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Abnormal skin barrier function is thought to be central in the pathophysiology of atopic dermatitis (AD). Filaggrin is required for normal barrier function, and loss-of-function mutations are a major risk factor for severe eczema and other allergic diseases. Daily emollient therapy is a cornerstone of treatment, but moisturizers have not been studied in the prevention of AD.
In a pilot study, 124 newborns in the U.S. and U.K. were randomized to daily emollient therapy or usual infant skin care started by age 3 weeks. All infants were at high risk for AD, with at least one atopic first-degree relative. Parents in the U.S. were allowed to choose among sunflower oil, Cetaphil cream, or Aquaphor Healing Ointment. After 6 months, 43% of infants i…