Trial examines if water softeners can prevent eczema in babies

A new study will for the first time investigate if using water softeners can reduce the risk of infants getting eczema.

The study of Softened Water for Eczema Prevention (SOFTER) is being led by researchers at Guy’s and St Thomas’ NHS Foundation Trust and is the first time that water softeners will be installed into the homes of babies at high risk of having eczema as part of a trial.

This includes babies who have a parent or sibling with eczema, asthma or hay fever. Eczema, a common itchy skin condition, is known to be more common in infants who live in hard water areas. Around 20% of children in the UK have eczema at some stage, with the figure rising to 50-60% if there is a family history of the condition.

The SOFTER trial involves recruiting women during pregnancy if their unborn child is thought to be at high risk of having the condition, and if they live in a hard water area. The women are then randomised to have a water softener installed or not and while they know if they have, this information is not passed onto the researchers. The softened water, which has minerals such as calcium and magnesium removed, is used to wash the babies.

A number of skin measurements, including water loss, pH levels, detergent deposits and skin bacteria, are taken from the baby at birth, one month, three months and six months to check for any changes to their skin.

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.

“So far Alessia hasn’t shown any signs of eczema or other skin problems so we are hopeful that she won’t develop it. 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.”

Professor Carsten Flohr, consultant dermatologist at Guy’s and St Thomas’, is the chief investigator of the SOFTER study. 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 pilot study is currently recruiting 80 patients from Guy’s and St Thomas’ and Kingston Hospital and depending on the results it could lead the way for a larger-scale trial across the UK involving hundreds of patients.

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).

Find out more information about the study.