Randomized controlled trial of impact of early regular emollient using on transepidermal water loss and cumulative incidence of atopic dermatitis in infants at risk

The solution of the problem of atopic dermatitis (AD) prevention is an important task of modern medicine. Recently the idea of early systematic skin care in infants aimed at improving the epidermal barrier function and reducing the risk of AD development is widespread. The aim of the study was to investigate the effect of early regular emollients application in infants at risk on transepidermal water loss (TEWL) and cumulative incidence of AD. Materials and methods. An open randomized controlled trial included 80 healthy newborns (41 girls and 39 boys) with a family history of allergic diseases has been conducted. All participants were divided into main (n=38) and control (n=42) groups. Infants of the main group received emollients application twice per day for 6 months as well as a symbiotic complex from 3 to 6 months daily compared to the no intervention in control group. All infants were followed-up during the first year of life, besides of clinical examination TEWL was assessed as an objective criterion of epidermal barrier function. The main outcome was the development of AD at the age of 12 months. Results. 72 infants have been included into final analysis (35 - main group, 37 - control group). By the end of follow-up 19 patients (26.4%) had confirmed AD, with significant difference in cumulative incidence of AD between group: 37.8% in the main group and 14.3% in control, р<0.05. A significant decrease in TEWL in infants of the main group was revealed compared to control at all stages of the study (р<0.05). Conclusion. The results of the study confirmed the effectiveness of early regular emollient application in infants at risk as a factor which improves the protective function of epidermal barrier and reduces the risk of AD development.

atopic dermatitis, infants, transepidermal water loss, allergy prevention