By Randy Dotinga
Eczema, also called atopic dermatitis, is characterized by an itchy, red rash. It affects as many as 30 percent of all kids, more than half of whom experience sleep difficulties, the researchers said.
These sleep problems can be difficult to treat in these children, said Dr. Yung-Sen Chang, an attending physician in pediatrics at Taipei City Hospital Renai Branch in Taiwan. Antihistamines can stop working after a few days, and tranquilizers have potentially serious side effects, Chang said.
But supplementation with melatonin, his study found, "is safe and effective for helping children with atopic dermatitis fall asleep faster."
The link between the skin condition and insufficient sleep "has an impact on people with eczema at all ages," said Dr. Lawrence Eichenfield, chief of pediatric and adolescent dermatology at the University of California, San Diego and Rady Children's Hospital.
According to Eichenfield, it's generally established that itching keeps people with eczema from getting enough sleep. However, Chang said research has questioned that idea.
In a previous study, Chang and colleagues found low levels of nocturnal melatonin in patients with eczema who had sleep problems. Those findings inspired the new study.
"Melatonin is a natural human hormone with minimal adverse effects," Chang said, "so it seemed like a good choice for children."
The study involved 48 children, about 22 months to 18 years old, who had eczema. The children received treatment with either an inactive placebo or a 3-milligram daily dose of melatonin at bedtime for four weeks. Thirty-eight participants then took the alternate treatment (melatonin or placebo) for another four weeks.
When the children took melatonin, the severity of eczema dipped slightly, possibly because melatonin's anti-inflammatory effect improved the skin condition, Chang said.
Also, kids taking melatonin fell asleep about 21 minutes sooner than kids taking the placebo, the findings showed.
Total nightly sleep rose by 10 minutes on average (from 380 to 390 minutes, or 6.5 hours total) in the melatonin group, while it fell by 20 minutes among those who took a placebo, according to the report.
The study participants didn't report any side effects. Melatonin supplements are inexpensive in the United States -- under 9 cents a pill at one major supplier.
Eichenfield, who wasn't involved in the research, said the study appears to be well-designed. Melatonin hasn't been studied much as a sleep treatment for kids, he cautioned.
Should parents of kids with eczema and sleep problems try melatonin?
Eichenfield said melatonin might be helpful, but "we have a broad set of tools" to treat eczema and minimize its effects on children. He suggested tackling the skin condition first to try to mitigate the sleep issues.
Chang recommended that parents talk to their child's doctor before starting melatonin. As for adults, melatonin may help them, too. But more studies are needed, Chang said.
The study is published in the Nov. 16 online edition of the journal JAMA Pediatrics.