For the first time in decades, new drugs and therapies that may provide real relief for anyone living with eczema are close to being available. For many, this is a time of unprecedented hope.
But what if there were a way to prevent the very first flare, to stop eczema from even starting?
Frustrated by seeing patients with eczema and atopic dermatitis (AD), and realizing the treatments he had to offer had many limitations, Dr. Eric Simpson began to wonder if eczema prevention was a possibility.
Simpson specializes in dermatology at Oregon Health & Science University (OHSU), and is the director of the clinical studies unit. He has been funded by the National Institutes of Health (NIH) to study eczema treatment and prevention. His early research in this area was funded by NEA, where he currently serves as Co-Chair of NEA’s Scientific Advisory Committee.
“My original inspiration was Jon Hanifin — my mentor since I was a young resident in dermatology,” said Simpson. Dr. Hanifin, whose research helped better understand the cause of AD is one of the founders of NEA, and currently sits on the NEA Board of Directors.
Hanifin also noted something else. “Dermatologists have suspected for many years that eczema is due to a barrier problem in the skin, as we have seen numerous cases of babies with severe eczema everywhere on their bodies except in the diaper area which stays surprisingly smooth,” said Hanifin. “The reason is that the constant moisture in the diaper area keeps the skin from cracking. That is why we encourage parents to treat eczema in infants as early as possible and continually moisturize the skin.”
This idea led Simpson to wonder whether it would be possible to stop eczema from starting by practicing early skin care. In 2008, Simpson applied for and was awarded a NEA grant to fund a pilot study of emollient therapy for the primary prevention of atopic dermatitis (AD), which is a common and chronic form of eczema. 22 babies considered to be at high risk for developing AD (those with at least one parent or sibling who has, or had, AD) participated in the study. Parents applied an emollient cream at least once a day over their baby’s whole body, except for the diaper area and scalp, preferably within three minutes of bathing. All babies treated did not have eczema, and they were followed over time to see if this approach prevented the development of eczema.
The result? Of the 22 babies, only 3 babies developed AD within the follow-up period of 547 days. The rest of the babies showed no signs AD during the study period, and also did not experience any adverse effects from their skin care regimen. Previous studies of similar high risk subjects revealed that the risk of developing AD by 2 years of age to be between 30% and 50%.
This original pilot study has led to more studies, and to more questions. Simpson is currently in the planning phase to conduct a population-based study that he hopes will help answer some of these questions.
“What drives my passion,” said Simpson, “is seeing how you can change someone’s life when you clear up their understanding of the disease and empower them to manage it. Eczema is such a mysterious disease, but when you’re able to help people change their lives, it’s amazing.”
“NEA plays an important role in dispelling misinformation about eczema,” Simpson continued. “But they are also actively working to uncover gaps in existing research to identify what we still need to learn.”
Simpson understands that eczema can feel like an isolating disease and that it’s important for patients, especially kids, to know that they are part of a wider community and that they are not alone. “Even though there is not yet a cure, there is hope that people with eczema can get their lives back. People at NEA and all over the world are working to support patients, research treatments, and advocate for access to medications.”
In his own work, Simpson believes that skin barrier protection is important component of a combined approach to prevention that also includes immune triggers. His continued research and work on behalf of people with eczema is one of the reasons to believe this is indeed a hopeful time and that people can, and should, expect to be able to treat their condition and get their lives back.