Introduction
Methods
Literature Search
Eligibility Criteria
Data Extraction
Compliance with Ethics Guidelines
Results
Database Search
Study Characteristics
References | Emollient(s) | Study setting (country) | Non-emollient comparator | Patient population | Eczema diagnostic criteria |
---|---|---|---|---|---|
Chamlin et al. [28] | TriCeram Cream | Pediatric dermatology clinics (USA) | – | Stubborn-to-recalcitrant AD Aged 1–12 years n = 24 | Unspecified |
Chishti et al. [30] | Dermovix | ShifaulMulk Memorial-Hospital and Al-Rasheed Darushifa Malkani Liaqut Pur (Pakistan) | Betnovate N-Cream | AD n = 60 Aged 2 years to > 40 years | Unspecified |
Draelos [27] | Atrapro Antipruritic HydroGel | Unspecified | – | Mild-moderate AD Aged 18–65 years n = 17 | Hanifin and Rajka |
Draelos and Raymond [25] | NeoCera | Unspecified | – | Mild-to-moderate atopic dermatitis or other xerotic/pruritic dermatoses Aged 1–86 years n = 50 | Unspecified |
Boguniewicz et al. [21] | Atopiclair Cream | 7 Study centers (US) | “Vehicle” (unspecified) | AD Aged 6 months to 12 years n = 142 | Hanifin and Rajka |
Boralevi et al. [11] | Dexeryl (glycerol containing emollient) | Unspecified | “Vehicle” | AD Aged 2–6 years n = 251 | UK Working Party |
Bissonnette et al. [7] | Iso-Urea (5% urea moisturizer) 10% urea lotion | Unspecified | – | Mild-moderate AD Aged 18–70 years n = 100 | Unspecified |
Gandy et al. [13] | CHD-FA 3.5% (carbohydrate-derived fulvic acid) “Placebo emollient” (unspecified) | Unspecified | – | Eczema > 2 years n = 36 | Unspecified |
Haider [10] | 10% Sodium cromoglycate ointment Placebo ointment (white soft paraffin) | Bury General Hospital (England) | – | Chronic atopic eczema Children n = 42 | Unspecified |
Hashizume et al. [23] | N-acetyl-hydroxyproline cream (AHYP; contains glyerin and glyceryl stearate) | Unspecified | “Control cream” (unspecified) | Slight AD Aged 20–49 years n = 14 | Atopic dermatitis treatment guidelines of the Japanese Dermatological Association |
Hlela et al. [12] | Cetomacrogrol Emulsifying ointment Glycerine/petroleum Petroleum jelly | Red Cross Children’s War Memorial Hospital (South Africa) | – | Mild-moderate AD Aged 1–12 years n = 80 | UK Working Party |
Kanehara et al. [14] | Borage oil (coated on undershirts) | Unspecified | Non-coated placebo undershirts | Mild-moderate AD Aged 1–10 years n = 32 | Hanifin and Rajka |
Korting et al. [15] | Verum (pale sulfonated shale oil cream 4%) | Outpatient centrers (Germany) | “Vehicle” | Mild-moderate AD Aged 0–12 years n = 99 | Unspecified |
Korting et al. [19] | Hamamelis distillate | Unspecified | Hydrocortisone cream on the other side “Drug-free vehicle” (unspecified) | Moderately severe atopic eczema Aged 18–62 years n = 72 | Hanifin and Rajka |
Lodén et al. [22] | Glycerin cream Urea cream | Unspecified | “Placebo” (unspecified) | AD Adults n = 197 | Unspecified |
Lynde and Andriessen [29] | CeraVe Moisturizing Cream | Unspecified | – | Mild-moderate AD Fitzpatrick skin types I–III Children and adults n = 151 | Unspecified |
Na et al. [26] | Atobarrier Cream | Unspecified | – | Mild-moderate AD Aged 5–19 years n = 30 | Unspecified |
Ruzicka et al. [20] | Ointment base containing propylene carbonate | Unspecified | 0.03% tacrolimus, 0.1% tacrolimus, 0.3% tacrolimus | Moderate-severe AD Aged 13–60 years n = 215 | Rajka and Langeland |
Seghers et al. [24] | Curel Moisture Cream | National Skin Center (Singapore) | – | Stable, mild-moderate AD Aged 7–60 years n = 40 | UK Working Party |
Shimelis et al. [16] | 10% Chamomile hydro-alcoholic extract cream | Mobile dermatological centers (Ethopia) | “Placebo” (unspecified) | AD Aged 1–78 years n = 11 | Dermatologist determined |
Simpson et al. [8] | Cetaphil Restoraderm | Pro-DERM Institute (Germany) | Untreated area | “Controlled AD” (no active lesions in target area) Aged 18–-65 years n = 20 | Unspecified |
Stainer et al. [17] | Altoderm lotion (4% sodium cromoglicate) | 3 NHS hospital outpatient clinics, 1 specialist clinical research center (England) | “Placebo” (base lotion alone) | AD Aged 2–12 years n = 114 | UK Working Party |
Tan et al. [9] | “Triclosan-containing emollient” | National Skin Center (Singapore) | “Vehicle” | Mild-moderate AD Aged 12–40 years n = 60 | Hanifin and Rajka |
Udompatajkul and Srisatwaja [18] | Eucerin Soothing Lotion 12% omega (Licochalcone) | Unspecified | 1% Hydrocortisone lotion | Mild-moderate AD Aged 2–15 years n = 30 | Hanifin and Rajka |
Emollient Type and Application
Type of emollient | Number of emollients | References | Main constituents of emollient | ||||
---|---|---|---|---|---|---|---|
Urea | Ceramide | Glycerol | Herbala | Otherb | |||
Lotion | 3 | Bissonnette et al. [7] | ● | ||||
Stainer et al. [17] | ● | ||||||
Udompatajkul and Srisatwaja [18] | ● | ||||||
Cream | 15 | Chamlin et al. [28] | ● | ||||
Seghers et al. [24] | ● | ||||||
Draelos and Raymond [25] | ● | ||||||
Lynde and Andriessen [29] | ● | ||||||
Boralevi et al. [11] | ● | ||||||
Hashizume et al. [23] | ● | ||||||
Hlela et al. [12] | ● | ||||||
Lodén et al. [22] | ● | ● | |||||
Korting et al. [19] | ● | ||||||
Shimelis et al. [16] | ● | ||||||
Korting et al. [15] | ● | ||||||
Boguniewicz et al. [21] | ● | ||||||
Na et al. [26] | ● | ||||||
Tan et al. [9] | ● | ||||||
Gel | 1 | Draelos [27] | ● | ||||
Ointment | 4 | Haider [10] | ● | ||||
Chishti et al. [30] | ● | ||||||
Hlela et al. [12] | ● | ||||||
Ruzicka et al. [20] | ● | ||||||
Jelly | 1 | Hlela et al. [12] | ● | ||||
Coated undershirt | 1 | Kanehara et al. [14] | ● | ||||
Unknown | 4 | Bissonnette et al. [7] | ● | ||||
Simpson et al. [8] | ● | ||||||
Hlela et al. [12] | ● | ||||||
Gandy et al. [13] | ● | ||||||
Total | 29 | 3 | 5 | 4 | 4 | 13 |
Adverse Events Associated With Emollients According to Constituents
Type of emollient | Emollient | Number of participants using emollients | Serious adverse events | Treatment-related adverse events | Adverse events not related to study treatment | References | ||
---|---|---|---|---|---|---|---|---|
Number of adverse events | Number of participants | Number of adverse events | Number of participants | |||||
Urea-containing | Iso-Urea (5% urea moisturizer) | 50 | 0 | 5 | Not reported | 21 | Not reported | Bissonnette et al. [7] |
10% Urea Lotion | 50 | 0 | Bissonnette et al. [7] | |||||
Urea Cream | 63 | Not reporteda | Not specifiedb | Not specified | Not reported | Not reported | Lodén et al. [22] | |
Ceramide-containing | Cetaphil Restoraderm | 20 | 0 | 0 | 0 | Not reported | Not reported | Simpson et al. [8] |
Curel Moisture Cream (pseudoceramide) | 40 | 0 | 2 | 8 (20.0%) | Not specified | Not specified | Seghers et al. [24] | |
NeoCera | 50 | 0 | 0 | 0 | 0 | 0 | Draelos and Raymond [25] | |
CeraVe Moisturizing Cream | 151 | 0 | 0 | 0 | 0 | 0 | Lynde and Andriessen [29] | |
TriCeram cream (ceramide-dominant, physiologic lipid-based emollient) | 24 | Not reported | 0 | 0 | Not reported | Not reported | Chamlin et al. [28] | |
Glycerol- containing | Dexeryl | 124 | 0 | 3 | 3 (2.4%) | Not reported | 31 (25.0%) | Boralevi et al. [11] |
Glycerine/petroleum (and baby oil as a soap substitute) | 20 | 1 | 1 | 1 (5.0%) | 0 | 0 | Hlela et al. [12] | |
Glycerin cream | 68 | Not reported | Not specified | Not specified | Not reported | Not reported | Lodén et al. [22] | |
N-Acetyl-hydroxyproline cream (AHYP; contains glyerin and glyceryl stearate) | 14 | 0 | 0 | 0 | 0 | 0 | Hashizume et al. [23] | |
Herbal | Dermovix | 30 | 0 | 0 | 0 | 0 | 0 | Chishti et al. [30] |
Borage oil coated on undershirts | 16 | 0 | 0 | 0 | 0 | 0 | Kanehara et al. [14] | |
10% Chamomile hydro-alcoholic extract cream | 11 | 0 | 0 | 0 | 0 | 0 | Shimelis et al. [16] | |
Hamamelis distillate | 72 | 0 | Not specified | Not specified | 3 | 3 (4.2%) | Korting et al. 1995 [19] | |
Other | “Triclosan-containing emollient” | 30 | Not reported | 3 | 3 (10.0%) | Not specified | Not specified | Tan et al. [9] |
10% Sodium cromoglycate ointment | 21 | 0 | 0 | 0 | 0 | 0 | Haider 1977 [10] | |
Cetomacrogrol (+ baby oil as a soap substitute) | 20 | 0 | 1 | 1 (5.0%) | 0 | 0 | Hlela et al. 2015 [12] | |
Emulsifying ointment (+ baby oil as a soap substitute) | 20 | 0 | 0 | 0 | 0 | 0 | Hlela et al. [12] | |
Petroleum jelly (+ baby oil as a soap substitute) | 20 | 0 | 1 | 1 (5.0%) | 0 | 0 | Hlela et al. [12] | |
Atobarrier cream (lipid granule containing emollient) | 30 | 0 | 1 | 1 (3.3%) | Not reported | Not reported | Na et al. [26] | |
Atrapro Antipruritic HydroGel | 17 | 0 | 1 | 10 (58.8%) | 0 | 0 | Draelos [27] | |
CHD-FA 3.5% (carbohydrate derived fulvic acid) emollient | 18 | 0 | Not specified | Not specified | 0 | 0 | Gandy et al. 2011 [13] | |
Verum (pale sulfonated shale oil cream 4%) | 51 | 0 | 3 | 2 (3.9%) | 3 | 3 (5.9%) | Korting et al. [15] | |
Altoderm Lotion (4% Sodium cromoglicate) | 58 | 0 | Not specified | 7 (12.1%) | Not reported | 25 (43.1%) | Stainer et al. [17] | |
Eucerin Soothing Lotion 12% omega (Licochalcone A lotion) | 30 | 0 | 0 | 0 | 0 | 0 | Udompatajkul and Srisatwaja [18] | |
Ointment base containing propylene carbonate | 54 | Not reported | 3 | 15 (27.8%) | 1 | 7 (13.0%) | Ruzicka et al. [20] | |
MAS063DP (Atopiclair) cream | 72 | 2 (not treatment related) | 10 | Not reported | 50 | Not reported | Boguniewicz et al. [21] |