Table 2 Main studies conducted on the use of emollients in pediatric patients with atopic dermatitis (modified from Mack Correa MC. et al. 2012 [6])
From: Consensus Conference on Clinical Management of pediatric Atopic Dermatitis
Population | Treatment | Frequency and duration of application | Efficacy | Safety |
|---|---|---|---|---|
Infants (age <12 months) with moderate to severe AD (n = 173). Grimalt et al. 2007 [21] | Emollient containing oat extract (Exomega, Laboratories Pierre Fabre, France) | Twice/day for 6 weeks | Significant reduction in the use of high potency topical CS and improvement of SCORAD and QoL | Two severe reactions. |
Good tolerability in 94 % of patients. | ||||
Infants and young children (aged 2 months-6 years) with mild to moderate AD (n = 25) Nebus et al. 2008 [30] | Occlusive cream containing colloidal oatmeal and detergent with colloidal oatmeal and glycerin (Aveeno, Johnson & Johnson Consumer Companies, Inc., Skillman, USA) | Cream: twice/day for 4 weeks | Significant improvement of IGA, dryness and itching at 2 and 4 weeks; QoL significantly improved at 4 weeks | Well tolerated; no severe reactions related to treatment |
Cleansing: every wash | ||||
Children (aged 3 months-16 years) with mild to moderate AD (n = 65) Kircik et al. 2011 [31] | Emulsion containing ceramides (EpiCeram) | Twice/day for 3 weeks | Improvement of IGA, patient satisfaction and QoL | No severe reactions to the treatment |
Children with AD (aged 6 months-12 years) (n = 76) Giordano-Labadie et al. J 2006 [32] | Moisturizing milk (Exomega) compared to control | Twice/day for 2 months | Significant improvement of dryness, itching and QoL | Satisfactory or excellent level of tolerance in 97 % of patients |
Children (aged 6 months-12 years) with mild to moderate AD (n = 142) Breternitz et al. 2008 [17] | Glycyrrhetinic acid based cream (Atopiclair) compared to vehicle | Three times/day for 43 days | Significant improvement of IGA, reduced use of topical corticosteroids | No severe reactions related to the treatment |
Children and adolescents (aged 6 months-18 years) with mild to moderate AD (n = 121) Sugarman et al. 2009 [29] | Emulsion-containing ceramides (EpiCeram) compared to topical fluticasone (Cutivate, Pharmaderm, Melville, NY, USA) | Twice/day for 28 days | Significant improvement in SCORAD index. Comparable effectiveness between the two treatments | No severe reactions related to treatment |
Children (aged 1.5–12 years) with resistant treatments/recalcitrant AD (n = 24) Chamlin et al. 2002 [27] | Emulsion containing ceramides (Triceram, Osmotics Corp., Denver, CO, USA) instead of the previous moisturizer, continuing topical tacrolimus or topical corticosteroids | Twice/day for 12 weeks, then once/day for 9 weeks | Significant improvement of SCORAD in 92 % of patients within 3 weeks, in 100 % within 21 weeks; decrease of trans-epidermal water loss; hydration and integrity of the stratum corneum improved | No severe reactions related to treatment |
Children and adolescents (aged 2–17 years) with mild to moderate AD (n = 39) Miller et al. 2011 [33] | Glycyrrhetinic acid based cream (Atopiclair) vs. ceramide- based emulsion (EpiCeram) vs. petrolatum-based ointment (Aquaphor Healing Ointment, Beiersdorf Inc., Wilton, CT, USA) | Three times/day for 3 weeks | Improvement in the 3 treatment arms with no difference; Ointment-based petrolatum showed the best improvement measured through clinical evaluation | No severe reactions related to treatment |
Children and adults (aged 2–70 years) with mild to moderate AD (Study 1, n = 66; Study 2, n = 127) Simpson et al. 2011 [34] | Cetaphil Restoraderm moisturizing (Galderma Laboratories, Fort Worth, TX, USA) | Study 1: twice/day for 4 weeks; Study 2: twice/day for 4 weeks in addition to topical corticosteroid. | Study 1: significant decrease in pruritus and improvement of hydration and QoL. Study 2: only compared to steroid: significant improvement of hydration, decrease in EASI score and more rapid action | No severe reactions related to treatment |