Currently there is no clearly effective way to prevent eczema.
The skin of people with the disease cannot retain water well, hosts an abnormal composition of microorganisms, and is inflamed due to chronic immune activation.
Many studies have tested a variety of eczema prevention strategies in pregnant and breastfeeding people and in infants. These include emollients or moisturizers, probiotics, prebiotics, synbiotics, vitamin D supplementation, hydrolyzed baby formula, early introduction of egg or cow’s milk, dietary supplements during breastfeeding, dust mite avoidance, Bacillus Calmette-Guerin (BCG) vaccination, antimicrobials, anti-worm medications, and antibiotic avoidance.
Of all these experimental interventions, only a few have led to a small or modest reduction in the risk for childhood eczema:
- emollients formulated to improve the skin barrier and applied starting in the first few days of life
- probiotics for pregnant women and infants
- vitamin D supplementation during pregnancy
- avoiding unnecessary antibiotic exposure during pregnancy and delivery
- BCG vaccination
An NIAID-supported clinical trial is testing whether proactively treating infants who have dry skin with a triple-lipid cream improves their skin barrier and prevents eczema or reduces its severity by age 2 years. Results of the trial, called the SEAL Study, are expected in 2027.