Project Name
BATHE (Bath Additives in the Treatment of cHildhood Eczema)

Value
£959,000

Funder
NIHR HTA

Principal Investigator
PI: Prof Paul Little, Southampton University
Cardiff lead: Dr Nick Francis

Co-applicants
Mrs Louise Stanton (nee Dent) (University of Southampton), Dr Nick Francis (Cardiff University), Professor Paul Little (University of Southampton), Dr Matthew Ridd (University of Bristol), Mrs Amanda Roberts (Centre for Evidence Based Dermatology), Dr Beth Stuart (University of Southampton), Associate Professor Kim Thomas (University of Nottingham), Professor Hywel Williams (University of Nottingham), Dr Wendy Wood (University of Southampton), Ms Maria Chorozoglou (University of Southampton)

Type of study
RCT

Summary
Eczema is a skin condition that is very common in young children. It causes itching and sleep problems which lead to distress for the child and the rest of the family and can also impact on schooling and everyday tasks. The main treatment is emollients, which moisturise the skin, and steroid creams/ointments to treat flare-ups caused by skin inflammation. A NICE guideline on childhood eczema has recommended ‘complete emollient therapy’ – a care package that includes directly applied emollient, soap substitute emollient and bath emollient (a liquid added to the bath). However, the guideline highlighted that there is little research evidence on whether adding in a bath emollient is helpful. While health professionals agree about the benefits of directly applied emollients and avoiding soap in eczema, there is less confidence in the possible additional benefits of bath emollients. It is possible that they do help because they are easy to pour in the bath and it is likely that they come into contact with all of the skin. But it is also possible that the emollient effect is much less than the direct application of emollients onto the skin, and not enough to produce any benefit. Bath emollients can have adverse effects as they sometimes cause stinging and redness of the skin, potentially cause accidents through leaving the bath slippery and may rot bath mats and lead to increased time spent cleaning the bath. Furthermore, there is concern that some families view bath emollients as an alternative to directly applied emollients and are therefore using a less effective therapy instead of something that would help their child’s eczema more. Bath emollients cost the NHS over £16 million per year, a substantial sum given the lack of evidence for their benefit.

This study aims to find out what the clinical and cost-effectiveness is of regular bath emollient use as part of the treatment package for childhood eczema in a primary care setting?

School role
WSPCR supported

Start date
01/11/2014

End date
01/03/2018

Related links
Study description on ISR CTN website