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The University of Southampton

Southampton research recognised with special award

Published: 1 November 2019
Young child adding cream to her arm

Research led by the University of Southampton, which found one of the most widely used treatments for childhood eczema is not helpful, has won a prestigious research award.

The study, published in The BMJ last May, aimed to investigate whether or not emollient bath additives help children with the symptoms of eczema.

The randomised controlled trial, also known as the BATHE trial, involved 482 children aged 1 to 11 years across 96 general practices in England and Wales over a 12-month period. It concluded that although emollient bath additives are safe, they are not a useful additional treatment for children who are receiving standard eczema care, such as using leave-on emollients and emollients as soap substitutes.

The study has won the coveted 2018 Royal College of General Practitioners (RCGP) Research Paper of the Year award.

Dr Miriam Santer, Associate Professor in Primary Care Research at the University of Southampton who led the study, said: “We are very grateful to the Royal College of General Practitioners for recognising the importance of this work. There are many unanswered questions in eczema, but this research is another step in finding out what does and doesn’t work.

“Eczema is very common and can have a big impact on quality of life for children and their families. Our study has answered an important question in the management of childhood eczema, by demonstrating that pouring emollient bath additives into the bath water doesn’t add benefit to standard management. Standard management includes soap avoidance, leave-on emollients and topical corticosteroids and our research will help parents and healthcare professionals focus time and resource on these effective treatments.”

About the study

Eczema is very common in children and can have a significant impact, causing itching and sleep problems. The main treatments are emollients, which are used to moisturise the skin, and steroid creams or ointments to treat flare-ups. Guidelines have suggested ‘complete emollient therapy’ for eczema, including an emollient for washing (soap substitute), an emollient applied directly to the skin (leave-on emollient) and emollient liquid added to the bath (bath additive). However, there is little evidence to show that using emollient bath additives is helpful.

Most children had mild or moderate eczema, 62 had severe eczema, and half were using corticosteroid cream. The patient-oriented eczema measure (POEM) questionnaire was filled out weekly by parents or carers during the study.

Only 74 per cent of the intervention group used emollient bath additives at every bath, raising questions around adherence to treatment, both within and outside of the trial environment. The control group were asked not to use emollient bath additives, though seven per cent did. Other limitations include missing outcome data for 12 per cent of the children.

A total of 482 children from 96 general practices took part. The Southampton team found no difference between the two groups, showing that emollient bath additives are not a useful treatment for children with eczema. Children with eczema should continue to use leave-on emollients and emollients and soap substitutes.



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