February 23, 2016
Atopic dermatitis (AD) is a pruritic chronic inflammatory skin disease that affects 15% to 20% of children and is often accompanied by sleep disturbances. According to findings from a recent randomized trial, melatonin was safe and effective in improving the severity of atopic dermatitis (AD) in children and adolescents while also reducing sleep disturbance (Chang YS et al. JAMA Pediatr. 2016;170:35-42).
Anita Slomski, MA
Forty-eight children (aged 1-18 years) with AD and with sleep disturbances (>3/week) were randomized 1:1 to 2 groups: either melatonin (3 mg/d) or placebo treatment for 4 weeks. After a 2-week washout period, the melatonin group received placebo, and the placebo group received melatonin for another 4 weeks. Participants continued with their original treatments for AD during the trial.
Atopic dermatitis severity was evaluated using the Scoring Atopic Dermatitis (SCORAD) index, and secondary outcomes included sleep variables. After melatonin treatment, the SCORAD index decreased by 9.1 points compared with placebo. The sleep-onset latency was also shortened by 21.4 minutes after melatonin treatment vs placebo. The improvement in the SCORAD index did not correlate significantly with the change in sleep-onset latency, melatonin did not affect other sleep variables compared with placebo, and no adverse events were reported.
Although the effect was modest, melatonin supplementation has the potential to improve quality of life for patients and families as it simultaneously improves sleep and may prevent children from scratching and exacerbating their condition, wrote the researchers.