Which emollients are effective and acceptable for eczema in children?

Atopic eczema or dermatitis, commonly referred to as eczema, is characterised by dry, itchy skin. Although mainly a childhood condition, this disease commonly persists into or develops in adulthood.1 Patients are advised to use “leave-on” emollients or moisturisers, applied directly to the skin which add or help retain moisture.23 While evidence of their clinical effectiveness is limited, their use is ingrained in clinical practice and guidelines.2

Many different emollients can be prescribed or bought over the counter. Most are formulated as lotions, creams, gels, or ointments (see infographic). There is little evidence to recommend one type of emollient over another. Healthcare professional recommendation is the main source of advice when choosing a prescribed emollient.4 Preferences of the patient or carer are critical and may be influenced by the characteristics of the emollient, patient, and environment.5 The National Institute for Health and Care Excellence (NICE) recommends patients try different emollients in the clinic before choosing.2 This approach is not practical in most primary care settings, and even in specialist clinics the range of emollients available to try can be arbitrary and influenced by pharmaceutical companies and local formularies.

Older, cheaper emollients may be as effective as newer, more expensive ones,6 and the advantages of products that claim “dermatologically tested,” “fragrance-free,” and “hypoallergenic” are dubious.7 Through a process of trial …