Conflicts of interest None declared.
Treatment with a barrier-strengthening moisturizing cream delays relapse of atopic dermatitis: a prospective and randomized controlled clinical trial
Article first published online: 8 JUN 2009
© 2009 The Authors. Journal compilation © 2009 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 23, Issue 11, pages 1267–1272, November 2009
How to Cite
Wirén, K., Nohlgård, C., Nyberg, F., Holm, L., Svensson, M., Johannesson, A., Wallberg, P., Berne, B., Edlund, F. and Lodén, M. (2009), Treatment with a barrier-strengthening moisturizing cream delays relapse of atopic dermatitis: a prospective and randomized controlled clinical trial. Journal of the European Academy of Dermatology and Venereology, 23: 1267–1272. doi: 10.1111/j.1468-3083.2009.03303.x
- Issue published online: 8 OCT 2009
- Article first published online: 8 JUN 2009
- Received: 6 January 2009; Accepted 25 March 2009
- disease control;
- long-term management/treatment;
- maintenance treatment;
- skin barrier function;
- topical corticosteroids;
Background Standard treatment of atopic dermatitis (AD) is based on topical glucocorticosteroids or calcineurin inhibitors to treat flares combined with moisturizer treatment to alleviate dry skin symptoms. Patients with AD have an abnormal skin barrier function, and strategies for reducing the risks for eczema would be to repair the barrier or prevent barrier dysfunction.
Objectives The objective of this study was to explore the time to relapse of eczema during a 26-week maintenance treatment with a urea containing moisturizer compared to no treatment (neither medical nor non-medicated preparations) after successful clearing of atopic lesions. The moisturizer has previously been shown to improve skin barrier function.
Methods Patients applied betamethasone valerate (0.1%) on eczematous lesions during a 3-week period. Those with cleared eczema entered a 26-week maintenance phase, applying the moisturizer or left the previously affected area untreated. Upon eczema relapse, patients were instructed to contact the clinic and to have the relapse confirmed by the investigator.
Results Fifty-five patients entered the study and 44 patients were included in the maintenance phase (22 using moisturizer twice daily and 22 using no treatment). Median time to relapse for patients treated with moisturizer was > 180 days (duration of the study) compared with 30 days for the no-treatment group. Sixty-eight per cent of the patients treated with the moisturizer and 32% of the untreated patients remained free from eczema during the observation period.
Conclusions Maintenance treatment with a barrier-improving urea moisturizer on previous eczematous areas reduced the risk of relapse to approximately one third of that of no treatment.