Glycerol 85% efficacy on atopic skin and its microbiome: a randomized controlled trial with clinical and bacteriological evaluation

Abstract

Background

Treating atopic dermatitis (AD) is still a challenge. The staphylococcal skin load is known to aggravate AD. Narrow band ultraviolet B (NB-UVB) and glycerol in low concentration (20–40%) are established therapies for AD. NB-UVB has proven antimicrobial actions, while high concentration glycerol (85–100%) showed similar effects in vitro but has not been clinically tested.

Objective

To evaluate the efficacy and tolerability of concentrated glycerol 85% compared to NB-UVB in patients with AD, as assessed by clinical improvement and reduction of staphylococcal colonization of the skin.

Methods

30 patients with mild to moderate AD were randomized into either NB-UVB or glycerol 85% group. Patients were treated for one month and followed for an additional month. Swabs were taken from the skin and nose to be cultured on mannitol-salt agar for Staphylococci and quantified to determine Colony Forming Units.

Results

Both groups showed statistically insignificant microbial changes and statistically significant clinical improvement after treatment. The results were comparable between both groups.

Conclusions

Concentrated glycerol 85% is a cheap effective readily accessible alternative for phototherapy in patients with mild-moderate AD who cannot access the facility. Reduction of staphylococcal skin load seems to be involved, but its role is minimal.

Keywords:

• Atopic dermatitis
• glycerol
• staphylococcus
• ultraviolet therapy
• phototherapy
• microbiome

Compliance with ethical standards

Ethical approval status

Reviewed and approved by the Research Ethics Committee of Faculty of Medicine, Cairo University. Approval number: N-54-2018. The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) and with the Helsinki Declaration of 1975, as revised in 1983.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.