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1809 softer trial

SOFTER trial investigates if water softeners can prevent eczema

A clinical trial has launched to investigate whether using water softeners can reduce risk of eczema in babies.

The trial is led by researchers at Guy's and St Thomas' NHS Foundation Trust and funded by our BRC. It builds on findings from our research, published in 2017, showing that hard water damages the skin's protective barrier and could contribute to the development of eczema.

Eczema is a dry skin condition affecting one in five children and one in 12 adults. It comes in many forms, where symptoms can range from itchy red skin to weeping or bleeding skin, which is at a high risk of infection. Living in a hard water area is known to increase the risk of having the condition.

The Softened Water for Eczema Prevention (SOFTER) trial will test whether using water softeners might help reduce the risk.

Professor Carsten Flohr, consultant dermatologist at Guy’s and St Thomas’, is the chief investigator of the SOFTER study, and is a programme lead at our BRC. He said: “The new study is exciting because it is the first time that researchers are looking at the effect of using water softeners on babies in their own homes.

“SOFTER builds on research published last year which found that eczema may be caused by hard water damaging the skin’s protective barrier. However, that study took place in a lab setting, focused on adults and was not randomised, so we hope that the SOFTER trial will give us a greater insight into whether water softeners can help infants avoid getting eczema, and allows us to gain more knowledge about the impact of hard water on babies’ skin.”

The team aim to recruit 80 pregnant women who live in hard water areas to the SOFTER trial if their unborn child is at high risk of having the condition, for instance if they have a parent or sibling with eczema, asthma or hay fever. As part of the trial, the women are randomised to either have a water softener installed in their homes or not. They will use either the softened or unsoftened water to wash their babies depending on the group that they had been assigned to.

The researchers won't know which of the women had a water softener installed in their baby's home and which didn’t. They will look at a number of skin measurements in the babies, including water loss, pH levels, detergent deposits and skin bacteria. These will be taken from the baby at birth, one month, three months and six months to check for any changes to their skin. It is hoped this initial trial will lead the way for a larger-scale trial across the UK involving hundreds of patients.

Isida Pierce, 30 from Greenwich in south-east London, had a daughter, Alessia, in May. She decided to enrol Alessia in the SOFTER study because her husband Edward has eczema and another skin condition, psoriasis.

Isida, who works in marketing, said: “Ed has had eczema all of his life and says living with both eczema and psoriasis is uncomfortable and annoying. If the research helps with the prevention of eczema then it could be very useful for us because Alessia is at risk of eczema, and it’s nice to know it might be helping others too.

“The team working on the trial at St Thomas’ have been very helpful and being part of the study has been a positive experience for our family.”

For more information about how to join the study visit the Guy's and St Thomas' website.

The trial is being funded by the National Institute for Health Research (NIHR) Guy’s and St Thomas’ Biomedical Research Centre (BRC). The water softeners are provided by Harvey Water Softeners.

Collaborators include the
University of Nottingham, the University of Sheffield, the University of Amsterdam, the US National Institutes of Health and the Skin Research Institute of Singapore (SRIS), a collaboration between the Agency for Science, Technology and Research (A*STAR), National Skin Centre (NSC) and Nanyang Technological University (NTU).

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