Use of emollients as early as within one week of birth may prevent atopic dermatitis in high-risk infants, according to results of the recently published Short-term Topical Application to Prevent Atopic Dermatitis (STOP AD) trial.¹

A total of 321 high-risk infants born at term at Cork University Maternity Hospital (CUMH) were recruited for this randomized controlled trial between April 2019 and November 2020. At least one parent had a positive history of atopic dermatitis, allergic rhinitis or asthma. These infants were randomized to either daily emollient application at 2 weeks, 4 weeks and 8 weeks (intervention group; n = 161) or standard routine skin care (control group; n = 160) within 4 days of birth to examine if early use of emollient could reduce the incidence of atopic dermatitis at one year of age. More than 80% of the infants applied the emollient once or twice-daily at the specified time points compared to 68% in the control group.

Results published in the journal Allergy showed that at 6 months, 18.3% infants in the intervention group developed atopic dermatitis versus 36.4% for the control group. At 12 months of age, nearly 33% infants in the intervention group developed atopic dermatitis compared to 46.4% in the control group. The two groups had comparable incidence of parent-reported skin infections; 5.0% vs. 5.7%, respectively.

Based on these findings, the authors concluded that early application of emollient, as early as within 4 days of birth as demonstrated in this single-centre study and using it till 2 months was associated with significant decline in the occurrence of atopic dermatitis in at-risk infants. At the same time, the authors also caution that “As we did not collect longer term data, we cannot exclude the possibility that the intervention may have only delayed the onset of AD beyond 12 months”.

Reference

1. Chaoimh CN, et al. Early initiation of short-term emollient use for the prevention of atopic dermatitis in high-risk infants-The STOP-AD randomised controlled trial. Allergy. 2022 Aug 23. doi: 10.1111/all.15491.