Centre of Evidence Based Dermatology

Clothing for the relief of eczema symptoms (CLOTHES) trial

Does Silk Clothing Help Children with Eczema? This short animation reveals the results of the CLOTHES trial. 
We are pleased to announce that the CLOTHES Trial has now been published in PLoS Medicine. The University of Nottingham have issues a press release to accompany the research. 


The CLOTHES trial aimed to find out whether using silk clothes in addition to standard care would help children with moderate-to-severe eczema. In total 300 children, with the help of their families, participated in the research.

The trial was led by Professor Kim Thomas from the Centre of Evidence Based Dermatology at the University of Nottingham. The trial was developed with the help and support of the UK Dermatology Clinical Trials Network (UK DCTN) and trial coordination was provided by Nottingham Clinical Trials Unit.


Key Information

1. What treatments did the CLOTHES trial test?

To decide whether silk clothing is a useful addition to the treatments currently available for children with eczema, we tested two brands of silk clothing available on prescription for the management of eczema: DermaSilk® (Espère Healthcare Ltd) and DreamSkin® (DreamSkin Health Ltd).

The two brands of clothing used in the trial were chosen because these were the only brands of therapeutic silk clothing available on prescription from the the NHS at the time of trial set-up.

Since this time, the range of therapeutic silk-garments available to the consumer and on NHS prescription has grown (and now includes Dermacea Ltd’s Skinnies™ Silk range).

2. How many people took part in the trial?

In total, 300 children with moderate to severe eczema, aged between 1 and 15 years old, took part in the CLOTHES trial.

You can hear a BBC radio interview with Professor Kim Thomas and Amina Ahmed, a parent of a child involved in the trial:

3. What were the results?

The eczema of children wearing the silk clothes improved over the 6 months, but so did the eczema in of children who didn’t wear the clothes. We found no difference between the two groups in eczema severity assessed by nurses.

We also looked at whether wearing the silk clothing more often affected the severity of the eczema, but did not find any difference. There was no difference between the two groups in number of skin infections, or quality of life. Wearing the silk clothing did not reduce the number of doctor visits for eczema or use of eczema medications.

The weekly questionnaires completed by parents/carers or their children indicated that the eczema symptoms in the silk clothing group may have improved more than the eczema symptoms in the group who didn’t wear the clothes. However, the difference between the groups was small, and was seen mainly in the first few months of the trial.

4. What does this mean?

The silk garments that we looked at as part of this trial did not appear to provide additional clinical or economic benefits over standard care for the management of children with eczema

5. How was industry involved in the study?

The CLOTHES trial is an independent trial that has been funded through the National Institute for Health Research (NIHR) Health Technology Assessment Programme. The clothing used in the trial has been donated by DreamSkin Health Ltd and Espère Healthcare Ltd, but these companies have had no involvement in the design, conduct or analysis of the trial results.


Study documents

Information sheets


CLOTHES Publications

Thomas KS, Bradshaw LE, Sach TH, Cowdell F, Batchelor JM, Lawton S, Harrison EF, Haines RH, Ahmed A, Dean T, Burrows NP, Pollock I, Buckley HK, Williams HC, Llewellyn J, Crang C, Grundy J D, Guiness J, Gribbin A, Wake EV, Mitchell EJ, Brown SJ & Montgomery AA. Randomised controlled trial of silk therapeutic garments for the management of atopic eczema in children: the CLOTHES Trial. Health Technology Assessment, volume 21, number 16. 2017

Thomas KS, Bradshaw LE, Sach TH, Batchelor JM, Lawton S, Harrison EF, et al. Silk garments plus standard care for treating eczema in children: a randomised controlled observer-blind pragmatic trial (CLOTHES TRIAL). PLOS Med. 2017.

Wake EV, Batchelor J, Lawton S3, Thomas KS, Harrison EF, Cowdell FC and the UK Dermatology Clinical Trials Network's CLOTHES Trial Team.The views of children and young people on the use of silk garments for the treatment of eczema: a nested qualitative study within the CLOTHES randomised controlled trial.Br J Dermatol. 2017

Harrison EF, Haines RH, Cowdell F, Sach TH, Dean T, Pollock I, Burrows NP, Buckley H, Batchelor J, Williams HC, Lawton S, Brown SJ, Bradshaw LE, Ahmed A, Montgomery AA, Mitchell EJ, Thomas KS.
A multi-centre, parallel group superiority trial of silk therapeutic clothing compared to standard care for the management of eczema in children (CLOTHES Trial): study protocol for a randomised controlled trial.
Trials. 2015 Sep 2;16(1):390. doi: 10.1186/s13063-015-0921-9.



This independent trial was funded by the National Institute for Health Research Health Technology Appraisal programme. The views expressed on this website are those of the author(s) and not necessarily those of the NIHR.

Clothing used in the study was kindly donated by the manufacturers, however, these companies have not been involved in the design or conduct of the study. 

Centre of Evidence Based Dermatology

The University of Nottingham
Applied Health Research Building
University Park, Nottingham

telephone: +44 (0) 115 84 68631
email: cebd@nottingham.ac.uk