Does daily bathing or showering worsen atopic dermatitis severity? A systematic review and meta-analysis

被引:13
|
作者
Hua, Tammy [1 ]
Yousaf, Muhammad [1 ]
Gwillim, Eran [1 ]
Yew, Yik Weng [2 ]
Lee, Brad [1 ]
Hua, Kevin [3 ]
Erickson, Taylor [1 ]
Cheng, Brian [1 ]
Silverberg, Jonathan I. [4 ]
机构
[1] Northwestern Univ, Dept Dermatol, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Natl Skin Ctr, Singapore, Singapore
[3] Kansas City Univ Med & Biosci, Kansas City, MO 64106 USA
[4] George Washington Univ, Sch Med & Hlth Sci, Dept Dermatol, Suite 2B-425,2150 Penn Ave NW, Washington, DC 20037 USA
关键词
Atopic dermatitis; Skin care; Treatment; Management; Eczema; Shower; Bath; Personal care; Evidence; STAPHYLOCOCCUS-AUREUS COLONIZATION; BLEACH BATHS; FREQUENCY RECOMMENDATIONS; ECZEMA; MANAGEMENT; CHILDREN; SKIN; BURDEN; ADULTS; SLEEP;
D O I
10.1007/s00403-020-02164-0
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
The optimal frequency of water bathing/showering in atopic dermatitis (AD) is unknown. We sought to determine the efficacy of different bathing/showering frequencies at improving AD severity. A systematic review and meta-analysis was performed of studies evaluating the clinical efficacy of bathing/showering regimen in AD. MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, China National Knowledge Infrastructure, Taiwan electronic periodical services and CiNii were searched. Two authors independently performed title/abstract and full-text review and data extraction. All 13 included studies were prospective and demonstrated numerically reduced AD severity in patients treated with a water bathing/showering regimen in >= 1 time-point compared with baseline. In random-effects regression models, baths/showers >= 7 vs. < 7 times per week were not associated with significant differences of Cohen's D scores for eczema area and severity index (n = 5 studies; least-square means: 1.34 vs. 0.90; P = 0.45; I-2 = 91.8), Scoring AD (n = 5 studies; 0.73 vs. 0.41; P = 0.13; I-2 = 97.4) or body surface area (n = 4 studies; 0.45 vs. 0.28; P = 0.17; I-2 = 93.4). Similar results were observed in sensitivity analyses by study design, quality, use of emollients, and use of topical corticosteroids. No publication bias was detected by Egger regression (P >= 0.26) or Begg rank (P >= 0.19) tests. Three studies were included in the qualitative analysis, which found that bathing/showering >= 7 resulted in significant improvement of Investigator Global Assessments, extent of skin lesions and itch caused by AD. In conclusion, the optimal frequency of water bathing/showering in AD remains unclear. Daily showers/baths were not associated with worse severity, and should be permitted in AD. Larger scale, well-designed RCT are still needed to determine the optimal bathing parameters.
引用
收藏
页码:729 / 735
页数:7
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