The Comparative Efficacy Between Shea Butter-Ceramide Cream and 1% Hydrocortisone Cream in Childhood Atopic Dermatitis

Background: Atopic dermatitis (AD) is the most common chronic eczema in children due to skin barrier dysfunction. Topical non-steroidal antiinflammatory agents such as Butyrospermum parkii (shea butter) and ceramide are developed to target specific defects in skin barrier function in AD patients and to reduce the side effects of topical corticosteroids. Objective: To compare the efficacy of the emollient containing shea butter and ceramide to 1% hydrocortisone in childhood AD. Materials and Methods: The present study was a randomized, double-blind study in 26 children, aged 2 to 18 years, with mild to moderate AD. The patients were randomized to treat twice daily with shea butter and ceramide cream (SC) on one side of the body and 1% hydrocortisone on the other side. The treatment period was eight weeks, with follow-ups on the second, fourth, sixth, and eighth week. The shea butter and ceramide side were applied for eight weeks; while the 1% hydrocortisone side was applied for the first four weeks and changed to cream base for the latter four weeks. The clinical outcomes were evaluated by using SCORAD and POEM at baseline, and on every follow up week. Time to remission, time to relapse, and adverse events were evaluated. Results: The result showed a significant improvement of SCORAD and POEM in both groups after eight weeks of treatment. When comparing the two groups, it was found that SCORAD and POEM were not different. Regarding the median time to remission and the median time to relapse, there was no statistical difference between the two groups of treatments. There were no related adverse events. Conclusion: The emollient containing shea butter and ceramide is effective in the treatment and prevention of relapse in childhood mild to moderate atopic dermatitis. Keywords: Ceramide; Butyrospermum parkii; shea butter; atopic dermatitis