Intended for healthcare professionals


New evidence challenges use of bath emollients for children with eczema

BMJ 2018; 361 doi: (Published 03 May 2018) Cite this as: BMJ 2018;361:k1791
  1. Carsten Flohr, head1,
  2. Amina Ahmed, patient panel member2
  1. 1Unit for Population-Based Dermatology Research, St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London SE1 7EH, UK
  2. 2Centre of Evidence Based Dermatology, Nottingham, UK
  1. Correspondence to: C Flohr carsten.flohr{at}

Are we wasting millions on an ineffective treatment?

Eczema (also known as atopic eczema or atopic dermatitis) is the commonest inflammatory skin condition in childhood, affecting around 20% of UK children and having a substantial impact on patients’ and families’ quality of life and National Health Service resources.1 The regular application of leave-on emollients is a cornerstone of treatment,2 based at least partly on evidence from intervention studies.

Little good evidence exists on the benefits of emollient bath additives,3 although the National Institute for Health and Care Excellence recommends regular use of “emollient wash products” for children with eczema.4 This is probably one of the reasons why emollient bath additives are commonly prescribed, costing the English NHS more than £17m a year in primary care alone.5 But do emollient bath additives really reduce the severity of eczema and improve quality of life, in conjunction with standard care?

To answer these important questions, Santer and colleagues (doi:10.1136/bmj.k1332) conducted a pragmatic randomised controlled trial (n=482) comparing standard care with …

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