigatto 1996 {published data only}
    1. Pigatto PD, Bigardi AS, Cannistraci C, Picardo M. 10% urea cream (Laceran) for atopic dermatitis: A clinical and laboratory evaluation. Journal of Dermatological Treatment 1996;7(3):171-5.
Puschmann 2003 {published data only}
    1. Puschmann M, Melzer A, Welzel J. Extensive treatment of itching, dry dermatoses with a polidocanol-urea-combination. Aktuelle Dermatologie 2003;29(3):77-81.
Shi 2015 {published data only}
    1. Shi VY, Foolad N, Ornelas JN, Hassoun L, Monico G, Takeda N, et al. Comparing the effect of bleach and water baths on skin barrier function in atopic dermatitis: a split-body randomized controlled trial. British Journal of Dermatology 2016;175(1):212-4. [PMID: ] - PubMed
    1. Shi VY, Foolad N, Takeda N, Hassoun L, Johal R, Saric S, et al. The effect of dilute bleach bath and moisturizers on skin barrier function in atopic dermatitis. Journal of the American Academy of Dermatology 2015;72(Suppl 1):AB76.
Shiratori 1977 {published data only}
    1. Shiratori A, Ikazi M, Tamada T, Sato Y, Igarashi R, Ishikawa H, et al. A double-blind study on clinical efficacy of urea ointment. Rinsho Hyoka (Clinical Evaluation) 1977;5(1):103-25.
Simpson 2011 {published data only}
    1. Dutronc Y, Guennoun M. Hydration potential of a new body moisturizer. Journal of the American Academy of Dermatology 2011;64(2 Suppl 1):AB58.
    1. Simpson E, Dutronc Y. A new body moisturiser increases skin hydration and improves atopic dermatitis symptoms among children and adults. Journal of Drugs in Dermatology 2011;10(7):744-9. [PMID: ] - PubMed
    1. Simpson E Dutronc Y Caveney S. A new body moisturizer increases skin hydration among children and adults with atopic dermatitis symptoms. Seminars in Cutaneous Medicine and Surgery 2012;31(1):A5.
Simpson 2013 {published data only}
    1. Simpson E, Böhling A, Bielfeldt S, Bosc C, Kerrouche N. Improvement of skin barrier function in atopic dermatitis patients with a new moisturizer containing a ceramide precursor. Journal of Dermatological Treatment 2013;24(2):122-5. [PMID: ] - PubMed
    1. Simpson E. Improvement of skin barrier function in atopic dermatitis patients with a new moisturizer containing a ceramide precursor. Journal of the American Academy of Dermatology 2013;68(4 Suppl 1):AB77. - PubMed
Sugarman 2009 {published data only}
    1. Sugarman IL, Parish LJ. A topical physiologic lipid-based, barrier repair formulation (Epiceram™ cream) is highly effective monotherapy for moderate-to-severe pediatric atopic dermatitis: a multicenter, investigator-blinded trial comparing a barrier repair formulation, Epiceram™, to fluticasone proprionate (Cutivate®) cream. Journal of Investigative Dermatology 2008;128(Suppl 1):S54.
    1. Sugarman JL, Parish LC. Efficacy of a lipid-based barrier repair formulation in moderate-to-severe pediatric atopic dermatitis. Journal of Drugs in Dermatology 2009;8(12):1106-11. [PMID: ] - PubMed
Takeuchi 2012 {published data only}
    1. Takeuchi S, Saeki H, Tokunaga S, Sugaya M, Ohmatsu H, Tsunemi Y, et al. A randomized, open-label, multicenter trial of topical tacrolimus for the treatment of pruritis in patients with atopic dermatitis. Annals of Dermatology 2012;24(2):144-50. [PMID: ] - PMC - PubMed
    1. Takeuchi S, Saeki H, Tokunaga S, Torii H, Nakamura K, Soma Y, et al. A randomized,multicenter trial of topical tacrolimus for treatment of pruritus in patients with atopic dermatitis. Acta Dermato-Venereologica 2009;89:704.
    1. Takeuchi S Furue M. Itch control in atopic dermatitis. In: New Trends in Allergy VII and 6th Georg Rajka Symposium on Atopic Dermatitis, Munich, Germany. 2010.
Tan 2010 {published data only}
    1. Tan WP, Goon A, Suresh S, Tey HL, Chiam LY. A randomized double-blind controlled trial to compare a triclosan-containing emollient with vehicle for the treatment of atopic dermatitis. Journal of the American Academy of Dermatology 2010;60(3 Suppl 1):AB70. - PubMed
    1. Tan WP, Suresh S, Tey HL, Chiam LY, Goon AT. A randomized double-blind controlled trial to compare a triclosan-containing emollient with vehicle for the treatment of atopic dermatitis. Clinical and Experimental Dermatology 2010;35(4):e109-12. [PMID: ] - PubMed
Thumm 2000 {published data only}
    1. Thumm EJ, Stoss M, Bayerl C, Schürholz T. Randomized trial to study efficacy of a 20% and 10% Hippophae rhamnoides containing creme used by patients with mild to intermediate atopic dermatitis [Überprüfung der Wirksamkeit einer 20%igen und 10%igen Sanddornkernölcreme bei Patienten mit leichter bis mittelgradiger atopischer Dermatitis]. Aktuelle Dermatologie 2000;26(8-9):285-90.
Tripodi 2009 {published data only}
    1. Tripodi S, Di Rienzo Businco A, Panetta V, Pingitore G, Volterrani A, Frediani T, et al. Lack of efficacy of topical furfuryl palmitate in pediatric atopic dermatitis: a randomized double-blind study. Journal of Investigational Allergology & Clinical Immunology 2009;19(3):204-9. [PMID: ] - PubMed
Udompataikul 2011 {published data only}
    1. Udompataikul M, Srisatwaja W. Comparative trial of moisturizer containing licochalcone A vs. hydrocortisone lotion in the treatment of childhood atopic dermatitis: a pilot study. Journal of the European Academy of Dermatology and Venereology: JEADV 2011;25(6):660-5. [PMID: ] - PubMed
Verallo‐Rowell 2008 {published data only}
    1. Verallo-Rowell VM, Dillague KM, Syah-Tjundawan BS. Novel antibacterial and emollient effects of coconut and virgin olive oils in adult topic dermatitis. Dermatitis 2008;19(6):308-15. [PMID: ] - PubMed
Wanakul 2013 {published data only}
    1. Wananukul S, Chatproedprai S, Chunharas A, Limpongsanuruk W, Singalavanija S, Chantorn R. Comparison study of moisturiser containing licochalcone A and 1%hydrocortisone in the treatment of childhood atopic dermatitis. Allergy 2012;67(Suppl 96):634. - PubMed
    1. Wananukul S, Chatproedprai S, Chunharas A, Limpongsanuruk W, Singalavanija S, Nitiyarom R, et al. Randomized, double-blind, split-side, comparison study of moisturizer containing licochalcone A and 1% hydrocortisone in the treatment of childhood atopic dermatitis. Journal of the Medical Association of Thailand 2013;96(9):1135-42. [PMID: ] - PubMed
Weber 2015 {published data only}
    1. Weber TM, Samarin F, Babcock MJ, Filbry A, Arrowitz CE, Rippke E. A novel daily moisturizing cream for effective management of mild to moderate atopic dermatitis in infants and children. Journal of the American Academy of Dermatology 2015;72(5 Suppl 1):AB73.
    1. Weber TM, Samarin F, Babcock MJ, Filbry A, Rippke F. Steroid-Free Over-the-Counter Eczema Skin Care Formulations Reduce Risk of Flare, Prolong Time to Flare, and Reduce Eczema Symptoms in Pediatric Subjects With Atopic Dermatitis. Journal of Drugs in Dermatology 2015;14(5):478-85. [PMID: ] - PubMed
Wilhelm 1998 {published data only}
    1. Wilhelm KP, Schölermann A, Bohnsack K, Wilhelm D, Rippke F. Efficacy and tolerability of a topical preparation containing 10% urea in patients with atopic dermatitis [Wirksamkeit und Verträglichkeit einer topischer Zubereitung mit 10% Urea (Laceran® Salbe 10% Urea bei Neurodermitis]. Aktuelle Dermatologie 1998;24(1-2):26-30.
Wirén 2009 {published data only}
    1. Hjalte F, Asseburg C, Tennvall GR. Cost-effectiveness of a barrier-strengthening moisturizing cream as maintenance therapy vs. no treatment after an initial steroid course in patients with atopic dermatitis in Sweden--with model applications for Denmark, Norway and Finland. Journal of the European Academy of Dermatology and Venereology : JEADV 2010;24(4):474-80. [PMID: PMID: 19793150] - PubMed
    1. Wirén K, Nohlgård C, Nyberg F, Holm L, Svensson M, Johannesson A, et al. Treatment with a barrier-strengthening moisturizing cream delays relapse of atopic dermatitis: a prospective and randomized controlled clinical trial. Journal of the European Academy of Dermatology and Venereology: JEADV 2009;23(11):1267-72. [PMID: ] - PubMed
Wu 2014 {published data only}
    1. Wu Y-Q, Pan J-S, Zhao W-Q. Clinical observation of moisture and softening cream (MSC) combined with compound flumetasone ointment for chronic eczema. Journal of Clinical Dermatology 2014;43(7):434-6.

References to studies excluded from this review

Duggan 2015 {published data only}
    1. Duggan C. Eczema on trial. Journal of Family Health 2015;25(3):10, 12. - PubMed
Dutronc 2011B {published data only}
    1. Dutronc Y. Irritation potential and cosmetic acceptability of a new body moisturizer. Journal of the American Academy of Dermatology 2011;64(2 Suppl 1):AB58.
Schoelermann 2003 {published data only}
    1. Schölermann A. 10% urea: an effective moisturizer in various dry skin conditions. In: 20th World Congress of Dermatology Paris 1st to 5th July. 2002- P0259.
    1. Schoelermann A, Fibry A, Rippke F. 10% urea: an effective moisturizer in various dry skin conditions. British Journal of Dermatology 2003;149(Suppl 64):79.
Szczepanowska 2008 {published data only}
    1. Szczepanowska J, Reich A, Szepietowski JC. Emollients improve treatment results with topical corticosteroids in childhood atopic dermatitis: a randomized comparative study. Pediatric Allergy and Immunology 2008;19(7):614-8. [PMID: ] - PubMed
Yang 2010 {published data only}
    1. Yang XY, Xu LM, Zhou AM, Wen H, Wu Y, Hao F, et al. The adjuvant treatment of atopic dermatitis with medical skin preparation containing extracts from Portulaca oleracea and avocado. Journal of Clinical Dermatology 2010;39(7):460-2.

References to ongoing studies

ACTRN12615000782538 {published data only}
    1. ACTRN12615000782538. A randomised, double blind, placebo controlled comparative trial of Ceramide Cream and Ceramide Cleanser in the management of moderate eczema in adults. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12615000782538 Date first received: 28 July 2015.
ACTRN12615000920594 {published data only}
    1. ACTRN12615000920594. A randomised double blinded placebo controlled study investigating Atopis for the improvement of skin health in subjects with eczema. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12615000920594 Date first received: 2 September 2015.
ACTRN12615001343594 {published data only}
    1. ACTRN12615001343594. Epaderm ointment in children with eczema [Pilot study comparing two emollients, Emulsifying ointment B.P. and Epaderm topical ointment in children with eczema]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12615001343594 Date first received: 9 December 2015.
ChiCTR‐IOR‐15007139 {published data only}
    1. ChiCTR-IOR-15007139. Effect andEfficacy of a Linoleic Acid-Ceramide Containing Moisturizer in atopic dermatitis [Effect and Efficacy of a Linoleic Acid-Ceramide Containing Moisturizer as an adjunctive therapy in the treatment of atopic dermatitis:A Randomized Controlled Trial]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-IOR-15007139 Date first received: 31 August 2015.
EudraCT2004‐002926‐23 {published data only}
    1. EudraCT 2004-002926-23. Evaluation of the impact of the moisturizing milk RV2478B on the use of corticoids and on quality of life, in a population of children with atopic dermatitis. clinicaltrialsregister.eu/ctr-search/trial/2004-002926-23/IT Date first received: 15 January 2007.
EudraCT2005‐003396‐21 {published data only}
    1. EudraCT2005-003396-21. Long-term management of atopic dermatitis with the emollient V0034 CR. A randomised, placebo-controlled, parallel-groups, double-blind study in infants and children. clinicaltrialsregister.eu/ctr-search/search?query=2005-003396-21.
EudraCT2006‐000877‐30 {published data only}
    1. EudraCT2006-000877-30. A 6 week, multi centre study to evaluate the efficacy and safety of E45 complete emollient therapy and E45 itch relief cream in the treatment of mild to moderate atopic eczema compared to a patients normal emollient regime defined as the frequent use of emollient/s (not containing lauromacrogols) listed in the BNF. - Harbour Study. clinicaltrialsregister.eu/ctr-search/search?query=2006-000877-30.
EudraCT2007‐002133‐36 {published data only}
    1. EudraCT2007-002133-36. A multicenter, randomized, double-blind clinical study to examine the efficacy and safety of Zarzenda® in comparison to Elidel® in the management of mild to moderate atopic dermatitis in children and adolescents. clinicaltrialsregister.eu/ctr-search/search?query=2007-002133-36.
EudraCT2008‐003485‐25 {published data only}
    1. EudraCT2008-003485-25. Impact of the V0034CR 01B emollient on atopic dermatitis symptoms in children. A randomised, placebo-controlled, parallel-groups, double-blind study. clinicaltrialsregister.eu/ctr-search/trial/2008-003485-25/DE Date first received: 12 September 2008.
EudraCT2008‐006844‐21 {published data only}
    1. EudraCT2008-006844-21. Evaluation of a developmental ‘long lasting’ emollient in subjects with dry skin. clinicaltrialsregister.eu/ctr-search/trial/2008-006844-21/GB.
EudraCT2009‐010609‐35 {published data only}
    1. EudraCT2009-010609-35. Is treatment with emollients always beneficial? Comparative biophysical and molecular biological studies of the skin barrier function in patients with atopic dermatitis, ichthyosis vulgaris and x-linked ichthyosis. clinicaltrialsregister.eu/ctr-search/trial/2009-010609-35/SE.
EudraCT2009‐016572‐78 {published data only}
    1. EudraCT2009-016572-78. Arm immersion test to compare the skin effects of routine bathing with and without the use of an emollient bath additive. clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2009-01... Date first received: 17 March 2010.
EudraCT2012‐004621‐24 {published data only}
    1. EudraCT2012-004621-24. Emollients in the management of atopic dermatitis in children: prevention of flares. www.clinicaltrialsregister.eu/ctr-search/search?query=2012-004621-24.
EudraCT2014‐001026‐16 {published data only}
    1. EudraCT2014-001026-16. Randomised, double-blind, bilateral comparison of two emollients in patients with dry skin. clinicaltrialsregister.eu/ctr-search/search?query=2014-001026-16.
ISRCTN97515110 {published data only}
    1. ISRCTN97515110. Investigating whether topical application of a non toxic molecule improves epidermal pH and barrier function in atopic dermatitis. isrctn.com/ISRCTN97515110 Date first received: 21 October 2010.
JPRN‐UMIN000005158 {published data only}
    1. JPRN-UMIN000005158. Randomized controlled trial to evaluate clinical efficacy of once- or twice-daily skin care with emollient for prevention of atopic dermatitis exacerbation. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000005158 Date first received: 7 March 2011.
JPRN‐UMIN000010009 {published data only}
    1. JPRN-UMIN000010009. Study to evaluate the efficacy of conventional topical therapy for atopic dermatitis based on Filaggrin-gene mutations. http://apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000010009.
JPRN‐UMIN000017957 {published data only}
    1. JPRN-UMIN000017957. The effect of moisturizer on both sweating function and sensitive skin in patients with atopic dermatitis, a randomized comparative study. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000017957 Date first received: 18 June 2015.
NCT00180141 {published data only}
    1. NCT00180141. Elidel-study: Elidel in patients with atopic dermatitis [Control of therapy with Elidel vs placebo in patients with atopic dermatitis using bioengineering methods]. clinicaltrials.gov/ct2/show/study/NCT00180141 Date first received: 12 September 2005.
NCT00576238 {published data only}
    1. NCT00576238. Skin tolerance study of betamethasone creams in atopic eczema and the preventative properties of a moisturiser [A multi centre, parallel, randomised study of the skin tolerance of betamethasone creams on atopic eczema and the influence of moisturiser treatment on the recurrence of eczema]. clinicaltrials.gov/ct2/show/NCT00576238?term=NCT00576238&rank=1 Date first received: 18 December 2007.
NCT00828412 {published data only}
    1. NCT00828412. Comparison of the efficacy and safety of two topical creams for pediatric atopic dermatitis [A randomized, investigator-blind, six-week, parallel group, multicenter pilot study to compare the safety and efficacy of EpiCeram skin barrier emulsion and desonide cream 0.05% in the twice daily treatment of pediatric subjects with moderate atopic dermatitis]. clinicaltrials.gov/show/NCT00828412 Date first received: 21 January 2009.
NCT01779258 {published data only}
    1. NCT01779258. Emollients in the management of atopic dermatitis [Emollients in the management of atopic dermatitis in children: Prevention of flares]. clinicaltrials.gov/show/NCT01779258 Date first received: 28 January 2013.
NCT01781663 {published data only}
    1. NCT01781663. Efficacy of KAM2904 face cream and KAM3008 body lotion treatment in children with atopic dermatitis (AD). clinicaltrials.gov/ct2/show/NCT01781663 Date first received: 29 January 2013.
NCT01915914 {published data only}
    1. NCT01915914. A randomized, open-label, comparative study to evaluate an intermittent dosing regimen of fluticasone propionate 0.05% cream (twice per week) in reducing the risk of relapse when added to regular daily moisturization using PHYSIOGEL lotion in paediatric subjects with stabilized atopic dermatitis. clinicaltrials.gov/show/NCT01915914 Date first received: 27 June 2013.
NCT02028546 {published data only}
    1. NCT02028546. The effect of bathing and moisturizers on skin hydration in atopic dermatitis: an in vivo study. clinicaltrials.gov/ct2/show/NCT02028546 Date first received: 19 December 2013.
NCT02286700 {published data only}
    1. NCT02286700. Skin effects of a topical amino acid moisturizing cream and desonide in atopic dermatitis [A randomized, double-blind, active control, 5 week study to evaluate the safety and skin effects of a new, twice-daily, topically applied amino acid moisturizing cream vs. desonide cream in adult atopic dermatitis]. clinicaltrials.gov/ct2/show/study/NCT02286700 Date first received: 4 November 2014.
NCT02376049 {published data only}
    1. NCT02376049. A clinical trial to compare topical agents in adults with mild to moderate atopic dermatitis (AD) [An explorative clinical trial to evaluate an intra patient comparison design of topical agents in adults with mild to moderate atopic dermatitis]. clinicaltrials.gov/ct2/show/NCT02376049 Date first received: 25 February 2015.
NCT02589392 {published data only}
    1. NCT02589392. Cetaphil Restoraderm effect on young children with atopic dermatitis [Effect of Cetaphil® Restoraderm® moisturizer on very dry skin in children with a controlled atopic dermatitis: a randomised, parallel group study]. clinicaltrials.gov/ct2/show/NCT02589392 Date first received: 23 October 2015.
NTR4541 {published data only}
    1. NTR4541. Efficacy of Dermalex Eczema in atopic dermatitis patients [Efficacy of a skin barrier repair cream (Dermalex Eczema) in atopic dermatitis patients - EDA]. www.trialregister.nl/trialreg/admin/rctview.asp?TC=4541 Date first received: 28 April 2014.
Ridd 2015 {published data only}
    1. Ridd MJ, Redmond NM, Hollinghurst S, Ball N, Shaw L, Guy R, et al. Choice of Moisturiser for Eczema Treatment (COMET): study protocol for a randomized controlled trial. Trials 2015;16:304. [PMID: ] - PMC - PubMed
Santer 2015 {published data only}
    1. Santer M, Rumsby K, Ridd MJ, Francis NA, Stuart B, Chorozoglou M, et al. Bath additives for the treatment of childhood eczema (BATHE): protocol for multicentre parallel group randomised trial. BMJ Open 2015;5(10):e009575. [PMID: ] - PMC - PubMed

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