Hygiene practices: Are they protective factors for eczema symptoms?

Abstract

IntroductionExact etiology and proper treatment of eczema are still unknown. The hygiene hypothesis and epidermal barrier dysfunction hypothesis attempted to give some plausible explanations for these issues but they still remain unclear. The identification of factors, including hygiene practices, related to eczema symptoms (ES) could shed some light on these matters. Therefore, this study aimed to determine risk factors related to ES and the ES prevalence in two disparate areas in terms of urbanization in Aceh, Indonesia.MethodsA cross‐sectional study with convenience sampling was conducted among schoolchildren living in urban and rural Aceh. Data on ES, socio‐demographic characteristics, environmental factors, partial ablution and other hygiene related factors were collected by parental questionnaires. In addition, children's anthropometric measurements were also collected.ResultsThe prevalence of current ES in the study population was 21%. When stratifying by residency, the prevalence of ES in urban and rural area was 20.93% versus 21.05%. Partial ablution was independently associated with a reduced risk of ES (OR = 0.36; 95% CI 0.13–0.96). Important risk factors for ES were paternal history of allergic disease (OR = 4.09%; 95% CI 1.51–11.11) and belonging to the older group of schoolchildren (10–13 years old) (OR = 2.57; 95% CI 1.03–6.40).ConclusionsThere were no significant differences in the prevalence of ES between urban and rural settings, and partial ablution had a protective effect on ES. These findings support the epidermal barrier dysfunction hypothesis as a possible pathway of eczema.

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“…Our findings have demonstrated a reduction in presentation of AD in outer regional and remote areas. This contrasts with previous findings of no significant differences between urban and rural areas in the prevalence of AD [42]. Barriers to access healthcare in regional and remote areas may account for this finding.…”

A systematic review and meta-analysis of risk factors associated with atopic dermatitis in Asia

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The Role of the Environmental Risk Factors in the Pathogenesis and Clinical Outcome of Atopic Dermatitis

“…Various studies conducted in this area did not show a convincing protective effect of this lifestyle [131–137]. It is a very interesting fact that the consumption of unpasteurized farm milk during the first 2 years of life is an independent protective factor against the development of AD, even in families not living in the countryside.…”