BEE: Best Emollient in Eczema


National Institute for Health (NIHR) Health Technology Assessment (HTA) Ref. 15/130/07

What is the research question?

Which of four different types of emollient (lotion, cream, gel and ointment) have best clinical and cost effectiveness for the treatment of children with eczema?

What is the problem?

One in five children in the UK have eczema, a lived-with skin condition that causes dry and itchy skin. It significantly affects both the child and their family – interfering with sleep, social activities and emotional well-being. Most children are diagnosed and looked after by their family doctor (GP) with emollients to relieve skin dryness and steroid creams (e.g. hydrocortisone) for “flares”. However, there are many different emollients and hardly any research comparing them. As a result, Health Care Professionals (HCPs) are unsure what to recommend and prescribing varies from one person to another. This is confusing and frustrating for parents – they often try several emollients before they find one that works for them. It also wastes everyone’s time and money. Patients, carers and HCPs agree that research is needed.

What is the aim of the research?

We will do a randomised clinical trial of the four most commonly used types of emollients (Aveeno® lotion, Diprobase® cream, Doublebase® gel and Epaderm® ointment), to provide better information about emollients to health care professionals (HCPs) and parents/carers who look after children with eczema.

How will this be achieved?

Children will be recruited via their GP surgery and given one of the four emollients to use for 16 weeks. To assess long-term effects, we will follow everyone up for 12 months. Our main question of which emollient is best will be answered by getting parents to regularly record eczema symptoms. We will also independently assess eczema severity and collect information on: the impact of the condition on the family; quality of life of the child and the main carer; satisfaction with the emollient; and costs to the NHS and family. We will do this by parent-completed questionnaires and examining medical records. To understand emollient use better, for example any trade-offs people make between effectiveness and acceptability, we will interview a sample of families.

Who is leading the research?

Dr Matthew Ridd, GP and Reader in Primary Health Care, Population Health Sciences, University of Bristol.

Further information:

Dr Matthew J Ridd

For more information or to get involved in this project, please contact

The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.