Research Summary

Can Daily Moisturizer Use Prevent Atopic Dermatitis in Infants?

Anthony Calabro, MA

Key Highlights

  • Daily emollient use reduced cumulative incidence of atopic dermatitis (AD) by 16%
  • Stronger effects were found in infants not at high risk for AD.
  • Having a dog in the home enhanced the protective effect.

In a decentralized, randomized clinical trial of more than 1200 infants, daily full-body emollient application beginning by 9 weeks of age significantly reduced the cumulative incidence of atopic dermatitis (AD) by 24 months. The overall relative risk (RR) reduction was 16% compared with standard care, with a more pronounced effect (25% reduction) in infants not at high risk for developing AD.

Atopic dermatitis affects millions of children worldwide and is associated with the subsequent development of allergic conditions such as food allergy and asthma. While some studies have explored skin barrier enhancement to prevent AD in high-risk infants, there remains limited evidence for preventive strategies in infants not selected for elevated risk. Given the burden of AD and the simplicity of topical interventions, this study sought to evaluate whether early skin care using emollients could have a broad public health impact.

This trial enrolled 1247 infant-parent dyads from 25 community-based clinics across four statewide practice-based research networks in the US. Infants were randomized to either a daily moisturizer group or a control group receiving standard skin care advice without emollient use. The intervention involved full-body emollient application starting before 9 weeks of age. The primary outcome was physician-diagnosed AD documented in the medical record by age 24 months. Participants were monitored with quarterly surveys, and trained research staff abstracted medical records to verify diagnoses and assess adverse events.

By the end of follow-up, 36.1% of infants in the moisturizer group developed AD compared with 43.0% in the control group (RR, 0.84; 95% CI, 0.73-0.97; P = .02). The preventive effect was greater in infants not at high risk for AD (RR, 0.75; 95% CI, 0.60-0.90; P = .01).

A modifier of this effect was the presence of a dog in the home, which further reduced the risk (RR, 0.68; 95% CI, 0.50-0.90; P = .01). Cutaneous adverse events were similar between groups, suggesting that the intervention was well tolerated.

“This randomized clinical trial found that daily emollient application beginning before age 9 weeks in a representative US population not selected for risk reduced the cumulative incidence of AD at age 24 months,” Simpson and colleagues concluded.

Reference:
Simpson EL, Michaels LC, Ramsey K, et al. Emollients to prevent pediatric eczema: a randomized clinical trial. JAMA Dermatol. Published online July 23, 2025. doi:10.1001/jamadermatol.2025.2357