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

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

OBJECTIVES: To compare parental satisfaction with emollients for the treatment of childhood eczema.

METHODS: Secondary analysis of data from the Best Emollients for Eczema (BEE) trial. 550 children aged between 6 months to 12 years were recruited from primary care in England and randomised 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 chi-squared, t-test calculations, and one-way ANOVA as appropriate.

RESULTS: Data on 378 participants (68.7% of those randomised) were analysed. Mean (SD) ESQ scores were gel 20.9 (5.3), lotion 20.4 (5.6), cream 18.8 (6.3) and ointment 15.2 (6.8) (p<0.0001). In pairwise comparisons, there was a statistically significant difference in mean ESQ scores between ointment and lotion (p<0.0001), ointment and cream (p<0.0001) and ointment and gel (p<0.0001) 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 find the right emollient(s) for them.