Investigating the Use of Melatonin in Children With Atopic Dermatitis: A Cross-Sectional Study.

Background/objectives: Children with atopic dermatitis (AD) frequently experience sleep disturbances. Melatonin, an over-the-counter supplement, is increasingly used in the general pediatric population; however, its prevalence and perceived effectiveness in children with AD remain unclear.

Methods: Caregivers of pediatric patients (ages 1-17 years) with physician-diagnosed AD completed surveys on melatonin use, Patient Oriented Eczema Measure (POEM), and age-appropriate sleep questionnaires.

Results: Among 102 total respondents, 27.5% reported a history of melatonin use, with 10.8% using it in the past 30 days. Gummies were the most common formulation (85.7%), though brands and dosages varied widely (0.5-10 mg; median: 3 mg). 32.1% of caregivers initiated melatonin based on a healthcare professional's recommendations, while the majority initiated use independently (50.0%) or based on recommendations from friends/family (21.4%) or online resources (7.1%). Melatonin use was significantly more common among children with behavioral or psychological comorbidities compared to those without (56.3% vs. 22.1%; p = 0.012). Children ages 6-17 who used melatonin had significantly higher PROMIS Sleep Disturbance scores than nonusers (p < 0.001). Perceived effectiveness varied: for sleep, 21.4% of caregivers found melatonin very useful, 32.1% somewhat useful, and 39.3% of little or no use. For nocturnal itch, 14.3% found melatonin very useful, 17.9% somewhat useful, and 50.0% of little or no use.

Conclusions: There is a high prevalence of melatonin use among children with AD. Most caregivers are initiating melatonin independently, and dosage varies widely. Given mixed caregiver-reported effectiveness of melatonin and limited long-term safety data, it is imperative that further studies are performed to evaluate melatonin's role in children with AD.