Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review
- PMID: 26267423
- DOI: 10.1007/s40257-015-0146-4
Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review
Abstract
Background: Moisturizers are widely used for atopic dermatitis (AD) and related conditions, but available evidence of their effectiveness has not been reviewed in a systematic fashion.
Objectives: Our objective was to investigate the effectiveness of emollients, as a group and individually, in the treatment of AD and related conditions, by means of a systematic review.
Data sources: Studies indexed in MEDLINE and/or Embase before 16 January 2015.
Study eligibility criteria: Controlled clinical studies comparing the clinical effect of a moisturizer against its vehicle, another moisturizer, or no treatment were eligible. For the outcomes transepidermal water loss (TEWL) and stratum corneum hydration, uncontrolled before-after designs were also eligible.
Participants: Participants were patients with AD, irritant hand dermatitis, and/or ichthyosis vulgaris.
Results: Out of the 595 publications initially identified, 45 (48 studies, 3262 patients) were eligible for inclusion. A vast majority of studies indicate that moisturizers have beneficial effects on clinical symptoms [SCORAD (SCORing Atopic Dermatitis) reductions ranging from 0 to 2.7 points], TEWL (range 0 to -12.2 g/m(2)h) and stratum corneum hydration (range +8 to +100%). Direct comparisons between individual moisturizers are still scarce, but the clinical effect appears to be much more well-documented for urea and glycerin than, for example, propylene glycol, lactate, ceramide, and aluminum chlorohydrate. Compared with urea studies, glycerin studies were more often associated with a high risk of bias.
Limitations: Due to differences in study designs and outcome measures, a quantitative meta-analytic approach was not deemed feasible, and formal indicators of publication bias such as funnel plots could not be used. However, a large number of moderately sized studies with positive outcomes could be compatible with selective publishing of favourable results.
Conclusions: The clinical effect of moisturizers is well-documented. Urea-based preparations may be preferable as a first-line treatment, but there is an unmet need for well-powered comparisons between individual moisturizers.
Similar articles
-
Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders.Am J Clin Dermatol. 2003;4(11):771-88. doi: 10.2165/00128071-200304110-00005. Am J Clin Dermatol. 2003. PMID: 14572299 Review.
-
Moisturizing treatment of patients with atopic dermatitis and ichthyosis vulgaris improves dry skin, but has a modest effect on gene expression regardless of FLG genotype.J Eur Acad Dermatol Venereol. 2015 Jan;29(1):174-7. doi: 10.1111/jdv.12333. Epub 2013 Dec 12. J Eur Acad Dermatol Venereol. 2015. PMID: 24330146
-
Different types of emollient cream exhibit diverse physiological effects on the skin barrier in adults with atopic dermatitis.Clin Exp Dermatol. 2022 Jun;47(6):1154-1164. doi: 10.1111/ced.15141. Epub 2022 Apr 12. Clin Exp Dermatol. 2022. PMID: 35167133 Free PMC article. Clinical Trial.
-
Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity.J Am Acad Dermatol. 2002 Aug;47(2):198-208. doi: 10.1067/mjd.2002.124617. J Am Acad Dermatol. 2002. PMID: 12140465
-
Moisturizers versus Current and Next-Generation Barrier Repair Therapy for the Management of Atopic Dermatitis.Skin Pharmacol Physiol. 2019;32(1):1-7. doi: 10.1159/000493641. Epub 2018 Oct 18. Skin Pharmacol Physiol. 2019. PMID: 30336483 Review.
Cited by
-
Efficacy and In-Use Tolerance of Venusia Baby Moisturizer for Skin Hydration in Babies With Dry and/or Normal Skin.Cureus. 2023 Sep 11;15(9):e45032. doi: 10.7759/cureus.45032. eCollection 2023 Sep. Cureus. 2023. PMID: 37842370 Free PMC article.
-
Urea in Dermatology: A Review of its Emollient, Moisturizing, Keratolytic, Skin Barrier Enhancing and Antimicrobial Properties.Dermatol Ther (Heidelb). 2021 Dec;11(6):1905-1915. doi: 10.1007/s13555-021-00611-y. Epub 2021 Oct 1. Dermatol Ther (Heidelb). 2021. PMID: 34596890 Free PMC article. Review.
-
What are the highest yielding search strategy terms for systematic reviews in atopic dermatitis? A systematic review.Arch Dermatol Res. 2021 Nov;313(9):737-750. doi: 10.1007/s00403-020-02165-z. Epub 2020 Nov 22. Arch Dermatol Res. 2021. PMID: 33221950
-
An Emollient Containing Aquaphilus dolomiae Extract is Effective in the Management of Xerosis and Pruritus: An International, Real-World Study.Dermatol Ther (Heidelb). 2020 Oct;10(5):1013-1029. doi: 10.1007/s13555-020-00415-6. Epub 2020 Jul 14. Dermatol Ther (Heidelb). 2020. PMID: 32666271 Free PMC article.
-
Efficacy of Nonprescription Moisturizers for Atopic Dermatitis: An Updated Review of Clinical Evidence.Am J Clin Dermatol. 2020 Oct;21(5):641-655. doi: 10.1007/s40257-020-00529-9. Am J Clin Dermatol. 2020. PMID: 32524381 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical