Parent satisfaction with lotion, cream, gel and ointment emollient types: secondary analysis of the Best Emollients for Eczema study

Background
The main determinant of emollient effectiveness is whether it is used, which in turn is linked with user satisfaction.

Objectives
To compare parental satisfaction with emollient type for the treatment of childhood eczema.

Methods
Secondary analysis of data from the Best Emollients for Eczema (BEE) trial was undertaken. In total, 550 children aged between 6 months and 12 years were recruited from primary care in England and randomized to use a lotion, cream, gel or ointment as their main emollient for 16 weeks. At week, 16 parents were asked to complete an Emollient Satisfaction Questionnaire (ESQ). Completion rates and scores were compared, using χ2 test, t-test calculations and one-way ANOVA as appropriate.

Results
Data on 378 participants (68.7% of those randomized) were analysed. Mean ESQ scores were gel 20.9 (SD 5.3), lotion 20.4 (SD 5.6), cream 18.8 (SD 6.3) and ointment 15.2 (SD 6.8) (P < 0.001). In pairwise comparisons, there was a statistically significant difference in mean ESQ scores between ointment and lotion (P < 0.001), ointment and cream (P < 0.001) and ointment and gel (P < 0.001) but not between lotion, cream and gel. Participants using lotions had highest overall satisfaction and were most likely to continue using their emollient. ESQ scores were correlated with reported emollient use and improvements in parent-reported eczema severity.

Conclusions
Overall, lotions and gels were favoured over creams and ointments. Although satisfaction is determined by personal preference, these results will aid parents, clinicians and children to find the right emollient(s) for them.