A close-up stock image of a young child with an outbreak of eczema on her cheek.

Reducing the debilitating effect of childhood eczema

Published: 6 October 2023

Eczema is a very common skin condition among children and young people and can have a substantial, debilitating impact on their quality of life. Treatment can be complex and many people with eczema say they receive insufficient or conflicting advice about how to use eczema treatments.

Professor Miriam Santer, a GP and Professor of Primary Care Research at Southampton, led research that has improved outcomes by developing a website to support self-care of eczema: Eczema Care Online.

Eczema Care Online

A free online tool that helps children and young people self-manage their eczema.

 

2 trials published in the British Medical Journal have shown that the website improves outcomes for children and young people with the condition.

Helping manage the condition

Eczema Care Online is a free online tool that helps children and young people self-manage their eczema. It provides information and support on:

  • what eczema is
  • how to use eczema treatments
  • how to avoid potential triggers
  • living well with eczema

Already, more than 26,000 people in over 160 countries have accessed the website. It is signposted from National Institute for Health and Care Excellence (NICE) guidelines, resulted in a National Institute for Health and Care Research (NIHR) alert, and is used in GP software and Boots pharmacist training. It is also being adapted for use in Australia, France and the Netherlands.

The website gives both patients and clinicians evidence-based resources. Participants were shown to have improved symptoms after six months and those improvements continued for another six months, compared to those who received usual care alone. Empowering parents and young people to take ownership of the condition can lead to sustained positive clinical outcomes at an affordable cost.

Professor Miriam Santer

The study was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research and was a collaboration between the universities of Southampton, Nottingham, Bristol and East Anglia, and the London School of Hygiene and Tropical Medicine.

Simplifying treatment by reducing the use of bath additives

Miriam has also led research into the regular use of bath additives (bath emollients) for eczema. The Bath Additives for the Treatment of Childhood Eczema (BATHE) study involved 400 children and investigated the use of emollients in the bath.

The study showed that there was no clinical benefit from using bath additives in the management of eczema, when used in addition to leave-on emollients. This has resulted in simplifying treatment for families, a reduction in the prescribing of bath additives and significant cost savings to the NHS. The findings were published in the British Medical Journal, led to a change in NICE and NHS England guidelines, and resulted in an NIHR alert.

A separate study, the Best Emollients for Eczema (BEE) trial, investigated the use of leave-on emollients in a collaboration between the universities of Bristol, Nottingham and Southampton.

The trial compared the 4 main types of leave-on emollients (lotions, creams, gels, and ointments) and found no difference in effectiveness between them. Associated research highlighted the need for families to be able to choose their emollient to discover which they are most likely to use. This research has been published in The Lancet Child and Adolescent Health.

This Eczema Care Online website gives both patients and clinicians evidence-based resources that have been shown to improve the symptoms of eczema. We hope it will be rapidly rolled out within the NHS to provide effective help for eczema.
Professor of Primary Care Research

Related publications

Miriam Santer, Matthew Ridd, Nick Francis, Beth Stuart, Kate Rumsby, Maria Chorozoglou, Taeko Becque, Amanda Roberts, Lyn Liddiard, Claire Nollett, Julie Hooper, Martina Prude, Wendy Wood, Kim Thomas, Emma Thomas-Jones, Hywel Williams & Paul Little, 2018, BMJ, 361(8151)
Type: article
Miriam Santer, Ingrid Muller, Taeko Becque, Beth Stuart, Julie Hooper, Mary Steele, Sylvia Wilczynska, Tracey H Sach, Matthew J. Ridd, Amanda Roberts, Amina Ahmed, Lucy Yardley, Paul Little, Kate Greenwell, Katy Sivyer, Jacqueline Nuttall, Gareth Griffiths, Sandra Lawton, Sinéad Langan, Laura M Howells, Paul Leighton, Hywel Williams & Kim S. Thomas, 2022, The BMJ, 379, e072007
Type: article
Matthew J. Ridd, Sian Wells, Louisa Edwards, Miriam Santer, Stephanie MacNeill, Emily Sanderson, Eileen Sutton, Alison R G Shaw, Jonathan Banks, Kirsty Garfield, Amanda Roberts, Tiffany J Barrett, Helen Baxter, Jodi Taylor, J Athene Lane, Alastair D. Hay, Hywel C. Williams & Kim Suzanne Thomas, 2019, BMJ Open, 9(11), 1-10
Type: article