Does daily bathing or showering worsen atopic dermatitis severity? A systematic review and meta-analysis
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ORIGINAL PAPER
Does daily bathing or showering worsen atopic dermatitis severity? A systematic review and meta‑analysis Tammy Hua1 · Muhammad Yousaf1 · Eran Gwillim1 · Yik Weng Yew2 · Brad Lee1 · Kevin Hua3 · Taylor Erickson1 · Brian Cheng1 · Jonathan I. Silverberg4 Received: 4 August 2020 / Revised: 16 October 2020 / Accepted: 30 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The optimal frequency of water bathing/showering in atopic dermatitis (AD) is unknown. We sought to determine the efficacy of different bathing/showering frequencies at improving AD severity. A systematic review and meta-analysis was performed of studies evaluating the clinical efficacy of bathing/showering regimen in AD. MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, China National Knowledge Infrastructure, Taiwan electronic periodical services and CiNii were searched. Two authors independently performed title/abstract and full-text review and data extraction. All 13 included studies were prospective and demonstrated numerically reduced AD severity in patients treated with a water bathing/showering regimen in ≥ 1 time-point compared with baseline. In random-effects regression models, baths/showers ≥ 7 vs. 50%. Therefore, random-effect models were performed to generate more accurate estimates of standard error between the studies. Generalized linear mixed models were constructed to determine the association of bathing practices with improvement of AD severity. The dependent variables were Cohen’s D for EASI, SCORAD, and BSA. The independent variable was frequency of showering/bathing (
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