The takeaway:
Whichever moisturizer people buy and use, the report says when people apply appropriate basic or therapeutic moisturizer two-to-three times a day in adequate quantities, it can reduce the need for more aggressive therapy and the time between flare ups. The report also talks about the need for regular bathing to reduce bacterial infections and to rehydrate the skin.
Just in time for winter when dry, cracked skin and eczema flare up most often, a new article by the University of Colorado College of Nursing helps consumers and providers by listing the most effective therapeutic moisturizers, their cost, and medication adherence levels. The article is expected to be used by nurses and doctors to better treat people with atopic dermatitis (AD), a common, chronic inflammatory skin disease that requires frequent moisturization to manage.
“Ultimately, moisturizers are an individual, personal choice, but surprisingly, few moisturizers have published efficacy data to help the consumer,” said lead author Noreen Heer Nicol, PhD, RN, FNP, NEA-BC, an associate professor at the University of Anschutz Colorado College of Nursing.
“This clinical article summarizes over-the-counter basic and therapeutic moisturizers that are available, the value of moisturizing daily for AD, and how health education leads to more moisturizer use and reduces the severity of the skin problems.”
The article was recently published in The Journal for Nurse Practitioners. It was co-authored by Nicol, Frank Rippke, PhD, Teresa Weber, PhD and Adelaide Herbert, MD.
In most countries, one in every five children has AD, while as many as 8% of adults suffer from dry, inflamed and cracked skin. The underlying defect in the skin’s protective barrier makes the skin prone to infection, according to the article. The disease is hereditary, but can also manifest from environmental and immunity factors.
The disease can be expensive to treat, cause people to miss work and school, lower productivity, increase sleep loss, and even cause mental distress from the appearance of the inflamed skin, according to the article. That’s why the authors decided to create a comprehensive list of moisturizers that can be bought without a prescription.
The evaluation found that few of the moisturizers have published data about their impact. The authors evaluated peer-reviewed relevant publications to determine:
- Dermacare Atopic Lotion, Atoderm Intensive Cream, and Physiogel AI Cream improve patient quality of life.
- Cetaphil Restoraderm Lotion and Wash Relief are associated with good compliance rates under trial conditions.
- Eucerin Eczema Relief Flare-up Treatment provides fast and lasting relief of itch and improved sleep quality for patients. Only Cetaphil and Eucerin have more than 1 publication with these outcome measures.
These over-the-counter therapeutic moisturizers cost less than other prescribed -topicals despite several studies that show they work about the same, according to the article. The researchers found the therapeutic products with the most data to support their use are also the cheapest to buy; Cetaphil and Eucerin. Other basic moisturizers, including those provided by popular brands such as Aquaphor (Beiersdorf Inc.), Eucerin (Beiersdorf Inc.), Vanicream (Pharmaceutical Specialties Inc.), CeraVe (L'Oreal Group), or Cetaphil (Galderma Laboratories), may be sufficient to help the dry skin of AD.
Despite that evidence, studies show people with AD don’t moisturize as well or as often as they should. Several other studies show nurse-led patient education about using topical therapies reduced the severity of chronic eczema 89%, improved sleep, and a feeling of control over the disease. Thus, researchers in the new article support engagement, time with patients, and education to improve the rate of treatment adherence. Researchers also recommend nursing practitioners and physician assistants play a major role in providing advice and guidance to patients and caregivers to manage their AD.
