Complementary therapy in atopic eczema: the latest systematic reviews

Abstract

Complementary and alternative medicines (CAM) are widely used for atopic eczema (AE) with user estimates as high as 63%. Despite the availability of effective conventional therapies, the chronic nature of AE and concerns about long-term steroid use lead many patients to seek alternative treatment. Evidence of the efficacy of these alternative therapies is inconsistent and available published data have shortcomings, making it difficult for clinicians to assess their role, if any, in management. To assess the evidence, systematic reviews of controlled studies have been undertaken for Chinese herbal medicines, homeopathy, evening primrose oil, borage oil, probiotics and certain dietary supplements. This overview summarises the findings from the most recent systematic reviews. Taken together, none of the alternative therapies evaluated demonstrated obvious and indisputable evidence of efficacy. Further studies are warranted with some therapies (Chinese herbal medicines, certain probiotic strains and fish oil), whereas homeopathy failed to show any treatment effect. Further studies on homeopathy, or evening primrose oil and borage oil, are difficult to justify. It must also be remembered that CAM products are currently under-regulated and may not meet the stringent quality standards of conventional medicines.