- Sarah J Matthews, technical analyst1,
- Nicola Housam, advanced care practitioner dermatology2,
- Sandra Lawton, nurse consultant dermatology3,
- Phil Taverner, guideline committee chair
- on behalf of the Guideline Committee
- 1National Institute for Health and Care Excellence, Manchester M1 4BT, UK
- 2United Lincolnshire Hospitals NHS Trust, Lincoln LN2 5QY, UK
- 3Rotherham NHS Foundation Trust, Rotherham S60 2UD, UK
- Correspondence to: S J Matthews sarah.matthews{at}nice.org.uk
What you need to know
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Do not offer emollient bath additives to children under 12 years old with atopic eczema
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Offer personalised advice to all so that children and carers are educated on how to wash with emollients
Atopic eczema is a common condition in children under 12 years old that can negatively affect quality of life for children and their carers. Emollients form the basis of eczema management and are available as either leave-on preparations (which include lotions, sprays, creams, and ointments), emollient soap substitutes, or emollient bath additives. Management of eczema with emollients includes regularly applying leave-on emollients and washing with leave-on emollients or emollient soap substitutes (box 1).
Tips on emollient safety
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Emollients can transfer from skin to clothes, bedding, and bandages, which can then become flammable. Regularly washing clothes and bedding at the highest temperature allowed for the fabric can reduce build-up of emollient, but it does not completely remove it and carers should try to keep children away from fire, flames, and cigarettes1
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Patients and carers should try to prevent contamination of emollients by either using a pump dispenser or by scooping emollients out of pots using a clean spoon or spatula rather than their hands23
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Emollients can make the bath or shower slippery. Patients and carers should always use a non-slip bathmat, clean the bath or shower after washing, and dry the bath or shower with paper towels or tissue2
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Emollient bath additives are also available; these are emollient products that are formulated to be added to bath water. In 2018, the BATHE trial found that emollient bath additives are not effective or cost effective when used in addition to standard care.4 Prescriptions for emollient bath additives remain limited in some areas of England,5 which has given rise to geographical variation in prescribing.
This article summarises …