Barrier Enhancement for Eczema Prevention - BEEP
Research type
Research Study
Full title
A randomised controlled trial to determine whether application of emollient from birth for a year, can prevent eczema in high risk children.
IRAS ID
149888
Contact name
Hywel Williams
Contact email
Research summary
Research Summary
Eczema is a very common skin problem affecting 16% to 30% of children in the UK and around 20% worldwide. The onset of eczema usually occurs in infancy, and generally dry skin is one of the first abnormalities in babies who eventually develop the condition. It is thought that skin barrier dysfunction (dry skin and increased trans-epidermal water loss) could be a primary event in the development of eczema and atopy.
Emollient therapy has been shown to improve skin barrier function by providing lipids to the stratum corneum(the outermost layer of skin), in turn improving skin hydration by trapping in water. Early and regular use of emollient could lead to a potential improvement in skin barrier function.
The primary objective of this study is to determine whether advising parents to apply emollient to their child’s skin daily for the first year of life in addition to best practice infant skin care advice can prevent or delay the onset of eczema in high-risk children, when compared with a control group who are given the best practice infant skin care advice only.Summary of Results
Eczema is a miserable itchy skin condition affecting around 1 in 5 children and 1 in 10 UK adults. We wanted to see if we could prevent eczema by protecting the skin of babies born to families with eczema, asthma or hay fever, with moisturisers that are used to treat dry skin. Other studies suggested that protecting the skin barrier like this could prevent not only eczema but food allergy too.We invited 1394 families to take part in our study where half were asked to apply study moisturisers every day on their newborn baby for 1 year and half to look after their baby’s skin in the normal way.
When we looked at their children at the age of 2 years, we did not see any real difference in eczema between the two groups: 23% had eczema in the moisturiser group and 25% in the normal care group. It did not matter how we measured eczema. We didn’t find any difference in related conditions like asthma or hay fever either. We found that children using moisturisers had seen their doctor more often for mild skin infections. There was a hint that food allergy might have been commoner in the moisturiser group, but the numbers were too small.
We carried on following up the families until the children were aged 5 years, but we still did not find any clear benefits of using moisturisers in early life. The families taking part were fantastic. Since our study, lots of other groups over the world have done similar studies with more fancy moisturisers, but the results are the same. Our study means that using daily moisturisers on healthy babies born to high-risk families does not prevent eczema. It is one less thing for busy families to worry about.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
14/WM/0162
Date of REC Opinion
9 Jun 2014
REC opinion
Further Information Favourable Opinion