Childhood eczema cannot be prevented by daily moisturiser use, study finds

20 February 2020

Using moisturisers on newborn babies does not prevent eczema as previously thought, according to a major new study.

The Barrier Enhancement for Eczema Prevention study (BEEP) was led by experts from at the School of Medicine at the University of Nottingham in collaboration with the Centre for Academic Primary Care at the University of Bristol.

Eczema is a very common skin problem affecting around one in five children in the UK. Eczema usually starts in infancy, and a generally dry skin is often one of the first symptoms in babies who go on to develop the condition.

It is thought that a faulty skin barrier could be the first step in the development of eczema. Moisturisers improve skin barrier function by providing a covering to the outermost layer of skin and trapping in water.

Some healthcare workers recommend that parents regularly use moisturisers to prevent eczema in newborn babies. The aim of the BEEP study was to determine whether such advice had any impact on preventing the development of eczema.

The team looked at 1394 newborn babies who were born to families with eczema, asthma or hayfever. The babies were randomly split into two groups. One group was advised to apply moisturiser all over their baby every day until their first birthday. The other group was asked not to use moisturiser. Both groups were given general skin care guidance.

The study found no evidence that the daily use of moisturiser during the first year of life could prevent eczema in the study children. There was however, a small increase in the risk of skin infections. The results also showed early indications that daily use of these creams may increase the risk of food allergy. The results are published today in The Lancet.

Professor Hywel Williams, a dermatologist at the University of Nottingham who led the study said “Much progress has been made in recent years on the treatment of severe eczema, but the goal of preventing eczema from developing in the first place remains elusive. Other small studies suggested that moisturisers from birth might prevent eczema, and we were surprised when our large study showed no effect at all.

“Whilst this is disappointing for sufferers who thought that was an option for their children, we can now recommend that this advice is not given to parents and begin looking at what other possible preventative options there may be. It is important not to confuse our study on moisturisers for eczema prevention with the use of moisturisers for people who have eczema, where the evidence of benefit is much greater”.

Dr Matthew Ridd, Reader in Primary Healthcare at the Centre for Academic Primary Care at the University of Bristol, said: "I'm very pleased that GP surgeries and families in the West of England area were able to contribute to this important study, albeit with disappointing negative findings."

The study was funded by the National Institute for Health research (NIHR) Health Technology Assessment Programme.

Further information

About the Centre for Academic Primary Care, University of Bristol

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.

About the NIHR

The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

funds, supports and delivers high quality research that benefits the NHS, public health and social care
engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
partners with other public funders, charities and industry to maximise the value of research to patients and the economy.

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.

This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. www.nihr.ac.uk/patientdata.