The use of Emollients in infancy prevents atopic dermatitis

Several investigations have found prophylactic emollients as a preventive strategy against atopic dermatitis (AD) and food allergy (FA). The present study synthesized the evidence on the efficacy and safety of prophylactic emollients started during the first six weeks of infancy for the prevention of AD and FA.

It searched MEDLINE, Embase, CINAHL, BIOSIS, and the Cochrane Library databases systematically for randomized controlled trials published between January 2000 and July 2020, which assessed the effects of prophylactic emollients initiated within the first six weeks of life on the development of AD within 24 months of age, compared to no treatment. It assessed the Risk of bias and certainty of evidence using the Cochrane Collaboration's tool and GRADE process, respectively.

The study found-

• Among the 1486 identified articles, ten studies fulfilled the inclusion criteria. 
• No significant reduction in the development of AD in infants given emollients compared to the control group. 
• A significant benefit of prophylactic emollients in the high-risk population. 
• A significant benefit in studies where emollients were used continuously to the point of AD assessment, but not when treatment was ceased for an interval before AD assessment. 
• No protective effects on FA.

This study suggests that the prophylactic application of emollients initiated in early infancy may prevent AD, especially in high-risk populations and when used continuously. It also hypothesizes that emollients may delay rather than prevent AD.

Zhong Y, Samuel M, van Bever H, Tham EH. Emollients in infancy to prevent atopic dermatitis: A systematic review and meta-analysis. 2022;77(6):1685-1699. https://doi.org/10.1111/all.15116