Conflicts — environmental-triggers (round 6)

Conflict: [National Eczema Society, n.d.] recommends practical house dust mite reduction (60°C washing, weekly vacuuming, freezing toys, hard flooring in severe eczema). [Nankervis et al., Cochrane, 2015] found no clear benefit from mite-reduction measures including mattress covers (very low-quality evidence; modest benefit only for a multi-component package in sensitised people). Unresolved — see House Dust Mites.

Conflict: [National Eczema Society, n.d.; British Association of Dermatologists, 2025] recommend silk, including therapeutic silk garments. [Thomas et al., CLOTHES Trial, PLoS Med, 2017] found silk garments gave no benefit over standard care in children with moderate–severe eczema. Unresolved — see Clothing and Fabrics.

Conflict: [Andersen et al., Acta Derm Venereol, 1998; Basketter et al., Br J Dermatol, 2008] found biological (enzyme) detergents do not worsen atopic dermatitis. Parent reports (anecdotal, r/toddlers 2024) credit switching to non-bio detergent with clearing flares. Unresolved — see Clothing and Fabrics.

Conflict: [Pelucchi et al., J Allergy Clin Immunol, 2013] says early dog exposure is protective (RR 0.72) and cat exposure neutral (RR 0.94). [Epstein et al., J Pediatr, 2011] says cat ownership plus cat sensitisation raises eczema risk 13-fold; [Bisgaard et al., PLoS Med, 2008] says neonatal cat exposure raises risk in filaggrin-mutation carriers. [Langan et al., Arch Dermatol, 2007] says no convincing protective effect after accounting for pet-avoidance behaviour. Unresolved — see Pets and Eczema.