MedicalResearch.com Interview with:
Esther van Zuuren MD
on behalf of the authors
Department of Dermatology
Leiden University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In view of the high prevalence of eczema and the exponential increase in number of clinical trials over recent years, the NIHR designated this clinical topic, emollients and moisturisers for eczema, as a high priority. Widely prescribed as the basis of eczema management the treatment strategy is often supported by a mixed array of reviews and guidelines. Evidence for the effectiveness of emollients and moisturisers is also of variable quality.
Eczema is a chronic skin disorder, the main symptoms being dry skin and intense itching with a significant impact on quality of life. As dry skin is an important feature, moisturisers are a cornerstone of eczema treatment, but there was uncertainty about their efficacy and whether one moisturiser is preferable to another. The main finding of our review is that indeed moisturisers are effective.
MedicalResearch.com: What should readers take away from your report?
Response: Moisturisers appeared to have a beneficial effect on eczema severity. They are safe and reduce flares and prolong the time to flare. Furthermore, they decrease the need for topical corticosteroids and increase the efficacy of active treatment. Therefore, it makes clinical sense to encourage adherence to moisturiser therapy. This is especially important as moisturiser therapy is time consuming and often required throughout life, as eczema is a chronic condition. There is no evidence to support a ‘one size fits all’ approach, as we did not find reliable evidence that one moisturiser is better than another. Therefore, clinical decisions about choices of moisturiser should be based on the available evidence, and should also take into account the experiences and preferences of the individual.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Since moisturisers can contain many different ingredients, more research is needed about their effects, and also about their safety, including their allergenic potential. We were not able to conclude that the use of moisturisers alone is sufficient to treat (very) mild eczema, which therefore needs future research. In addition, more research is needed to determine what adequate use of moisturisers and active treatment actually entails. Both under-treatment and over-treatment with moisturisers or topical corticosteroids should be avoided. This is especially important for children, since the prevalence of eczema in this group is much higher than in adults. Another area for further research is how to improve and ensure adherence by means of proper and timely information and education, and increasing self-management skills.
MedicalResearch.com: Is there anything else you would like to add?
Response: We hope that the conclusions of this review will be included in clinical guidelines and that they will guide clinicians, policymakers and third party payers in their decision-making. All to the benefit of people with eczema.
None of the authors had anything to disclose and there were no competing interest
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van Zuuren EJ, Fedorowicz Z, Christensen R, Lavrijsen A, Arents BWM. Emollients and moisturisers for eczema. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD012119. DOI: 10.1002/14651858.CD012119.pub2.
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