September 2025
Study finds daily emollient use in infants lowers atopic dermatitis incidence
By Rebecca Jenkins
Daily emollient application starting in the first two months of an infant’s life results in a lower incidence of atopic dermatitis (AD) at 2 years of age, a randomised trial has found.
AD imposed a global health burden for children and was a risk factor for developing food allergy and asthma; however, few studies had evaluated emollient application as a preventive intervention for AD in infants in the general population, researchers wrote in JAMA Dermatology.
The researchers recruited 1247 sets of parents and infants (44.3% female) from 25 US community-based paediatric and family medicine clinics for the Community-based Assessment of Skin Care, Eczema, and Allergies (CASCADE) trial.
The sets were randomised 1:1 to an intervention group where parents applied a full-body emollient daily to the infants starting by 9 weeks of age or a control group where parents refrained from using emollients.
At 24 months, the cumulative incidence of AD was 36.1% in the daily moisturiser group and 43% in the control group, which equated to a 16% reduced risk in the emollient group, or a number needed to treat of 15.
The magnitude of the effect was greater in those without an atopic history in the family (24% reduction) and in those who reported having a dog in the household.
There were no differences in cutaneous skin-product-related adverse event (AE) rate proportions between the two groups, the researchers added.
Rash was the most frequently reported AE, and most AEs were mild to moderate in severity.
Dr Georgina Harvey, a Dermatologist with a specialist interest in Paediatrics at the Women’s and Children’s Hospital in Adelaide, said previous studies had produced contradictory results, with a 2022 Cochrane review concluding skin care interventions during infancy probably did not change risk of eczema by 1 to 2 years of age.
‘The current study provides additional data and has several strengths, including its large sample size,’ she told Medicine Today.
‘The results may provide useful information on emollient use for infants considered low risk for AD, in particular, and are also reassuring regarding the safety of emollient use for infants and young children up to 2 years of age.’
GPs counselling parents who were worried about their infant developing AD could recommend daily emollient use based on this study’s findings, Dr Harvey said, but she added that given the differing previous data, she would also like to see further research conducted.
‘The results of this study are promising – it certainly would be valuable for it to be further explored as public health advice,’ she said.
‘This intervention would likely be reasonably practical for many families to follow; however, the associated cost may be a barrier for some.’