Early unselected emollient bathing is associated with subsequent atopic
dermatitis in an observational cohort study
Abstract
Background: Skin barrier dysfunction is a key component of the
pathogenesis of atopic dermatitis (AD). Recent research on barrier
optimization to prevent AD has shown mixed results. The aim of this
study was to assess the relationship between emollient bathing at two
months and the trajectory of AD in the first two years of life in a
large unselected observational birth cohort study. Methods: The Babies
After SCOPE: Evaluating the Longitudinal Impact Using Neurological and
Nutritional Endpoints Birth Cohort study enrolled 2183 infants.
Variables extracted from the database related to early skincare, skin
barrier function, parental history of atopy, and AD outcomes.
Statistical analysis was performed to adjust for potential confounding
variables. Results: 1,505 children had data on AD status available at
six, 12, and 24 months. Prevalence of AD was 18.6% at six months,
15.2% at 12 months, and 16.5% at 24 months. Adjusted for potential
confounding variables, the odds of AD at any point were higher among
infants who had emollient baths at two months (OR (95% CI): 2.41 (1.56
to 3.72), p<0.001). Following multivariable analysis, the odds
of AD were higher among infants who had both emollient baths and
frequent emollient application at two months, compared to infants who
had neither (OR (95% CI) at six months 1.74 (1.18-2.58), p=0.038), (OR
(95% CI) at 12 months 2.59 (1.69-3.94), p<0.001), (OR (95%
CI) at 24 months 1.87 (1.21-2.90), p=0.009). Conclusion: Early emollient
bathing was associated with greater development of AD by two years of
age in this unselected birth cohort study.