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Adolescent Use of Emollients and Topical Medications for Eczema

Explore the topical treatment habits of adolescents with eczema, focusing on emollients and glucocorticoids. Study reveals inadequate self-treatment and discrepancy between reported and dispensed medications.

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Adolescent Use of Emollients and Topical Medications for Eczema

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  1. Use of emollients and topical glucocorticoids among adolescents with eczema: data from the population-based birth cohort BAMSE 1Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden 2Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden 3Dermatology and Venerology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden 4Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden 5Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden 6Centre of Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden 7Dermatological and Venereal Clinic, Södersjukhuset, Stockholm, Sweden 8Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden S. Lundin,1,2 C.F. Wahlgren,3,4 A. Bergström,5,6 E.K. Johansson,2,3,7 E. Dahlén,8 N. Andersson5 and I. Kull1,2 British Journal of Dermatology. DOI: 10.111/bjd.16484

  2. Susanne Lundin, first author

  3. Introduction - What’s already known? Knowledge on topical treatment with emollients and glucocorticoids in adolescents with eczema, at a population-based level, is insufficient

  4. Objective • To explore the use of emollients and topical glucocorticoids in adolescents with eczema in relation to sex and disease severity • In addition study dispensing patterns of topical glucocorticoids (TGS)

  5. Methods Questionnaire-based data (n=3108) at 16 years • Symptoms of eczema and severity • Treatment with emollients and topical glucocorticoids the preceding 12 month • Severity was assessed with the BAMSE Eczema Severity Score (BESS)

  6. Methods - Clinical examination: • Skin was examined by a trained nurse • Severity of current eczema was self-assessed byadolescents with ongoing eczema - using the Patient-Oriented Eczema Measure (POEM) • Questions were asked about treatment and bloodsamples were obtained

  7. Linkage to the Swedish Prescribed Drug Register • Data on dispensed TGCs were obtained for thepreceding 12-months, with expanded time windowsup to 24-months • Compare the use of TGCs reported in the questionnaire and at the clinical examination

  8. ResultsProportions with self-reported treatment with topical glucocorticoids in relation to eczema severity based on the BAMSE Eczema Severity Score.

  9. Multi-regression model analyzing factors affecting the likelihood of treatment with emollients, topical glucocorticoids or both among adolescents with current eczema (n=104).

  10. Dispensed topical glucocorticoids in adolescents with eczema in relation to severity of the disease measured by BESS and POEM

  11. Discussion • These findings indicate that adolescents treat themselves inadequately • Few studies illustratethis • Possible explanations: • Concern about side-effects • Insufficient knowledge about treatment principles (amount of cream, length of treatment and when to apply TGCs etc.)

  12. Discussion • Misleading information from health care professionals and pharmacists • In Sweden is it possible to buy small packages (30 g) of mild TGCs without a prescription, over the counter • Mild TGCs is not enough treatment if your eczema ismoderate to very severe

  13. Discussion • Transition into adulthood is a challenge for the individual, the family and health care providers • It seems to be a discrepancy between reported treatment with TGCs (55 %) and dispensed TGCs (24 %) the preceding 12 months

  14. Conclusions- What does this study add? • Almost all adolescents with eczema use emollients, but only half use topical glucocorticoids, with no difference between sexes. • Only one of four with moderate to very severe eczema has a potent topical glucocorticoid dispensed. • Symptoms of more severe eczema were not associated with increased likelihood to treat with a topical glucocorticoid.

  15. The research team

  16. Call for correspondence • Why not join the debate on this article through our correspondence section? • Rapid responses should not exceed 350 words, four references and one figure • Further details can be found here

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