Skin barrier dysfunction can lead to eczema development. A study was done to test whether the daily use of emollient in the first year of children can prevent eczema in high-risk children.

A multicenter, rational, parallel-group, randomized controlled trial in 12 hospitals and four primary care sites across the UK was conducted. Families of children were approached via antenatal or postnatal services for enrolment of term infants of at least 37 weeks gestation. Those infants were included who were at high risk of developing eczema, for example at least one first-degree relative with reported eczema, allergic rhinitis, or asthma, or diagnosed by a doctor.

The term newborns with a family history of atopic disease were randomly allocated (1:1) to application of emollient daily (Diprobase cream or DoubleBase gel) for the 1st year with standard skin-care instruction for the emollient group and standard skin-care instruction only for the control group.

The primary outcome was eczema at age 2 years with analysis. Overall, 1394 newborns were randomly assigned to study groups from November 2014 to November 2016; 693 newborns were assigned to the emollient group and 701 to the control group.

Almost 88% (466 of 532) adherence was seen in the emollient group at 3 months, 82% (427 of 519) at 6 months, and 74% (375 of 506) at 12 months. At the age of 2 years, eczema was seen in 139 (23%) of 598 infants in the emollient group and 150 (25%) of 612 infants in the control group.

At the end of the study, no evidence was found that daily emollient during the first year of life prevents eczema in high-risk children. The study has concluded that families with eczema, asthma, or allergic rhinitis should avoid using daily emollients to prevent eczema in their newborn babies.

Source: Chalmers JR, Haines RH, Bradshaw LE, et al. Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial. Lancet. 2020;395(10228):962–972.