Use of topical treatment among Swedish children with eczema during the first 18 months of life

BACKGROUND: Real-world use of topical therapies in children with eczema during the first 18 months of life is insufficiently characterized. Despite guideline recommendations for regular emollients, population-based data on treatment intensity are limited. OBJECTIVES: To quantify topical treatment use at 18 months, proportion reaching recommended emollient dose, and factors associated with repeated dispensing. METHODS: = 5,275) in the population-based NorthPop Birth Cohort (Västerbotten, Sweden) were analyzed. Atopic dermatitis (AD) was defined using UK Working Party criteria. Eczema severity was assessed with the Patient-Oriented Eczema Measure (POEM). IgE-sensitization was analyzed using ImmunoCAP. Dispensed emollients and topical corticosteroids (TCS) during the first 18 months of life were retrieved from the Swedish Prescribed Drug Register. RESULTS: = 0.037). Only 15.1% of children with AD reached recommended emollient dose (≥100 grams/week) (mean 43.5 g/week). Repeated emollient dispensing occurred in 42.5% (≥2 dispensings) and 14.6% had ≥5 dispensings; 60.8% were dispensed TCS. Male sex and IgE-sensitization, but not eczema severity, were associated with repeated dispensing of emollients and TCS. CONCLUSIONS: In this population-based cohort, topical treatment for early AD was below guideline recommendations, highlighting the importance of caregiver education and structured follow-up.