Balneotherapy for atopic dermatitis in children at Comano spa in Trentino, Italy

Background: No controlled studies have investigated whether balneotherapy is effective in atopic dermatitis (AD). Objectives: To investigate the efficacy and safety of balneotherapy performed at Comano spa (Trentino, Italy) compared to topical corticosteroids (TCS) in the treatment of AD. Methods: This was an open, randomized, clinical trial including 104 children (aged 1-14 years) with mild to moderate AD who were assigned either to balneotherapy (n == 54) or TCS (n == 50) once daily for 2 weeks. AD severity and quality of life were measured using the SCORAD, investigator global assessment (IGA), patients' self global assessment (PSGA), children's dermatology life quality index (CDLQI) and family dermatitis impact questionnaire (FDIQ). Subjective measures were re-evaluated 4 months after the end of therapy. Results: Balneotherapy and TCS resulted in a significant reduction of all parameters at week 2. TCS were more effective than balneotherapy regarding SCORAD (46% +/- 7.71 vs 26% +/- 9.4, mean +/- SD; p < 0.03). In contrast, IGA, PSGA, CDLQI and FDIQ improvement was similar. At month 4, the number and duration of relapses were less in patients treated with balneotherapy compared to those treated with TCS (p < 0.0001). Conclusions: Balneotherapy at Comano spa appears to be beneficial in children with mild to moderate AD.