Simple skincare routine could stop babies developing eczema

Applying moisturiser to a baby’s skin every day could reduce their risk of developing eczema, but it seems to depend on whether they are genetically at risk of the condition.

Eczema, or atopic dermatitis, is an inflammatory condition characterised by itchy and dry skin that may blister or bleed. It usually begins in infancy, with symptoms generally subsiding with age.

To explore whether moisturisers can help, Hywel Williams at the University of Nottingham, UK, and his colleagues recruited more than 1200 parents in the US whose babies didn’t have eczema.

Half of the babies, who were aged between 0 and 8 weeks, had an immediate family member with eczema, so probably had a higher genetic risk of the condition.

The researchers randomly assigned about half of the parents to apply any of five moisturisers, which were available without a prescription, all over their babies’ bodies every day. The parents could choose any of the moisturisers and swap between them.

The remaining parents were told to refrain from using moisturisers unless they deemed it necessary, for instance if their babies’ skin seemed dry. More than half of the parents in this group reported doing this up to once a week.

Two years later, the researchers analysed the infants’ health records. They found that overall, 43 per cent of those in the non-moisturiser group had been diagnosed with eczema compared with 36 per cent in the moisturiser group. “That’s a substantial reduction,” says Michael Cork at the University of Sheffield, UK.

But when the researchers analysed the results more closely, they found that moisturisers were only protective among participants who didn’t have an immediate family member with the condition. This aligns with the results of a previous study that found moisturisers had no benefit when applied to babies with a high genetic risk of eczema.

It could be that those at low genetic risk are more likely to develop eczema due to environmental factors, such as air pollution. Moisturisers are thought to fill gaps between skin cells, helping to prevent such irritants from entering the body and triggering inflammation that manifests as eczema.

But elevated levels of inflammation may already exist in the bodies of people who have a high genetic risk of eczema, which moisturisers cannot protect against, says Cork.

The researchers didn’t monitor when the parents were swapping between different types of moisturiser, so they cannot determine which ones worked best. Further research is needed to untangle this, says Cork.

Studies should also explore whether the findings apply to people in other countries, where the degree of triggers like air pollution can differ, says Carsten Flohr at King’s College London.