A pilot study of emollient therapy for the primary prevention of atopic dermatitis

Background: Prevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of AD and possibly food allergy and asthma. Correcting skin barrier defects from birth may prevent AD onset or moderate disease severity. Objective: We sought to determine the feasibility of skin barrier protection as a novel AD prevention strategy. Methods: We enrolled 22 neonates at high risk for developing AD in a feasibility pilot study using emollient therapy from birth. Results: No intervention-related adverse events occurred in our cohort followed up for a mean time of 547 days. Of the 20 subjects who remained in the study, 3 (15.0%) developed AD, suggesting a protective effect when compared with historical controls. Skin barrier measurements remained within ranges seen in normal-appearing skin. Limitations: No conclusions regarding efficacy can be made without a control group. Conclusions: Skin barrier repair from birth represents a novel and feasible approach to AD prevention. Further studies are warranted to determine the efficacy of this approach. (J Am Acad Dermatol 2010;63:587-93.)