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Softer water fails to relieve eczema

U. NOTTINGHAM (UK) — Installing a water softener for three months brings no additional relief for eczema sufferers, according to a study with more than 300 children.

Population surveys have suggested a possible link between atopic eczema prevalence and the degree of water hardness. Researchers in the U.K. tested the theory with a recent study that included children between the ages of six months and 16 years living in hard water areas in Nottingham, Cambridge, London, the Isle of Wight, Portsmouth, Leicester, and Lincoln.

The results showed no relief from the itchy and uncomfortable condition. Findings are reported in the journal PLOS Medicine.

“Although the outcome is disappointing in terms of future treatment options for children with eczema, the outcome of the trial is very clear; both the water softening and control groups improved equally in the study when the eczema was measured objectively,” says lead investigator Hywel Williams, a professor of dermatology at the University of Nottingham.

“Despite this, some parents still believed that water softeners were helpful in eczema, and it is important to realize that other benefits of water softening in the home might be important for families, too,” Williams adds.

Children suffering from moderate to severe atopic eczema took part in the pragmatic, observer-blind 12 week trial. Participants were randomized by a computer into two groups—those whose families had a water softener installed and those who did not. Those who did not have the water softener were then given a softener to try at the end of the study.

The results surprised even the experts. “Our research had already shown that eczema is more common in primary school children living in hard water areas in the UK compared with children living in soft water areas,” says Williams. “No one really knows why, but it could be because hard water contains high levels of calcium and magnesium, leading to increased use of soaps which can act as skin irritants.

“We would have been happier if we had shown a clear benefit of using water softeners. However, that is not the case, and we need to face the truth.”

The severity of the disease can vary. In mild forms of eczema the skin is dry, red, and itchy, while in more severe forms the skin can become broken, raw and bleeding—leading to sleep loss and a poor quality of life.

The water softener industry (through their representative body, the UK Water Treatment Association)—was closely involved in providing expertise on technical aspects of water softening during the trial and a generic water softener has been specially produced for the study. The industry met the cost of producing and installing water softener units. However, the study findings are independent from any industry influence.

The study was funded by the National Institute for Health Research in the U.K.

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