A new study published in The Cochrane Database of Systematic Reviews aimed to assess the effects of skincare interventions, such as emollients, for primary prevention of eczema and food allergy in infants; and to identify features of study populations such as age, hereditary risk and adherence to interventions that are associated with the greatest treatment benefit or harm for both, eczema and food allergy.

In this study, Cochrane Skin Specialised Register, CENTRAL, MEDLINE and Embase databases were searched up to July 2020. Randomized controlled trials (RCTs) of skincare interventions that could potentially enhance skin barrier function in healthy term (> 37 weeks) infants—0 to 12 months—without pre-existing diagnosis of eczema, food allergy, or other skin condition were included.

Overall, 33 RCTs, comprising 25827 participants were included. Durations of intervention and follow-ups ranged from 24 hours to two years. The findings indicated that skincare interventions during infancy may not change the risk of eczema by one to two years of age, nor the time to onset of eczema. While it is not certain whether skincare interventions during infancy change risk of IgE-mediated food allergy by one to two years of age or allergic sensitisation to a food allergen at age one to two years. Nevertheless, skincare interventions during infancy may slightly increase risk of parent report of immediate reaction to a common food allergen at two years. In addition, skincare interventions during infancy probably increase risk of skin infection over the intervention period and may increase risk of stinging/allergic reactions to moisturizers. Moreover, the effects of these interventions were not influenced by age, duration of intervention, hereditary risk, FLG mutation or classification of intervention type for risk of developing eczema. 

From the results, it was inferred that skincare interventions, such as emollients, during the first year of life are probably not effective for preventing eczema in healthy infants. In fact, they might even increase risk of skin infection. Furthermore, the effects of skincare interventions on risk of food allergy remains uncertain. 

Source: The Cochrane Database of Systematic Reviews. 2021 Feb 5;2(2):CD013534. doi: 10.1002/14651858.CD013534.pub2.