Moisturizer Use and Transepidermal Water Loss in a Multi-Center Birth Cohort

Document Type

Conference Proceeding

Publication Date

2-10-2026

Publication Title

J Allergy Clin Immunol

Keywords

atopic dermatitis, bath, birth, birth cohort, child, cohort analysis, conference abstract, controlled study, cream, drug therapy, ethnicity, family history, female, ghee, human, humidifier, infancy, infant, lotion, male, ointment, skin surface, skin water loss, special situation for pharmacovigilance, topical drug administration, water, water loss

Abstract

Rationale: Skin barrier disruption is involved in the pathogenesis of atopic dermatitis, and bathing practices may impact skin barrier integrity. Transepidermal water loss (TEWL) is an objective measure of passive water flux from the skin surface, with higher values indicating greater water loss and skin barrier dysfunction. We hypothesized that the type of topical moisturizer used impacts TEWL during childhood. Methods: Data from CANOE (N=539)—a multi-center birth cohort study of children with a family history of allergic disease—were analyzed. Moisturizer type, categorized as balm/butter/oil, lotion, or cream/ointment, was assessed at age 2 months. TEWL was assessed at birth, 4, 12, 18, and 24 months. The association between moisturizer type at 2 months and TEWL from 4 to 24 months was examined using multivariable linear regression on multiply imputed datasets. Models were adjusted for site, age, season, perinatal TEWL, child race, and child ethnicity. Results: 307 children used topical moisturizer at 2 months and had 4-month TEWL measurements. Children who used cream or ointment at 2 months (N=82) had significantly lower TEWL at 4 months compared to children who used lotion at 2 months (N=144) (estimate [95% CI] = -13.9% [-25.5%, -0.4%], p=0.044). However, 2-month moisturizer use did not significantly associate with TEWL at later time points. Conclusions: Compared to other moisturizer types, cream or ointment use at 2 months was associated with improved skin barrier function at 4 months of age, but not at later time points, suggesting that their effect on skin barrier disruption is greatest during early infancy.

Volume

157

Issue

2

First Page

AB36

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