A clinical trial investigating if antibacterial therapeutic clothing could improve atopic dermatitis

Aviël Ragamin, Renske Schappin, Marlies de Graaf, Ron A Tupker, Karin B Fieten, Minke M F van Mierlo, Madelon B Bronner, Geertruida L E Romeijn, Manon M Sloot, Celeste M Boesjes, Lisa P van der Rijst, Bernd W M Arents, Thomas Rustemeyer, Marie L A Schuttelaar, Suzanne G M A Pasmans. British Journal of Dermatology, Volume 190, Issue 3, March 2024, Page e29, https://doi.org/10.1093/bjd/ljae024

Atopic dermatitis (AD), also known as eczema, is a common skin condition that affects up to 20% of children and 10% of adults. Previous research has suggested that a common type of bacteria, Staphylococcus aureus, may worsen AD.

In this study, we investigated if wearing special antibacterial therapeutic clothing could improve AD by reducing Staphylococcus aureus.

This study included 159 children and adults with moderate-to-severe AD in the Netherlands. Participants received standard therapeutic clothing or antibacterial therapeutic clothing based on either chitosan (an antibacterial protein obtained from the shells of crustaceans) or silver, along with basic AD treatment (i.e. steroid ointment). We considered the antibacterial therapeutic clothing to be successful if people had considerably fewer clinical signs of AD compared with using standard therapeutic clothing over the course of 1 year.

Primary outcome: median atopic dermatitis severity scores
(Eczema Area and Severity Index) with interquartile range.

All participants in the three different groups improved similarly. No added benefits of antibacterial therapeutic clothing were found for the clinical signs of AD, quality of life, steroid ointment use, amount of Staphylococcus aureus bacteria found on the skin and the need for medical care. None of the patients had serious side-effects and there was no absorption of silver from the clothing into the skin.

Overall, we found no additional benefits from wearing antibacterial therapeutic clothing compared with wearing standard therapeutic clothing in people with moderate-to-severe AD.

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