The results of the trial, published in the journal PLOS Medicine and funded by the National Institute for Health Research, revealed that wearing specialist silk garments did not reduce the severity of eczema for the children taking part, not did it reduce the amount of creams and ointments used for their eczema, or the number of skin infections experienced.

Professor Kim Thomas, from the Centre for Evidence Based Dermatology in the University’s School of Medicine, led the study.

Three small clinical trials had suggested that the use of DermaSilk™ clothing might offer some possible benefits for children with eczema. However, these previous trials were insufficient for guiding clinical practice because of limitations in their methodology, prompting the Nottingham study to examine the issue in more detail.

The CLOTHing for the relief of Eczema Symptoms trial (CLOTHES trial), which involved recruiting hospitals from across the UK, was the first large, randomised controlled trial to evaluate the use of silk garments (DermaSilk or Dreamskin) for children with moderate to severe eczema.

Due to limited evidence supporting the efficacy of silk clothing for the relief of eczema, the NIHR HTA programme commissioned the CLOTHES trial, which aimed to examine whether adding silk garments to standard eczema care could reduce eczema severity in children with moderate to severe eczema, compared to use of standard eczema treatment alone. The CLOTHES trial also looked at whether the use of the silk clothing was cost–effective.

The study took place in five recruiting centres across the UK, and included children aged between one and 15 years of age. The children were randomly given either standard eczema treatment or standard treatment plus the use of silk clothing.

The participants were given either Dermasilk™ or Dreamskin™ clothing – the two brands of garments available on prescription at the time the trial was designed. Both brands are made with antimicrobially–protected, knitted, sericin–free 100% silk. The participants were given three sets of long–sleeved vest and leggings and were instructed to wear the clothing as often as possible during the day and night.

All the children continued with their regular use of emollient creams and topical corticosteroids for controlling inflammation, and were asked not to change their standard treatment for the duration of the trial if possible. The participants’ skin was assessed by nurses every two months using the Eczema Area and Severity Index (EASI), which measures how bad the eczema is.

Use of the garments was good and probably reflects how people might wear the silk clothing normal practice – 82 per cent of the participants wore the clothes for at least 50 per cent of the time, although the clothing was worn more often at night than during the day.

In terms of severity of eczema, quality of life and use of eczema medications, the trial found no difference between the two groups. Safety outcomes e.g. the number of skin infections and hospitalisations due to eczema were also similar in the two groups.

When asking patients to monitor the severity of their eczema symptoms weekly, those using the silk clothing reported small improvements in the eczema, but these differences were small and unlikely to be clinical meaningful.

At the time the research was commissioned, £840, 272 was spent on prescriptions for silk garments per year in the UK, rising to more than £2 million by 2014. The CLOTHES study found that the average cost of garments for 6 months was £318.52 per participant, and this amount was not offset by a reduction in other healthcare costs, such as prescriptions or GP visits.

The research paper is titled, "Silk Garments Compared with Standard Care for Treating Atopic Dermatitis in Children: A Randomised, Observer Blind, Pragmatic Trial (CLOTHES Trial)."