Moisturizers Are Cost-Effective Mainstay of Eczema Treatment Interview with:

Steve Xu MD, MSc Resident Physician Department of Dermatology Northwestern Feinberg School of Medicine

Dr. Steve Xu

Steve Xu MD, MSc
Resident Physician
Department of Dermatology
Northwestern Feinberg School of Medicine What is the background for this study? What are the main findings?

Response: Given the limited data on the effectiveness or safety of the different moisturizers examined in the study, how much do you think parents should decide what to use on their babies based on the “cost-effectiveness” determined in this study? Would you just say cheapest is best since we don’t know how well these things work? Or what’s the message?

Price. Petrolatum is an extremely effective moisturizer. It also happens to be one of the most affordable. Unlike adults, I don’t suspect newborns will complain too much about the greasiness of petrolatum. They’re less concerned that their work clothes will get ruined. They are less likely to care about cosmetic elegance.

I also will say that petrolatum is less likely to include any artificial fragrances, preservatives that could serve as irritants or allergens in the future. That’s an added bonus. What should readers take away from your report?

Response: If Eczema isn’t well controlled with moisturizers or other interventions, what’s the harm to children beyond just itchy skin – will these babies develop other health problems?

First off, eczema is a really debilitating disease that means so much more than just itchy skin. Children with eczema have sleep problems. They have development delay. They have increased risk of attention deficit hyper-sensitivity disorder. There is even evidence that eczema increases the risk of obesity because sweating and exercise worsens the itch.

Yes, eczema represents the first leg of the atopic march. Nearly half of these patients will go on to develop asthma (which can be fatal) and allergic rhinitis later in life. Also, there is clear relationship between eczema and the development of food allergies (which can also be fatal).

This is why we think the work published by Eric Simpson at OHSU and Kenta Horimukai in Japan is so important. If we can change the natural progression of the disease and potentially reduce the development of associated illnesses such as asthma and food allergies simply by using moisturizers right away, then we could really save a lot of newborns and families a lot of suffering. In our paper, we’re making an economic argument for this strategy as well. What recommendations do you have for future research as a result of this study?

Response: Yes, these studies are preliminary. We don’t know if the benefit seen by Dr. Simpson and Dr. Horimukai are sustained for their newborns beyond the study period. But, I believe that our burden of proof should correlate to the risk of harm for an intervention.

Moisturizers are a mainstay of how we treat our patients with eczema. There really is very little risk. It’s also a pretty good deal in terms of cost. Thank you for your contribution to the community.


Xu S, Immaneni S, Hazen GB, Silverberg JI, Paller AS, Lio PA. Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis. JAMA Pediatr. Published online December 05, 2016e163909. doi:10.1001/jamapediatrics.2016.3909

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on December 7, 2016 by Marie Benz MD FAAD