Early Emollient Use Reduces Risk of Atopic Dermatitis in Infants: JAMA
A new study published in the Journal of American Medical Association showed that daily application of full-body emollients during the first 9 weeks of life significantly reduced the risk of developing atopic dermatitis by the age of 2 years.
Children with atopic dermatitis (AD) face a worldwide health burden and are at risk for food allergies and asthma. Emollient intervention for primary AD prevention in infants not chosen for risk has not been well studied. In order to ascertain if emollient intervention lowers the incidence of AD by the age of 24 months among babies who were not chosen for risk, Eric Simpson and team carried out this study.
A total of 1,247 infant-parent pairs were selected from 25 community-based pediatric and family medicine clinics that are part of four statewide practice-based research networks to participate in a randomized, decentralized pragmatic clinical study. Recruitment of participants took place between July 2018 and February 2021, and follow-up was finished in February 2023.
Dyads were randomly assigned to either a control group that did not use emollients or a full-body emollient application group that began using moisturizers daily by the age of 9 weeks. By the time the kid was 24 months old, the main result was a doctor's diagnosis of AD noted in their medical file. In order to record adverse effects and notify the team if an AD diagnosis had been established, participants filled out computerized surveys every 3 months.
At randomization, the mean (SD) age of 1247 newborns was 23.9 (16.3) days, with 553 (44.3%) of them being female. With a relative risk (RR) of 0.84 (95% CI, 0.73-0.97; P =.02), the cumulative incidence of AD at 24 months was 36.1% (SE, 2.1) in the daily moisturizer group and 43.0% (SE 2.1) in the control group. The magnitude of the effect was greater in the population that was not at high risk of AD (RR, 0.75; 95% CI, 0.60-0.90; P =.01).
The addition of a dog in the home substantially altered the protective effect (RR, 0.68; 95% CI, 0.50-0.90; P =.01). Skin-related adverse events did not differ across groups. Overall, the cumulative incidence of AD at age 24 months was found to be decreased by daily emollient application starting before age 9 weeks in a representative US population that was not selected for risk, according to this randomized clinical trial.
Source:
Simpson, E. L., Michaels, L. C., Ramsey, K., Fagnan, L. J., Nease, D. E., Henningfield, M., Dolor, R. J., Lapidus, J., Martinez-Ziegenfuss, X., Vu, A., Ferrara, L., Zuckerman, K. E., Morris, C. D., Williams, H. C., & CASCADE Consortium. (2025). Emollients to prevent pediatric eczema: A randomized clinical trial: A randomized clinical trial. JAMA Dermatology (Chicago, Ill.). https://doi.org/10.1001/jamadermatol.2025.2357
