Daily emollient application in infants a feasible way to reduce AD burden

Daily emollient application in infants helps reduce the cumulative incidence of atopic dermatitis throughout the 2 years of life and may be a feasible way to reduce its burden in communities, according to a study.

The study included 1,247 infant–parent pairs (mean age of infants at baseline 23.9 days, 44.3 percent female) recruited across 25 community-based paediatric and family medicine clinics. These pairs were randomly allocated to the group instructed to apply a daily emollient moisturizer to the full body of the infant, beginning at 9 weeks of age or the group that refrained from emollient use.

The primary outcome was physician-diagnosed AD by age 24 months. Quarterly electronic surveys were completed by all participants. These surveys were used to document adverse events and alert the team if an AD diagnosis had been made.

At 24 months, the cumulative incidence of AD was 36.1 percent in the daily moisturizer group vs 43.0 percent in the control group. Daily emollient application was associated with a 16-percent reduced risk of AD within 2 years of life (relative risk [RR], 0.84, 95 percent confidence interval [CI], 0.73–0.97; p=0.02).

Of note, the magnitude of effect of daily emollient application was more pronounced in the population not at high risk of AD (RR, 0.75, 95 percent CI, 0.60–0.90; p=0.01). Additionally, the presence of a dog in the home modified the protective effect of daily emollient application (RR, 0.68, 95 percent CI, 0.50–0.90; p=0.01).

There were no differences observed in cutaneous adverse events between the daily moisturizer and control groups.