A randomized controlled study in Chinese children (N=64, age 2-12 years) with mild-to-moderate AD enrolled participants within 1 week after successful treatment with a topical corticosteroid.8 Patients were randomly assigned to a group that applied a ceramide-containing body wash and moisturizer once and twice daily, respectively (n=32), or only ceramide-containing body wash once daily (n=32) for 12 weeks. A delay in the median time to AD flare of nearly 2 months was shown for the group applying body wash and moisturizer compared to those using body wash alone (89 vs 27 days, respectively).8
A randomized controlled study investigated the efficacy of 2 non-prescription, steroid-free skincare formulations in relieving the symptoms and reducing the risk of flare in infants and children with AD.7 Following a 2-week washout period, participants (N=45; mean age 3.5 years [range 3 mos-12 y]) were randomized to apply either the cleanser only (control group) or the cleanser and a daily moisturizing body cream once daily for 6 months or until flaring. The cleanser contains mild surfactants and panthenol and the cream contains colloidal oatmeal, licochalcone A, and ceramide 3. Compared with the control group, the incidence of flaring was significantly lower in the moisturizer plus cleanser group (21% vs 65%; P=.006).
The consensus among medical practitioners is that a significant proportion of high-risk children will develop persistent cases of AD and/or other atopic diseases such as allergic rhinitis or asthma. A higher prevalence of rhinitis and asthma35 or asthma36 has been associated with more severe AD compared to milder disease. In an Italian cohort of patients with AD (followed 16.9 years on average), the risk of asthma onset increased 4 times in patients with severe AD compared to moderate AD and 2 times in patients with moderate AD compared to mild AD.36 Data collected in retrospective and prospective cohort studies in patients with severe AD have shown similar results.37,38 Based on these findings, the ability of moisturizers to help reduce the severity of AD and the incidence of flares in young patients could assist in attenuating atopic march.
