Systematic Review and Meta-analysis of the Effectiveness of Topical Aloe vera on Diaper Dermatitis with Parameters Degree of Diaper Dermatitis with Scale

Abstract

Background: For toddlers younger than 36 months, most of them still use diapers, so diaper rashes frequently appear in the diaper area. To improve the skin barrier, a moisturizer is needed to repair the skin barrier. Besides, the ceramide gold standard of moisturizer for diaper dermatitis, topical ingredients with natural ingredients can be used, for example, topical Aloe vera. Objective: To prove the effectiveness of topical Aloe vera moisturizer compared to other topical ingredients against diaper dermatitis. Methods: The results of the electronic database search Medline Pubmed, Scopus, EBSCOhost, ProQuest, Cochrane library, ClinicalTrials.gov, found 5 articles were included in the qualitative review (n = 289 subjects) and 4 articles (n = 214 subjects) were included in the meta-analysis. Results: Meta-analysis showed that after the administration of topical Aloe vera, there was a mean difference in the score of the degree of diaper dermatitis before and after therapy, the result showed negative value in the studies which were included the treatment group with Aloe vera. This indicates a decrease in the degree of diaper dermatitis after treatment with Aloe vera. The control group also showed that the mean score difference in the degree of diaper dermatitis after administration of control therapy was all negative. This shows that after the administration of therapy in the control group there was also a decrease in the score of the degree of dermatitis. The biggest decrease in the degree of diaper dermatitis was in the study conducted by Murni 2020, which was -2.10 ± 1.39. The lowest decrease in the degree of diaper dermatitis was found in the study conducted by Badelbuu 2019 B which received Chamomile, which was -0.93 ± 1.08. Meanwhile, in the Panahi’s study, the heterogeneity test results showed the value of Q=5,324 df=43; p=0,256, I2=24,866. This shows that the data is homogeneous, it is in line with the results of the statistical Q test and heterogeneity, the results of the I2 test obtained p < 0.001 which also indicates the data is homogeneous. The analysis was carried out using a fixed effect model because the data were homogeneous. The results of the meta-analysis showed that the statistical Q value was z value = -0.969 (p = 0.047). It has quite meaningful results. Conclusion: The meta-analysis showed that statistically there were only slight differences, but there were also studies that provided significant results. Topical application of Aloe vera appears to be more effective. The results of qualitative analysis on other skin barrier function parameters indicate that topical Aloe vera can improve skin barrier function in diaper dermatitis patients. In addition, it provides the same results as standard therapy and several other topical therapies that had been studied which had a good effect on repairing the skin barrier.