Eczema is the most frequent chronic inflammatory skin disease of childhood. It usually starts during the first few years of life, and tends to continuously reappear during a person’s lifetime. Many factors can worsen it, including sweating, skin infections, allergens, weather conditions, stress, and chemical or physical irritants.
Clothing can be an effective barrier against some of these flare-inducing factors and can also deter scratching (especially in children), which can allow quicker healing and prevent bacterial infections. Unfortunately, some fabrics may irritate the skin and worsen eczema due to their rough “spiky” fibers, such as wool and nylon.
Conventional silk has smooth fibers that are generally woven for textiles in the manufacturing of clothes, but this material is not particularly useful in the management of children with eczema due to it’s lack of breathability, which can upset the skin’s natural moisture levels and cause discomfort.
A new silk fabric (MICROAIR DermaSilk®) has been specially developed for individuals with eczema and has shown some very promising results in the management of this condition. The unique properties of this knitted silk have unique beneficial properties that reduce friction, allow the skin to breathe, and absorb perspiration, which may be an important factor in maintaining the moisture balance of the skin. In addition, this fabric is treated with a water-resistant antimicrobial finish that can help prevent infection. This new knitted silk fabric appears to be useful in managing children with eczema due to its non-irritating and antibacterial features.
Additionally, a synthetic silk-like fabric (DermaTherapy®) has received US FDA clearance as a Class I medical device and is commercially available as bedding, which has also shown some favorable results.
This article will review these promising new fabrics and their supporting studies.
Silk, in its natural state, consists of single long threads secreted by the silkworm Bombyx mori and is made up of a double filament of protein material glued together with sericin, an allergenic gummy substance that is normally extracted during the processing of the silk threads. Each silk thread is comprised of filaments that are more than 800 meters in length. Thread fibers are strong, perfectly smooth, and cylindrical, therefore, minimizing friction on the skin. Degumming represents a key process in the manufacturing of silk threads, whereby the sericin is completely removed and the silk fibers gain their characteristic sheen, softness, and flexibility.
Management of Eczema with DermaSilk®
A new type of silk fabric made of breathable and slightly elastic knitted silk is commercially available (MICROAIR DermaSilk®, thereafter referred to as DermaSilk) and may be beneficial in children with eczema. Moreover, this fabric is treated with a durable water-resistant antimicrobial finish known as AEGIS AEM 5772/5, that prevents odors and stops bacteria survival.5,6
In a blind study6 of 46 children experiencing eczema: 31 patients received special DermaSilk clothes that were worn for 1 week but changed daily; another 15 children (the control group) wore cotton clothing. At the end of the study, a significant decrease in eczema severity was observed in the children who wore the silk garments.
In a subsequent investigation8 the antibacterial properties of this special fabric treated with AEGIS AEM 5572/5 (AEGIS), were tested.5 The study population consisted of 12 children affected by eczema with symmetrical lesions and 4 patients without any skin disease served as controls. Children were asked to wear for 7 days two tubular garments that were changed daily. A significant improvement was observed in the covered skin areas.
Synthetic Silk-like Fabric (DermaTherapy®)
Due to the favorable data demonstrated by the use of special silk fabrics in eczema management, a synthetic silk-like fabric has also been developed. DermaTherapy® received 510(k) clearance from the US FDA as a Class I medical device for use by patients susceptible to or who have mild eczema.11 The manufacturer asserts the material is highly durable and provides therapeutic benefits that are attributable to its ability to minimize friction due to the smooth texture of the fibers, which are composed of approximately 50% polyester and 50% nylon.
In addition, the fabric may inhibit bacterial growth by wicking away moisture from the surface of the bedding, resulting in drier conditions.12 The threads are produced with continuous-filament fibers that create a completely smooth surface, reducing skin irritation. Moreover, a durable antimicrobial finish is applied to the fabric to prevent bacterial infections. Research13 has shown that the use of silk-like bedding in subjects with mild to moderate eczema reduced severity of the condition at 8 weeks, including itching, and partial improvements in the quality of life were also observed.
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5. Gettings RL, Triplett BL. A new durable antimicrobial finish for textiles. In: AATCC Book of papers. American Association of Textile Chemists and Colorists National Technical Conference, p.259-61 (1978).
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7. Koller DY, Halmerbauer G, Bock A, et al. Action of a silk fabric treated with AEGIS in children with atopic dermatitis: a 3-month trial. Pediatr Allergy Immunol. 2007 Jun;18(4):335-8.
8. Ricci G, Patrizi A, Mandrioli P, et al. Evaluation of the antibacterial activity of a special silk textile in the treatment of atopic dermatitis. Dermatology. 2006;213(3):224-7.
9. Senti G, Steinmann LS, Fischer B, et al. Antimicrobial silk clothing in the treatment of atopic dermatitis proves comparable to topical corticosteroid treatment. Dermatology. 2006;213(3):228-33.
10. Stinco G, Piccirillo F, Valent F. A randomized double-blind study to investigate the clinical efficacy of adding a non-migrating antimicrobial to a special silk fabric in the treatment of atopic dermatitis. Dermatology. 2008;217(3):191-5.
11. U.S. Food and Drug Administration. Medical Devices. January 2007 510(k) Clearances. Available at: http://www.accessdata.fda.gov/SCRIPTs/cdrh/devicesatfda/index.cfm?db=pmn&id=K061242. Accessed January 25, 2012.
12. National Eczema Association. EASE Program. Seal of acceptance fabrics. Available at: http://www.easeeczema.org/product_directory/fabrics.htm. Accessed: January 25, 2012.
13. Kurtz EJ, Yelverton CB, Camacho FT, et al. Use of a silklike bedding fabric in patients with atopic dermatitis. Pediatr Dermatol. 2008 Jul-Aug;25(4):439-43.