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- Cecilia Bukutu, PhD*
- Janjeevan Deol, BSc*
- Larissa Shamseer, BSc*
- Sunita Vohra, MD, MSc*
- *Complementary and Alternative Research and Education (CARE) Program, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. On behalf of the American Academy of Pediatrics Provisional Section on Complementary, Holistic, and Integrative Medicine
Introduction
Atopic dermatitis (AD), or atopic eczema, has been increasing worldwide; the lifetime prevalence is estimated to be between 10% and 20%. (1) In 90% of patients, the onset of AD occurs before 5 years of age. Despite a wide range of conventional treatments, including corticosteroids, symptoms may not always improve. Furthermore, because some therapies are associated with serious adverse effects, patients may consider using complementary and alternative medicine (CAM) to prevent, cure, or relieve symptoms. (2) The lifetime prevalence of CAM use by patients who have dermatologic diseases (including AD) ranges from 35% to 69%. (3) This review of published scientific literature assesses the efficacy and safety of some common CAM therapies in treating pediatric AD.
Natural Health Products
Traditional Chinese Medicine (TCM) Herbs
A systematic review (n=159) that included three randomized, controlled trials (RCTs) (two from the United Kingdom [UK] and one from Hong Kong) and an open label trial (UK) investigated the short-term effects of a blend of 10 herbs (Potentilla chinensis, Tribulus terrestris, Rehmannia glutinosa, Lophatherum gracile, Clematis armandii, Ledebouriella saseloides, Dictamnus dasycarpus, Ponia lactiflora, Schizonepeta tenuifolia, and Glycyrrhiza glabrae) in treating patients who had AD. (4) The herbs were ground, placed in porous paper sachets, boiled into a thick concentrate, strained, and ingested orally as a drink for 8 weeks. Only one of the RCTs focused on efficacy in children (n=37); it found a median 51% decrease in erythema scores for the herbal group (95% confidence interval [CI] 34.5, 72.6) compared with 6.2% (95% CI −25.2, 30.7) for the placebo group. (5)
A subsequent 1-year follow-up study of 23 children found a persistent benefit from using the herbal blend in 18 children (78%), who had a 90% reduction in eczema activity score. (6) In this follow-up study, 14 of the original 37 children withdrew (10 due to lack of response, 2 because of …
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