The positive effects of habit reversal treatment of scratching in children with atopic dermatitis: A randomised controlled study

Abstract

Background

Scratching and itch are common clinical signs of atopic dermatitis (AD). Studies of adult patients have shown that a decrease in scratching behaviour results in regression of inflammation and improved healing of the skin.

Objectives

This study aimed to investigate whether a modified habit reversal treatment (HR) protocol could be used for the treatment of scratching in children to improve skin status.

Methods

The study is a single-blind, randomised controlled trial of 39 patients who started with registration a week before randomisation into one of two groups (intervention, control). The participants in the intervention group received a habit-breaking therapy of their scratching behaviour (i.e. HR) in addition to a potent steroid (mometasone furoate), whereas the patients in the control group received the steroid alone. The patients were assessed by an independent dermatologist after the first week of registration (baseline assessment) and then after three and eight weeks post-treatment. The primary efficacy variable was a change in objective SCORAD (SCORing Atopic Dermatitis).

Results

At the end of the three-week treatment period, the change in mean objective SCORAD was significantly (p=0.027) higher in the intervention group -31.9 (SD 9.5) compared with the control group -23.8 (SD 10.1). After the eight-week follow-up, the change in mean objective SCORAD was significantly (p=0.0038) higher in the intervention group -31.7 (SD 10.4) than in the control group -19.7 (SD 9.4).

Conclusions

The treatment of scratching with the HR method in combination with a potent steroid was found to significantly improve skin status after 3 and 11 weeks.

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