Do bath emollients work for eczema in children?

What the evidence says

Eczema is dry, itchy, inflamed skin that many children get. Doctors usually recommend using a leave-on moisturizer, called an emollient, every day to help the skin hold onto water and feel better. Some doctors also suggest adding a special emollient liquid or oil to the bathwater, called a bath additive, thinking it might help even more.

A large study called the BATHE trial tested this idea directly. Researchers followed almost 500 children with eczema for a year. Half of the children added emollient bath additives to their baths, and half did not. Both groups kept using their regular leave-on moisturizer and other eczema treatments as usual.

The result was clear. Children who used bath additives did not have better eczema control than children who did not use them. Their skin scores, sleep, mood, and need for steroid cream were all about the same between the two groups. The study also found no cost benefit to using bath additives.

A Canadian medical journal article for doctors treating babies and young children with eczema repeated this same finding, noting that bath additives do not help beyond what direct moisturizer use already provides. This means parents do not need to spend extra money on special bath products, though using them is not harmful if a family prefers to.

The one thing that clearly helps, based on strong evidence, is using a plain leave-on moisturizer regularly, applied directly to the skin, ideally right after a bath while skin is still damp.