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No benefit seen from silk clothing in reducing eczema symptoms
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Wearing silk garments is not likely to lessen moderate to severe pediatric eczema or prevent infection, according to research published in PLOS Medicine.
“Specialist clothing [for eczema] is now available on prescription in a variety of forms including sericin-free silk. Viscose and silver-impregnated fabrics,” Kim S. Thomas, PhD, co-director of the Centre of Evidence Based Dermatology at the University of Nottingham, United Kingdom, and colleagues wrote. “To date, there have been just three small randomized controlled trials of silk clothing for the management of eczema [which included …] few participants, were of generally short duration, did not incorporate an economic evaluation and were at risk of bias.”
To determine the cost of silk garments and their benefits when combined with standard care, the researchers conducted a parallel-group, randomized, control, observer-blind trial, which included children between the ages of 1 and 15 in the U.K. with moderate to severe eczema. Participants from five centers were randomly assigned to receive standard care and additional silk garments, which were worn for 6 months. Other participants continued standard care.
All participants were assessed at the start of the trial and at 2, 4, and 6 months. Nurses graded the severity of eczema using the Eczema Area and Severity Index (EASI), and evaluators were not aware of treatment group.
The two groups contained 141 children each; silk clothing was more often worn at night (median = 81% at night, median = 34% during daytime). For children wearing silk, the average EASI of each assessment equaled 9.2 (baseline), 6.4 (2 months), 5.8 (4 months) and 5.4 (6 months). Similar results were seen in the standard-care group, with 8.4 (baseline), 6.6 (2 months), 6.0 (4 months) and 5.4 (6 months). There was no difference between the scores when adjusting for age, center and baseline score.
Skin infections were developed by 25% of children in the silk clothing group and 28% in the standard-care group. Although a slight decrease in skin infections was observed, the incremental cost per quality-adjusted life year to maintain this treatment equated to £56,881 ($73,029).
“We are unable to comment on the effectiveness of the silk garments if used continuously day and night, although sensitivity analysis found no evidence of improved outcomes in those who adhered more fully in wearing the garments,” Thomas and colleagues wrote. “It is also possible that the beneficial effects of silk garments are best realized during a period of eczema flare, and daily use of the garments in [the] trial could have led to more rapid deterioration of the clothing than might have been seen if the garments were worn … when eczema was at its worst.” — by Katherine Bortz
Disclosure: Refer to the full study for a list of the researcher's financial disclosures.
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