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

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


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.

Restricted Access

Natalia Begievna Migacheva

Samara State Medical University

Email: nbmigacheva@gmail.com

Alexander Viktorovich Zhestkov

Samara State Medical University

Email: avzhestkov2015@yandex.ru

Tatiana Ivanovna Kaganova

Samara State Medical University

Email: t.kaganova2010@yandex.ru

  1. Silverberg JI. Public Health Burden and Epidemiology of Atopic Dermatitis. Dermatol Clin. 2017;35(3):283-289. doi: 10.1016/j.det.2017.02.002.
  2. Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;21;4(1):1. doi: 10.1038/s41572-018-0001-z.
  3. Sidbury R, Khorsand K. Evolving Concepts in Atopic Dermatitis. Curr Allergy Asthma Rep. 2017;17(7):42. DOI: 10.1007/ s11882-017-0710-5.
  4. Elias PM, Schmuth M. Abnormal skin barrier in the ethiopathogenesis of atopic dermatitis. Curr Opin Allergy Clin Immunol. 2009;9(5):437-446. DOI: 10.1097/ ACI.0b013e32832e7d36.
  5. Sullivan M, Silverberg NB. Current and emerging concepts in atopic dermatitis pathogenesis. Clin Dermatol. 2017;35(4):349-353. doi: 10.1016/j.clindermatol.2017.03.006.
  6. Kubo A, Nagao K, Amagai M. Epidermal barrier dysfunction and cutaneous sensitization in atopic diseases. J Clin Invest. 2012;122:440-447. doi: 10.1172/JCI57416.
  7. Matsumoto K, Saito H. Epicutaneous immunity and onset of allergic diseases - per-“eczematous” sensitization drives the allergic march. Allergol Int. 2013:62(3):291-296. doi: 10.2332/allergolint.13-RAI-0603.
  8. Giam YC, Hebert AA, Dizon MV, Van Bever H, Tiongco-Recto M et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy. 2016;6(2):120-128. DOI: 10.5415/ apallergy.2016.6.2.120.
  9. Flohr C, Mann J. New approaches to the prevention of childhood atopic dermatitis. Allergy. 2014;69(1):56-61. doi: 10.1111/all.12343.
  10. Lack G. Epidemiologic risks for food allergy. J Allergy Clin Immunol. 2008;121:1331-1336. doi: 10.1016/j.jaci.2008.04.032.
  11. Flohr C, Perkin M, Logan K et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol. 2014;134(2):345-350. doi: 10.1038/jid.2013.298.
  12. Kelleher M, Dunn-Galvin A, Hourihane J, Murray D, Campbell LE et al. Skin Barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year. J Allergy Clin Immunol. 2015;135:930-935. doi: 10.1016/j.jaci.2014.12.013.
  13. Simpson EL, Chalmers JR, Hanifin JM, Thomas KS, Cork MJ et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. 2014;134(4):818-823. DOI: 10.1016/j. jaci.2014.08.005.
  14. Xu S, Immaneni S, Hazen GB, Silverberg JI, Paller AS, Lio PA. Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis. JAMA Pediatr. 2017;171(2):e163909. doi: 10.1001/jamapediatrics.2016.3909.
  15. Ladrup Carlsen KC, Rehbinder EM, Skjerven HO, Carlsen MH, Fatnes TA, Fugelli P, Granum B, Haugen G, Hedlin G, Jonassen CM, Landre L, Lunde J, Marsland BJ, Nord-lund B, Rudi K, Sjeborg K, Soderhall C, Cathrine Staff A, Vettukattil R, Carlsen KH, study group. Preventing Atopic Dermatitis and Allergies in Children-the PreventADALL study. Allergy. 2017;73(10):2063-2070. DOI: 10.1111/ all.13468.
  16. Chalmers JR, Haines RH, Mitchell EJ, Thomas KS, Brown SJ, Ridd M, Lawton S, Simpson EL, Cork MJ, Sach TH, Bradshaw LE, Montgomery AA, Boyle RJ, Williams HC. Effectiveness and cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children (The BEEP trial): protocol for a randomized controlled trial. Trials. 2017;18(1):343. doi: 10.1186/s13063-017-2031-3.


Abstract - 79

PDF (Russian) - 4




  • There are currently no refbacks.

Copyright (c) 2020 Russian Allergological Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies