There is no evidence that bath emollients to relieve the symptoms of eczema actually work, a medical journal says.
Every year the NHS spends more than £16 million on bath emollients and the October issue of the Drug and Therapeutics Bulletin (DTB) suggests this may be a waste of money.
But the effectiveness of these specialised bath products in relieving the symptoms of allergic (atopic) eczema is "questionable", it says.
While there is long clinical experience and some published research to justify the use of topical emollients in the form of gels, creams and lotions to relieve the symptoms of allergic (atopic) eczema, it questions the usefulness of bath emollients. "Not only are there no published randomised controlled trials on bath emollients in atopic eczema, there is no consensus of clinical opinion that such therapy is effective."
Bath emollients, which generally contain liquid paraffin, are used to improve the symptoms and appearance of dry skin conditions and cut down on the use of steroid creams. The theory is that they prevent water loss from the skin and form a protective barrier against external skin irritants.
National treatment guidelines widely recommend the liberal use of emollients two to three times a day, including after bathing. But important questions, such as how effective these products are compared with other bathing products and the use of skin creams after washing, have not been answered, the DTB says.
"Given that bath emollients are expensive, and the NHS spends a considerable sum on them, we believe their use requires proper evaluation," it concludes. Adequate application of topical skin creams without the addition of bath emollients is "entirely reasonable".