NICE has issued a draft updated clinical guideline on the diagnosis and management of atopic eczema in children under 12 years of age for public consultation.

After considering new evidence on adding bath emollients to the standard management of atopic eczema in children, the draft guideline recommends that bath additives should not be offered.

The draft recommendations bring NICE’s guideline, originally published in 2007, into line with NHS England’s advice that emollient bath additives should not be prescribed as part of their 2019 guidance on items which should not routinely be prescribed in primary care.

The independent guideline committee looked at evidence from the BATHE trial, a randomised controlled trial assessing the clinical and cost-effectiveness of emollient bath additives in the management of childhood eczema.

The results of the study showed that emollient bath additives are not clinically or cost effective. While evidence suggested that emollient bath additives do not make eczema worse, the committee considered that prescribing an ineffective product places unnecessary burdens on patients and carers in terms of acquiring and using the product.