Journal of the European Academy of Dermatology and Venereology (JEADV): Published on November 2022

Atopic dermatitis (AD), also named atopic eczema, is the most common, chronic, recurrent, inflammatory disorder of the skin, affecting 5%–30% of children worldwide. Most AD subjects suffered from persistent skin dryness, pruritus, eczematous rash, cutaneous dysbiosis and defective epidermal barrier.

Because impairment of the epidermal barrier at birth usually precedes the development of AD, providing an opportunity for improving skin hydration and skin barrier function.  

As a simple, inexpensive and widely available strategy, regular application of emollients has been found to help alleviate clinical symptoms in AD patients, delay flares and reduce the dosage of topical corticosteroids.

Authors performed this systematic review and network meta-analysis to answer two questions as follows:

(a) whether the early application of emollients in infancy can effectively prevent the later development of AD and

(b) which types of emollients may be the optimal option for preventing the development of AD in infants.

A systematic search was performed in PubMed, EMBASE and Cochrane library to identify relevant studies from their inception through 28 February, 2022. 

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This systematic review and network meta-analysis of 11 studies comprising 3483 infants found a lower risk of atopic dermatitis (AD) in all groups that received early emollient application, including in high-risk infants.

The results of this systematic review and network meta-analysis show that early application of skin emollients can effectively prevent AD development in high-risk infants.

Three types of emollients, including cream, emulsion and mixed types were comparable in preventing AD development.

Moreover, among the available three types of emollients, the emollient emulsion is probably the optimal option in infancy to prevent AD development more effectively. 

Early emollient use should be strongly considered in infants at high risk of developing AD.