Skip to main content Skip to main navigation menu Skip to site footer

Comparison of skin hydration degrees based on moisturizing time in children's atopic dermatitis

  • Puteri Wulandari ,
  • Syahril Rahmat Lubis ,
  • Deryne Anggia Paramita ,


Background: Atopic dermatitis (AD) is a skin disease accompanied by an inflammatory reaction influenced by heredity and environment. Atopic dermatitis commonly occurs in infants and children. Overcoming dryness of the skin is an important strategy in the management of AD. One way is by using a moisturizer (emollient) to increase the skin barrier function. This study aimed to compare the degree of skin hydration based on moisturizing time in children with AD, immediately after bathing and 30 minutes after bathing.

Methods: This analytical study's design was quasi-experimental (pre-post clinical trial) conducted in dermatology-venereology policlinic of Universitas Sumatra Utara Hospital. Subjects who met inclusion criteria were children with AD, 2-14 years who met William's criteria,  no recent use of topical preparations, and informed consent approved. The bath soap and moisturizer used were Johnson's® baby milk soap and those containing ceramide-3 (Atocalm®), respectively, applied twice a day.  Moisturizing time is given immediately and 30 minutes after bathing on the volar part of the right forearm and left forearm, respectively. The degree of skin hydration was measured by Corneometer CM 825®, taken four times on the 1st, 8th, 15th, and 21st day, and categorized into very dry skin, dry skin, and normal skin.  Test analysis using SPSS software with p<0.05 was significant.

Result: Thirty-seven children with AD followed this study. The median age was 5 (2-13) years, female sex (21 children [56.8%]). There were differences in skin hydration between these groups. There was also significant right forearm volar skin hydration measured immediately after bathing, 1st, 8th, 15th, 21st day (42.3; 48.0; 55.3; 61.3 AU (Arbitrary Unit); p<0.001), respectively. Skin hydration on the left forearm's volar part is significant between 30 minutes after bathing, respectively 1st, 8th, 15th, 21st day (42.3; 44th,7th; 47.7; 52.0 AU; p<0.001). The total amount of dry skin and very dry skin was more in the moisturizing group 30 minutes after bathing than immediately after bathing. 

Conclusion: Significant difference in skin hydration degrees found between immediately after the bathing group (on the right forearm volar) and 30 minutes after bathing (on the left forearm volar).


  1. Sentosa H. Dermatitis Atopik. Dalam: Akib, editor. Buku Ajar Alergi Imunologi Anak 2ed. Jakarta: Ikatan Dokter Anak Indonesia; 2010. p. 234-43.
  2. Evina B. Clinical Manifestation and Diagnostic Criteria of Atopic Dermatitis. Majority. 2015;4:23-30.
  3. Febriansyah JPE, Kapantow GM, Hariyanto A. Profil Dermatitis Atopik di Poliklinik Kulit dan Kelamin RSUP PROF . DR . R . D Kandou Manado. Biomedik (JBM). 2015;7:23-8.
  4. Wahyuni TD. Pembersihan Luka Dermatitis Atopik dengan Cairan Normal Salin. Keperawatan. 2014;5(1):79-91.
  5. Kim BE, Leung DYM. Significance of Skin Barrier Dysfunction in Atopic Dermatitis. Allergy Asthma Immunol Res. 2018;10(3):207-15.
  6. Simpson E, Böhling A, Bielfeldt S, Bosc C, Kerrouche N. Improvement of Skin Barrier Function in Atopic Dermatitis Patients with a New Moisturizer Containing a Ceramide Precursor. The Journal of dermatological treatment. 2013;24:122-5
  7. Elias P, Steinhoff M. "Outside-to-inside" (and now back to "outside") pathogenic mechanisms in atopic dermatitis. J Invest Dermatol. 2008;128:1067-70.
  8. Wollenberg A, Oranje A, Deleuran M, Simon D, Szalai Z, Kunz B, et al. ETFAD / EADV Eczema Task Force 2015 Position Paper on Diagnosis and Treatment of Atopic Dermatitis in Adult and Paediatric Patients. European Academy of Dermatology and Venereology. 2016;30:729–47.
  9. Albaar M, Tabri F, Ilyas FS, Suwandi D. Effect Moisturizing of Palmitoylethanolamide on Transepidermal Water Loss and Colonies of Staphylococcus Aureus in Children with History of Atopy and Non Atopy. Unhas. 2011:1-13.
  10. Lyons JJ, Milner JD, Stone KD. Atopic Dermatitis in Children: Clinical Features, Pathophysiology and Treatment. Immunol Allergy Clin North Am. 2015;35(1):161–83.
  11. Eichenfield LF, Hanifin JM, Luger TA, Stevens SR, Pride HB. Consensus conference on pediatric atopic dermatitis. J Am Acad Dermatol. 2003;49:1088-95.
  12. Sinaga, Y. Hubungan Pemberian Asi Ekslusif dengan Kejadian Dermatitis Atopik pada Anak Playgroup dan TK Happy Holy Kids [Thesis]. Universitas Sumatra Utara: Repositori Institusi Universitas Sumatra Utara. 2016.
  13. Egeberg, A., Griffiths, C. E. M., Williams, H. C., Andersen, Y. M. F., & Thyssen, J. P. Clinical characteristics, symptoms and burden of psoriasis and atopic dermatitis in adults. British Journal of Dermatology. 2020;183(1):128-138.
  14. Kowalska-Olędzka, E., Czarnecka, M., & Baran, A. Epidemiology of atopic dermatitis in Europe. Journal of drug assessment. 2019;8(1):126-128.
  15. Adkis CA, Akdis M, Bieber T et al. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Alllergy, Asthma and Immunology/PRACTALL Consensus Report. J Allergy Clin Immunol. 2006;118:152–169.
  16. Clarys P, Barel A, Gabard B. Non-invasive electrical measurements for the evaluation of the hydration state of the skin: comparison between three conventional instruments - the Corneometer, the Skicon, and the Nova DPM. Skin Research and Technology. 1999;5:14–20.
  17. Asano-Kato N, Fukagawa K, Tsubota K, et al. Quantitative evaluation of atopic blepharitis by scoring of eyelid conditions and measuring the water content of the skin and evaporation from the eyelid surface. Cornea. 2001; 20:255–259. [PubMed: 11322412]
  18. Lynde C, Barber K, Claveau J, Gratton D, Ho V, Krafchik B, et al. Canadian Practical Guide for the Treatment and Management of Atopic Dermatitis. Journal of Cutaneous Medicine and Surgery. 2005;8(Suppl. 5):1-9.
  19. Rubel D, Thirumoorthy T, Soebaryo RW, Weng SC, Gabriel TM, Villafuerte LL, et al. Asia-Pacific Consensus Group for Atopic Dermatitis. Consensus guidelines for the management of atopic dermatitis: an Asia-Pacific perspective. J Dermatol. 2013;40:160-71.
  20. Ellis C, Luger T, Abeck D, Allen R, Graham-Brown RAC, De-Prost Y, et al. International Consensus Conference on Atopic Dermatitis II (ICCAD II): clinical update and current treatment strategies. Br J Dermatol. 2003;148(Suppl. 63):3-10
  21. National Collaborating Centre for Women’s and Children’s Health (UK). Atopic eczema in children: management of atopic eczema in children from birth up to the age of 12 years. London: RCOG Press; 2007.
  22. Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: Section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71:116–32

How to Cite

Wulandari, P., Lubis, S. R., & Paramita, D. A. (2021). Comparison of skin hydration degrees based on moisturizing time in children’s atopic dermatitis. Bali Medical Journal, 10(1), 194–198.




Search Panel

Puteri Wulandari
Google Scholar
BMJ Journal

Syahril Rahmat Lubis
Google Scholar
BMJ Journal

Deryne Anggia Paramita
Google Scholar
BMJ Journal