Evaluation of a paraffin‐based moisturizer compared to a ceramide‐based moisturizer in children with atopic dermatitis: A double‐blind, randomized controlled trial

• Published in: Pediatric dermatology Vol. 40; no. 4; pp. 627 - 632
• Main Authors: Gupta, Sachin, Ramam, M., Sharma, V. K., Sethuraman, G., Pandey, R. M., Bhari, Neetu
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2023
• Subjects: Atopic dermatitis; Ceramide; Ceramides; Child; Children; Clinical trials; Dermatitis; Dermatitis, Atopic - drug therapy; Double-Blind Method; Double-blind studies; Eczema; emollients; Emollients - therapeutic use; Humans; Infant; moisturizers; Paraffin; Paraffin - therapeutic use; Patients; Pediatrics; Quality of Life; Remission; Severity of Illness Index; Treatment Outcome; emollients; atopic dermatitis; ceramide; paraffin; moisturizers
• ISSN: 0736-8046; 1525-1470; 1525-1470
• DOI: 10.1111/pde.15355

Background Moisturizers are first‐line therapy for treatment of atopic dermatitis (AD). Although there are multiple types of moisturizers available, head‐to‐head trials between different moisturizers are limited. Objective To evaluate if a paraffin‐based moisturizer is as effective as ceramide‐based moisturizer in children with AD. Materials and Methods In this double‐blind, randomized comparative trial of pediatric patients with mild to moderate AD, subjects applied either a paraffin‐based or ceramide‐based moisturizer twice daily. Clinical disease activity using SCOring Atopic Dermatitis (SCORAD), quality of life using Children/Infants Dermatology Life Quality Index (CDLQI/IDLQI), and transepidermal water loss (TEWL) were measured at baseline and at follow‐up at 1, 3, and 6 months. Results Fifty‐three patients were recruited (27 ceramide group and 26 paraffin group) with a mean age of 8.2 years and mean disease duration of 60 months. The mean change in SCORAD at 3 months in the ceramide‐based and paraffin‐based moisturizer groups was 22.1 and 21.4, respectively (p = .37). The change in CDLQI/IDLQI, TEWL over forearm and back, amount and days of topical corticosteroid required, median time to remission and disease‐free days at 3 months were similar in both groups. As the 95% confidence interval (CI) of mean change in SCORAD at 3 months in both groups (0.78, 95% CI: −7.21 to 7.52) was not within the predefined margin of equivalence (−4 to +4), the conclusion of equivalence could not be proven. Conclusion Both the paraffin‐based and ceramide‐based moisturizers were comparable in improving the disease activity in children with mild to moderate AD.