Efficacy of Over-the-Counter Moisturizers in Pediatric Atopic Dermatitis: An Update to a Systematic Review

Gabrielle Rose Osher, Krystal Madkins, Peter Lio

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Moisturizers are a mainstay of treatment for atopic dermatitis (AD), a common skin condition affecting children. Pediatric skin is notably different from adult skin, possessing qualities that increase its susceptibility to AD. Care must be taken when choosing the correct emollient for a pediatric AD patient. This review synthesizes the effects of different emollients on various outcome measures in pediatric patients with AD and highlights shortcomings in the literature. Methods: PubMed, EMBASE, and Cochrane Library were indexed, and results were limited to those published after 2015. Randomized controlled trials or controlled clinical studies comparing the effects of an emollient or emollient ingredient against another moisturizer or ingredient, its vehicle, or against no treatment in patients under the age of 18 diagnosed with AD were included. Outcomes measured were clinical outcome data, transepidermal water loss, and stratum corneum hydration. Results: 1348 results were collected, 947 were screened, and 16 were identified as eligible for inclusion. The clinical effect of ceramides is well documented: these products performed better than urea-based formulas and untreated controls, and similarly to paraffin-based formulas in 3 studies. Improvements from glycerin-based products were greater compared to no treatment, and equivalent to other formulas. Two studies comparing emollients of four different vehicle types (lotions, creams, gels, and ointments) found comparable effectiveness among them. Conclusion: Compared to no treatment, moisturizers of any type effectively improve symptoms and skin conditions seen in children with AD. However, due to heterogeneity in protocols, products, and outcome measures across the studies, few widespread conclusions could be drawn. Further investigation into emollient formulations for pediatric AD is warranted to provide reliable information that is applicable in clinical settings.

Original languageEnglish
JournalCurrent Dermatology Reports
DOIs
StateAccepted/In press - 2024
Externally publishedYes

Keywords

  • Atopic dermatitis
  • Emollient
  • Moisturizer
  • Pediatrics
  • Treatment

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