Emollient treatment of atopic dermatitis: latest evidence and clinical considerations

Abstract

AimTo review current classes of emollients in the market, their clinical efficacy in atopic dermatitis (AD) and considerations for choice of an emollient.MethodsPubMed Clinical Queries under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow) and Systematic Reviews were used as the search engine. Keywords of ‘emollient or moisturizer’ and ‘atopic dermatitis’ were used.Overview of findingsUsing the keywords of ‘emollient’ and ‘atopic dermatitis’, there were 105 and 36 hits under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow) and Systematic Reviews, respectively. Plant-derived products, animal products and special ingredients were discussed. Selected proprietary products were tabulated.ConclusionsA number of proprietary emollients have undergone trials with clinical data available on PubMed-indexed journals. Most moisturizers showed some beneficial effects, but there was generally no evidence that one moisturizer is superior to another. Choosing an appropriate emollient for AD patients would improve acceptability and adherence for emollient treatment. Physician’s recommendation is the primary consideration for patients when selecting a moisturizer/emollient; therefore, doctors should provide evidence-based information about these emollients.

A cream containing omega‐3‐fatty acids, humectants and emollients as an aid in the treatment of equine Culicoides hypersensitivity

“…Propylene glycol and paraffin oil can possibly decrease the dryness of human atopic skin . Petrolatum is a controversial ingredient, with one study showing an improvement of the human skin barrier but other authors assuming that petrolatum as well as lanolin rather impede the repair of the barrier . The moisturizers and emollients within the product used herein may have contributed, to some degree, to the improvement seen.…”

“…Urea and glycolic acid are keratolytic and have moisturizing effects . Humectants and emollients such as liquid paraffin, propylene glycol, petrolatum and lanolin alcohol have been used in people with AD to reduce dryness and itchiness of the skin …”

Dismissing the fallacies of childhood eczema management: case scenarios and an overview of best practices

“… 24 A multidisciplinary approach with integrative strategies (including psychosocial, mindfulness, integrative medicine) might be useful. 25 , 26 Specifically, mindfulness therapy is claiming efficacy in many atopic conditions including AD. 25 The attending physician must be aware of the stress in these families, and not to allow the stress to be internalized and negating his or her role in the management of the often antagonizing situation.…”

“…Practically and at best, most teenagers might only use an emollient once or twice per day. 26 Most patients claim that they prefer nongreasy emollients that are creamy or colorless. However, the authors observe that many parents or patients are not consistent with the type or frequency of emollient usage.…”

Noninvasive Skin Barrier Assessment: Multiparametric Approach and Pilot Study

“…An impaired skin barrier is characterized by increased transepidermal water loss (TEWL) and reduced epidermal hydration, and predisposes one to cutaneous inflammation [2]. Conversely, skin moisturizers can improve the skin barrier and help prevent inflammation [2,9,[11][12][13][14]. However, not all moisturizers are beneficial to the skin barrier, and, for unknown reasons, some topical ointments may exacerbate symptoms in inflammatory skin disease [15,16].…”