title: Functional textiles for atopic dermatitis: a systematic review and meta-analysis.
abstract: Atopic dermatitis (AD) is a relapsing inflammatory skin disease with a considerable social and economic burden. Functional textiles may have antimicrobial and antipruritic properties and have been used as complementary treatment in AD. We aimed to assess their effectiveness and safety in this setting. We carried out a systematic review of three large biomedical databases. GRADE approach was used to rate the levels of evidence and grade of recommendation. Meta-analyses of comparable studies were carried out. Thirteen studies (eight randomized controlled trials and five observational studies) met the eligibility criteria. Interventions were limited to silk (six studies), silver-coated cotton (five studies), borage oil, and ethylene vinyl alcohol (EVOH) fiber (one study each). Silver textiles were associated with improvement in SCORAD (2 of 4), fewer symptoms, a lower need for rescue medication (1 of 2), no difference in quality of life, decreased Staphyloccosus aureus colonization (2 of 3), and improvement of trans-epidermal water loss (1 of 2), with no safety concerns. Silk textile use was associated with improvement in SCORAD and symptoms (2 of 4), with no differences in quality of life or need for rescue medication. With borage oil use only skin erythema showed improvement, and with EVOH fiber, an improvement in eczema severity was reported. Recommendation for the use of functional textiles in AD treatment is weak, supported by low quality of evidence regarding effectiveness in AD symptoms and severity, with no evidence of hazardous consequences with their use. More studies with better methodology and longer follow-up are needed.
authors: Immunology Department, Faculty of Medicine, University of Porto, Porto, Portugal. clabreu@med.up.pt
authors: Cristina
authors: C
authors: Lopes
authors: Diana
authors: D
authors: Silva
authors: Luís
authors: L
authors: Delgado
authors: Osvaldo
authors: O
authors: Correia
authors: André
authors: A
authors: Moreira
mesh_terms: D000529:Complementary Therapies; D032561:Cotton Fiber; D003876:Dermatitis, Atopic / Q000150:complications / Q000628:therapy*; D018450:Disease Progression; D006801:Humans; D010938:Plant Oils / Q000008:administration & dosage / Q000009:adverse effects; D011145:Polyvinyls / Q000008:administration & dosage / Q000009:adverse effects; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D047011:Silk / Q000008:administration & dosage / Q000009:adverse effects; D012834:Silver / Q000008:administration & dosage / Q000009:adverse effects; D013207:Staphylococcal Skin Infections / Q000150:complications / Q000628:therapy*; D013211:Staphylococcus aureus / Q000276:immunology*; D013784:Textiles / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D017965:gamma-Linolenic Acid / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D010938:Plant Oils; D011145:Polyvinyls; D047011:Silk; C020320:ethylene-vinyl alcohol copolymer; D012834:Silver; D017965:gamma-Linolenic Acid; C079363:borage oil
keywords: atopic dermatitis; functional textiles; immunomodulation; systematic review