Emollients as an adjunct therapy to topical corticosteroids in children with mild to moderate atopic dermatitis

Background: Topical corticosteroids are considered to be the mainstay of treatment for mild to moderate atopic dermatitis. However, their use is expensive and associated with many side effects. Many researchers recommend the use of emollients as steroid sparing agents. To prove or refute this hypothesis, we designed an open right vs. left comparison trial using topical corticosteroids alone versus corticosteroid plus emollient. Patients and methods: 50 children (26 female and 24 male, mean age 3.5±2.5 years), suffering from mild to moderate atopic dermatitis (mean SCORAD score 19.9±8.1) were recruited in the study. Betamethasone valerate (0.1%) ointment alone was used twice daily on the lesions on right side of body whereas the lesions on left side of body were treated with betamethasone valerate (0.1%) ointment in the morning and emollient in the evening. The patients were followed up weekly for four weeks. SCORAD score was used to measure the disease activity before the start, during follow-up and then at the end of therapy. Results: Both treatment regimens showed significant improvement by the end of week 1 (p<0.05), it continued till week 4 (p<0.05). However, there was no statistically significant difference between the two groups in terms of clinical improvement or reduction in the mean size of lesions (p>0.05). The two sides did not show any side effects. Conclusion: Emollients can be used as steroid sparing agents in the treatment of mild to moderate atopic dermatitis.