Parents should not waste their money on high street allergy tests for children suffering eczema, experts warned today.
The ‘inappropriate’ tests could provide false results and will not help most youngsters with the condition, which leaves skin red, itchy and swollen.
The health watchdog also warned that complementary medicines have not been rigorously tested.
New Nice guidance
In new guidance to NHS staff and patients, the National Institute for Health and Clinical Excellence (Nice) said: ‘The effectiveness and safety of complementary therapies and food supplements for eczema have not been adequately assessed.
‘Caution should be exercised with the use of herbal medicines in children, especially any herbal product that is not labelled in English or does not come with information about safe usage.’
The Nice guidance – on managing eczema in children from birth to the age of 12 – said steroids have been deliberately added to some herbal products, meaning children could receive a too-high dose if they also have steroids prescribed by their GP.
While regular massage with skin moisturisers (emollients) prescribed for eczema can help alleviate symptoms, other treatments are unproven, it said.
‘Liver toxicity has been associated with some Chinese herbal medicines,’ it added.
Dr Sarah Purdy, a GP in Bristol, said those working on the guideline had deliberately wanted to issue a warning about allergy testing.
‘It’s not intended to have particular relevance to any professional group (who offer the tests),’ she said.
It was more about ensuring test results were ‘accurate to the standards that we would expect any NHS allergy test to be delivered [to]’.
She added: ‘We were hoping that, by suggesting this, we could protect people from having spurious tests and getting results that are not to be trusted.
‘We have also made recommendations around when parents should seek allergy testing on the NHS.’
Sandra Lawton, a nurse consultant in dermatology who also worked on the guideline, said she had seen many cases ‘when parents spent lots and lots of money on inappropriate tests’.
They had received ‘misinformation’ from friends or colleagues telling them to try allergy testing, she added.
Dr Sue Lewis-Jones, a consultant dermatologist and chair of the guideline development group, said such testing did not benefit the 80% of children in the UK with mild eczema.
Most food allergies were outgrown by the time the child was about five while older children tended to suffer airborne allergies, such as to cat dander and dust mites.
Today’s guideline is aimed at health workers and parents caring for the one in five schoolchildren in the UK who have eczema.
It recommends giving families a choice of which emollients to use and prescribing them in large enough quantities (250g to 500g weekly) so they can be used regularly.
The guideline also points out when treatment should be ‘stepped up’, the use of steroids, and how doctors should take account of whether eczema inhibits quality of life.
Dr Lewis-Jones said it was important parents were not put off using steroids because of reported side-effects, such as the skin becoming microscopically thinner or an increased risk of infections.
Nice also defended the use of bath emollients, which are prescribed on the NHS to treat eczema.
In October, a study published in the Drug and Therapeutics Bulletin said the products, which are said to help form a protective skin barrier, were of questionable value.
The NHS pays more than £16million a year on such emollients, according to the article, but yet there is no evidence to show they actually help patients.
However, the National Eczema Society said there was ‘extensive evidence’ from patients and parents that bath oils were useful.
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