Atopic eczema, also known as atopic dermatitis, is a common skin condition in children. The symptoms can be very uncomfortable and painful for the children who suffer from it, as well as for their parents who are seeking solutions to soothe their irritated skin. Some turn to emollients for bathing. But what is the usefulness of this type of care?
Childhood Eczema: Is it Really Necessary to Use Emollients for Bathing?
Eczema: Children are the primary subjects.
Eczema is a chronic skin condition characterized by red lesions on the skin surface and intense itching. This disorder is very common, in fact, it is the second most common skin disease, behind acne. Children and infants are the most affected by eczema, and it is estimated that about 17% of 6 - 11 year olds suffer from it. Eczema can be either innate or acquired, depending on its type.
One of the most common forms of eczema is atopic eczema, which is due to a specific genetic predisposition. Individuals with atopic eczema have a skin barrier that no longer fulfills its function, accompanied by a significant permeability of the stratum corneum. This results in substantial water loss and increases the ease with which microorganisms and allergens can penetrate the skin. It is also possible to suffer from eczema without having any genetic predispositions. This is referred to as contact eczema, which is a reaction to a specific allergen in the environment.
Eczema and emollient.
Primarily composed of fats (lipids), emollients hydrate and nourish the skin to promote the reconstruction of its hydrolipidic film protector. These treatments strengthen the skin barrier, making it less permeable to external aggressions. Used daily, they alleviate tightness, itching, and other discomforts associated with eczema. Their lipid-replenishing power makes their use particularly relevant in cases of eczema.
To maximize the effects of an emollient, it is generally advised to apply it after the child's bath, ideally on slightly damp skin.
Bath Emollient: Is it Really Useful?
In addition to the previously mentioned emollients, there are emollient treatments designed to be added to the bath. Their objectives are the same as those of traditional emollients : to hydrate dry skin, restore the skin barrier, and strengthen skin protection. The major difference lies in their method of use: while traditional emollients are applied out of water, on dry to slightly damp skin, bath emollients are oils or emulsions that are added directly to the bath water.
A recent study has explored the potential benefits of this type of emollients for children suffering from eczema. The researchers concluded that the addition of such a product to bath water, in addition to the usual care, did not provide any significant clinical benefit. This study was conducted over 12 months and involved 482 children suffering from atopic dermatitis. Half of them used an emollient in the bath with each wash, while the other half did not use any.
Thus, it does not seem necessary to use a bath emollient for children suffering from eczema. However, the emollients in cream form applied after the bath remain essential to soothe atopic skin and help them rebuild their protective barrier.
GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).
LITTLE P. & al. Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness. British journal (2018).