Option 1

How much moisturiser is needed to treat eczema?  

What is the problem?  

People with eczema are told to apply moisturisers (emollients).  

But applying moisturisers is not easy. Many people report how challenging it can be to use moisturising creams (1). It can be greasy, it can take a lot of time, and children sometimes don’t like their parents putting it on them. 

Guidelines used by doctors and other health professionals around the world recommend moisturisers. But the guidelines don’t all agree on how much moisturiser is needed (2). Most currently recommend using large amounts of moisturiser 2 to 3 times a day (2). 

What is the current evidence?  

We have high quality evidence that using moisturisers does help eczema. So there are good reasons to use them (3).  

Why is this study needed?  

There are no studies that help us know how much moisturiser needs to be applied. People with eczema would benefit from knowing if they need to put it on a set number of times a day or just when their skin feels dry.

Option 2

How long to use flare control creams for?   

What is the problem?  

People with eczema are often told to apply flare control creams (such as topical corticosteroids or topical calcineurin inhibitors) when their eczema flares up.  

People can worry about using flare control creams for too long (1). The packaging and doctor prescriptions will usually suggest a limit to how long to use them for. This is important to make sure people are safe and not using too much. 

But not using enough flare control cream could also be a problem. If a flare is not fully treated, you might have to use more in the long-term because flares keep returning. 

What is the current evidence?  

There has been one small study in children aged 1 to 11 (4). 75% of children using flare control creams for more than 5 days had good eczema control. Only 28% of children using flare control creams for 5 days or less had good eczema control.(4). The study was not a randomised controlled trial, which means we have low quality evidence. 

Why is this study needed?  

There are no randomised controlled trials to help people know how long to use their flare control creams for (5). People with eczema would benefit from knowing how long to apply creams to get control of a flare. Whilst also not having to put on more than is necessary! 

Option 3 and 4

If flare-ups keep happening…  

• can using a mild flare control cream a couple of times a week between flares stop them from coming back?  

• does the cream need to be used on two days next to each other?   

What is the problem?  

Some people find eczema keeps flaring up (1). This can have a big impact on people. It also leads to people having to keep visiting the doctor or other health professionals. 

What is the current evidence?  

Nine studies have looked to see if using flare control creams (topical corticosteroids) twice a week helps stop eczema returning. This is sometimes called ‘weekend’ therapy. A review of this evidence was able to combine the results of 7 of the studies (5). Data from 1179 people, both children and adults, was used. Using flare control creams twice a week decreased the likelihood of a flare returning from 58% to 25% (5). The reviewers rated the evidence as moderate quality (5). 

Why is these study needed?  

Mild flare control cream: 

All of the existing studies used a potent (strong) steroid (5).  

Not all people with eczema are given a potent (strong) steroid to use. 

People with eczema would benefit from a study telling them if this strategy also works with a milder flare control cream. 

Which days to use: 

 The studies all used different strategies for applying the creams. Sometimes this was two days in a row. Sometimes not.  

No study has looked at if it is better to use creams two days in a row or spread those two days out throughout the week (5). 

People with eczema would benefit from knowing when is best to apply the creams.