In addition to research into treating atopic dermatitis (AD), there is a growing body of study dedicated to the prevention of the condition. Currently, there is no scientific consensus on the prevention of AD, however, several potential options have been theorized and tested.
Although the exact cause of AD is unknown at this time, most theories center around, or include in part, a faulty or damaged skin barrier. Since a faulty skin barrier may play a role in the development of AD, several experts have theorized that taking steps early in life to repair the skin barrier or prevent cracking of the skin may help reduce an individual’s risk of developing AD.
Is there research on early emollient use?
Multiple studies have arisen in recent years to test the impact of early emollient use on the development of AD. These studies often focus on newborn babies who are at an increased risk of developing AD. These babies are typically identified based on their parents’ or other family members’ history with AD or other similar allergic conditions (such as asthma). Emollients are used on these newborns every day (sometimes multiple times a day) for the first six months to one year of life.
What does the research entail?
In one such study, roughly half of the participating families were instructed to use one of three emollients at least once a day every day for the first six months of life (starting before three weeks old). The remaining families were not instructed to use emollients. Over 100 families with infants deemed to be at a higher risk of developing AD participated in the study.
These families had regular check-ins with members of the research team throughout the six-month period in order to ensure that emollients were regularly being used in the treatment group as well as to check for signs of AD development in both groups.
What were the results?
By the six-month check-in, the infants in the emollient group had a 50% reduction in risk of developing AD when compared to their counterparts in the non-emollient group.
While this study does indicate that early emollient use may decrease the risk of developing AD before six months of age, more research is needed to determine the impact on early emollient use beyond the six-month point.2
Is there a trend?
Two other studies in recent years demonstrated similar trends, with one study’s emollient-receiving infant population experiencing a decrease in risk of developing AD through eight-months old.3 The second study used a specific ceramide-dominant emollient, and showed a decrease in risk of developing AD at the six- and 12-month points.4
These studies also theorized that early emollient use may impact the development of food sensitivities, however, more research is needed to investigate this potential link.3,4
What’s the consensus?
Overall, more research is needed to determine the potential preventative effects of early emollient use on AD development, however, several studies point toward a relationship between early emollient use and an overall decrease in AD risk.
Emollients. National Eczema Society. http://www.eczema.org/emollients. Accessed July 17, 2018.
Simpson EL, Chalmers JR, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. Oct 2014; 134(4), 818-23. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180007/. Accessed July 17, 2018.
Horimukai K, Morita K, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol. Oct 2014; 134(4), 824-30.e6.
Lowe AJ, Su JC, et al. A randomized trial of a barrier lipid replacement strategy for the prevention of atopic dermatitis and allergic sensitization: The PEBBLES pilot study. British Journal of Dermatology. Jan 2018; 178(1), e19-21. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.15747. Accessed July 17, 2018.