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Bath oil does not improve eczema symptoms in children (BATHE)
Clinical Question
Does the addition of oil to the bath decrease the symptoms of children with eczema?
Bottom line
Wow. According to a cited review in this paper, bath additives account for one-third of the costs of treating eczema in the United Kingdom. This study—conceived of and conducted by the James Lind Alliance, a group aimed at addressing uncertainties of routine clinical practice—found no improvement with the addition of oil to the bath of a child with eczema. 1b
Reference
Study design: Randomized controlled trial (nonblinded)
Funding: Government
Setting: Outpatient (primary care)
Synopsis
The investigator enrolled 483 children between the ages of 1 year and 11 years with atopic dermatitis, recruited from 96 general practices in the United Kingdom. The children were randomized, using concealed allocation, to a usual care group or a group that, in addition to usual care, were instructed to add an oil-based emollient of their choice to their bath water. Oilatum was used by 45%, 26% used Aveeno bath oil, 4.5% used Balneum bath oil, and 30% used another type of bath product. Most (74%) carers reported using the bath oil at every bath. Interestingly, two-thirds of children in each group were bathed at least every other day (14% were bathed at least daily). Using the 7-question patient-oriented eczema measure (0 - 7: mild; 8 - 16: moderate; 17 - 28: severe), scores improved equally in both groups, from a baseline of 9.5 to 10.1 to an average weekly score of 7.5 to 8.4 over 16 weeks of treatment. Scores were minimally better (-2.27; a clinically important difference is at least 3 points) with bath oil for children who bathed 5 or more times a week.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
good poem
If the bath calms the itch it may be of value. Also, generally, I find that Aveeno is best for that purpose, in any case.
No matter what your speciality patients would like ask a question , about any concern they have this subject helps more than my speciality related subject since I know most of answer in my speciality. Thanks for providing these subjects.
Thanks I always felt adding oil to bath water posed a potential danger (slipping ) to the child and didn’t work
I think it is worth assessing if there is any benefit in spending money on bath emollient
It would be refreshing to see a dietary intervention or illumination diet intervention trial as an alternative treatment to just putting stuff on top of skin. Clinically, I have seen dramatic results in some patients once we remove sugar, processed foods, dairy, and wheat. Not everyone mind you, but when it works, it’s amazing. I’ve seen the same thing happen with juvenile arthritis, Asthma, and migraine.