Bath oils used for 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 on the NHS, according to the prescribing watchdog.

Emollient bath additives are ‘not clinically or cost effective’ in the treatment of eczema for children under-12, new National Institute for Health and Care Excellence (NICE) guidelines say.

But doctors should continue to prescribe emollient creams, which are proven more effective at easing symptoms, they suggest.

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

It causes patches of skin to become itchy, cracked and sore with many sufferers experiencing regular or even continuous flare-ups, often triggered by irritants and allergens.

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

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

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

Nice’s committee looked at evidence from the year-long Bathe trial in 2018, which found that pouring emollient additives into the bath provided no additional benefit over standard eczema care.

They concluded ‘prescribing an ineffective product places unnecessary burdens on patients and carers, in terms of acquiring and using the product,’ while also a significant cost on the NHS.

Under the draft guidelines which are subject to public consultation, it acknowledged some children may still benefit from bath emollients and GPs should advise they can still be bought over the counter if people want them.

Nice said the guidance brings it into line with NHS England’s advice in 2019 that emollient bath additives should not be routinely prescribed.

Patients are also advised to avoid things that make the condition worse and that steroids can also be prescribed to reduce irritation and inflammation, when necessary.

The National Eczema Society has previously expressed concern over the design of the BATHE research study, suggesting it was not a fair reflection of real-word use of these products.

Andrew Proctor, its chief executive, warned Nice’s decision could lead to children missing out on treatment.

He said: ‘Emollients and soap substitutes are vital in helping 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 these under the new proposals.

‘We believe doctors should be able to continue prescribing bath emollients when it’s in the child’s best interests, to achieve the best eczema care. Hard-pressed parents can’t always find the time to use leave-on emollients with their children and they may rely on bath emollients to help manage their child’s eczema.’