A multicentre randomised controlled trial and economic evaluation of ion-exchange water softeners for the treatment of eczema in children: the Softened Water Eczema Trial (SWET)

Abstract

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A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…A similar approach was successfully used in the HTA-funded Softened Water Eczema Trial in which the nurses were inadvertently unblinded in just 3.5% of cases (11/316). 356 Packaging, labelling and distribution of clothing will be performed by staff at the co-ordinating centre and sent to participants by first-class post. Although it will not be possible to blind participants to their treatment allocation, efforts will be made to minimise expectation bias by emphasising in the trial literature that the evidence supporting the use of silk clothing for eczema is currently limited and that we do not yet know if this clothing offers any benefit over standard care.…”

“…This approach has been successfully used by the study team in a previous eczema trial. 356 l Adherence, acceptability and tolerability of the garments as assessed by children and parents/carers in participant diaries [for the intervention group during the 6 month RCT and by questionnaire at 8 months (for both groups)]. These issues will also be explored in more detail through focus group discussions with trial participants.…”

“…We will also identify and measure other NHS costs that may change as a result of the intervention, including visits to health professionals and medication usage. In line with previous work in this clinical area, 356 these will be collected via patient diaries to be completed by the families in both arms of the study. Related resources used by the family will be collected in a similar manner.…”

Update on Atopic Eczema with Special Focus on Dryness and the Impact of Moisturizers

“…Observational studies have shown factors such as urban living and proximity to pollution may modify one's risk of developing AD [ 48,62 ] . Exposure to hard water had been associated with a higher prevalence of AD, but a recent randomized controlled trial failed to fi nd utility in water softeners as an adjunct to AD therapy [ 74 ] . Repeated skin exposure to water and detergents during infancy has also been proposed as a cause of the increasing prevalence of AD [ 53 ] .…”

Dry Skin in Childhood and the Misery of Eczema and Its Treatments

“…The role of soaps and detergents remains unproven [ 10 ] , although alkaline soaps dissolve the lipid bilayer and increased pH results in up-regulation of serine protease activity and an increase in epidermal cell desquamation and dryness [ 2 ] , so the use of soap substitutes seems sensible despite a lack of confi rmatory evidence [ 14 ] . Hard water has been thought to be a cause of dry skin and eczema, but a recent UK study [Softened Water Eczema Trial [SWET]] on the use of water softeners in hard water areas did not show any overall statistical signifi cance to justify their use in treating eczema [ 15 ] .…”