Eczema bath products, most of which contain liquid paraffin, are of “questionable” value, according to an article in the Drug and Therapeutics Bulletin (DTB), from the BMJ Group. The UK National Health Service (NHS) spends 40% of its total eczema treatment costs for pre-school children on bath emollients.

These gels, creams and lotions have very little published research to back them, says the DTB. The report explains that even medical expects do not seem able to agree on their effectiveness.

Emollients are aimed at improving the symptoms and the look of dry skin conditions and reducing the use of steroid creams. They are supposed to stop water loss from the skin and form a protective barrier against external skin irritants. The DTB explains that the long experience of healthcare professionals seems to indicate that normal emollients applied directly to the skin are beneficial for the patients. Some research indicates that emollients are effective. In fact, national treatment guidelines recommend that emollients be used liberally, up to three times per day, even after an eczema patient has had a bath.

Bath emollients, on the other hand, do not seem to have such consensus. How bath emollients compare with other bathing products and post-washing skin creams is unknown. So, why do healthcare professionals often tell their patients to use them? Even the British Association of Dermatologists recommends their use in its advice to patients.

The DTB explains “Given that bath emollients are expensive, and the NHS spends a considerable sum on them, we believe their use requires proper evaluation.”

The article concludes that the application of topical creams without the addition of bath emollients is “entirely reasonable”.

“Bath emollients for atopic eczema: why use them?”
DTB; 45: October 2007

Written by: Christian Nordqvist