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Should we use bath emollients for atopic eczema?

BMJ 2009; 339 doi: (Published 13 November 2009) Cite this as: BMJ 2009;339:b4273
  1. Andrea Tarr, associate editor,
  2. Ike Iheanacho, editor
  1. 1Drug and Therapeutics Bulletin, BMJ Group, London WC1H 9JR
  1. Correspondence to: I Iheanacho iiheanacho{at}

    Regular topical application of an emollient cream or ointment is key in the management of patients with atopic eczema and is thought to help the skin maintain a defensive barrier effect, which is defective in atopic eczema.1 Support for such treatment comes from one (non-blinded) randomised controlled trial, which found that regular application of emollients direct to the skin reduced the amount of topical corticosteroid cream needed for atopic eczema in infants.2 Long clinical experience also suggests that directly applied emollients are safe and effective in atopic eczema.

    People with atopic eczema are commonly also advised to use an emollient substitute for soap (such as aqueous cream or emulsifying ointment), as soap can irritate the skin (as can bubble bath preparations); patients are also often prescribed a bath emollient to add to their bath water.3 Bath emollients typically consist of liquid paraffin plus another emollient (usually wool fat or isopropyl myristate); a few also contain an antimicrobial drug.

    Some prescribers recommend bath emollients to avoid use of bubble bath preparations. …

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