Bath oils used for eczema ‘do NOT help’: Watchdog tells NHS doctors to stop prescribing them 

Bath oils used to soothe the skin of children with eczema ‘DO NOT help’: Watchdog tells NHS doctors to stop prescribing them

Bath oils used to treat children with eczema offer little benefit and should not be provided by the NHS, according to the prescribing watchdog.

Emollient bath additives are “not clinically or cost-effective” in treating eczema in children under 12, according to new guidelines from the National Institute for Health and Care Excellence (NICE).

But doctors should continue to prescribe soothing creams, which have proven to be more effective at relieving symptoms, they suggest.

Eczema is the most common inflammatory skin condition in children, affecting about one in five children.

It causes patches of skin to itch, crack and become painful, with many sufferers experiencing regular or even continuous flare-ups, often caused by irritants and allergens.

Eczema is the most common inflammatory skin condition in childhood

Soothing bath additives are 'not clinically or cost-effective' in treating eczema in children under 12, new NICE guidelines say

Emollient bath additives are ‘not clinically or cost-effective’ in treating eczema in children under 12, new NICE guidelines say

Treatments for atopic eczema include moisturizing treatments, known as emollients, which can be creams, soap substitutes, and bath additives — often prescribed in combination with each other.

But doctors are told not to prescribe the bath versions of products because they have not been proven to work.

The Nice committee looked at evidence from the one-year Bathe trial in 2018, which showed that pouring soothing additives into the bath provided no additional benefit over standard eczema care.

They concluded that ‘prescribing an ineffective product places an unnecessary burden on patients and carers in terms of purchasing and using the product’, while also imposing significant costs on the NHS.

Under the draft guidelines, which are subject to public consultation, it recognized that some children may still benefit from bath emollients and that GPs should advise that they are still available over-the-counter if people so wish.

Nice said the guidance is in line with NHS England advice in 2019 that soothing bath additives should not be routinely prescribed.

Patients are also advised to avoid things that aggravate the condition and that steroids can also be prescribed to reduce irritation and inflammation if needed.

The National Eczema Society has previously expressed concerns about the design of the BATHE study, suggesting it did not honestly reflect the real word usage of these products.

Andrew Proctor, the CEO, warned that the Nice decision could result in children missing out on treatment.

He said: ‘Emollients and soap substitutes are vital in helping to manage the dry skin associated with eczema. We are concerned that only children whose parents can afford to buy bath emollients will have access to them under the new proposals.

“We believe that doctors should be able to continue to prescribe bath emollients if it is in the best interest of the child to receive the best eczema care. Parents who are struggling can’t always find the time to use emollients on their children, and they may rely on emollients in the bath to help manage their child’s eczema.”