Scratch Less Study
| ISRCTN | ISRCTN15774173 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN15774173 |
| Integrated Research Application System (IRAS) | 329123 |
| Central Portfolio Management System (CPMS) | 58276 |
| Sponsor protocol number | 22DE002 |
| Sponsor | Nottingham University Hospitals NHS Trust |
| Funder | National Institute for Health and Care Research |
- Submission date
- 12/05/2026
- Registration date
- 13/05/2026
- Last edited
- 13/05/2026
- Recruitment status
- Not yet recruiting
- Overall study status
- Ongoing
- Condition category
- Skin and Connective Tissue Diseases
Plain English summary of protocol
Background and study aims
This study is part of the Rapid Eczema Trials project (Eczema Bathing Study: https://www.isrctn.com/ISRCTN12016473, and
Keep Control of Eczema Study: https://www.isrctn.com/ISRCTN29214215). These studies hope to answer many questions about how to look after eczema. People with eczema are helping to design and run these studies. This means that the project will answer important questions for people with eczema.
Itch is a common symptom of eczema, and scratching is a response to feeling itchy. Over time, the response of scratching can form a habit, where people scratch even if they don’t feel itchy. Scratching can also lead to worsening of the itch and make the eczema worse. There are various ways of helping people to reduce how much they scratch in the hope of breaking this itch-scratch cycle. One of these approaches – the Scratch Less programme is being tested in this study.
Who can participate?
People aged 8 years or older who have eczema and would like to reduce their scratching can join the study. The researchers are encouraging people from all different backgrounds to take part.
What does the study involve?
People will join the study by signing up on the study website. They will answer questions about their eczema and how they currently treat it. They will then be put into one of two groups at random. One group will be asked to follow the Scratch Less 3-part online programme. The other group will be asked to follow their usual care for their eczema.
The Scratch Less programme starts by helping people to treat their eczema, and then supports people to try to reduce their scratching behaviour. This involves becoming more aware of the scratching, identifying the situations and reasons scratching is occurring, and then replacing the scratching with doing something else instead. The Scratch Less programme can be done at people’s own pace, but is designed to be completed over 3 weeks.
Everyone will be in the study for 4 months. They will be asked to complete some questions, sent to them by email/text message, each month. People will receive reminders to complete the questionnaires by email/text message/telephone call, and information may be collected over the phone if needed. People can take part from home and do not need to travel.
It is not yet known if the Scratch Less programme works, but people in the usual care group will be able to try it at the end of the study if they would like to.
Soon after the study results are known, they will be shared on the study website (https://rapideczematrials.org/).
What are the possible benefits and risks of participating?
It is hoped that this study will help people to understand how best to manage their eczema. Some people like to feel they are helping others by taking part, and some people like to try new things out for themselves.
The researchers do not think people are likely to come to any harm in this study. People can use their eczema creams and treatments to help improve their symptoms and should speak to their usual healthcare professionals if needed.
Where is the study run from?
The study is being organised by Nottingham University Hospitals NHS Trust (the Sponsor) and is coordinated by the University of Nottingham. Participants join the study online and take part from home, so they can live anywhere within the UK.
When is the study starting and how long is it expected to run for?
May 2026 to August 2027
Who is funding the study?
National Institute for Health and Care Research (NIHR), UK.
Who is the main contact?
RapidEczemaTrials@nottingham.ac.uk
Contact information
Public
Nottingham Clinical Trials Unit
University of Nottingham
Applied Health Research Building
University Park
Nottingham
NG7 2RD
United Kingdom
 ORCID ID |
0000-0003-0652-3980 |
|---|---|
| Phone | +44 (0)115 8231600 |
| rapideczematrials@nottingham.ac.uk |
Principal investigator, Scientific
Centre of Evidence Based Dermatology
School of Medicine
University of Nottingham
Applied Health Research Building
University Park
Nottingham
NG7 2RD
United Kingdom
| ORCID ID |
0000-0001-7785-7465 |
|---|---|
| Phone | +44 (0)115 84 68632 |
| kim.thomas@nottingham.ac.uk |
Scientific
Centre of Evidence Based Dermatology
School of Medicine
University of Nottingham
Applied Health Research Building
University Park
Nottingham
NG7 2RD
United Kingdom
| ORCID ID |
0000-0003-4157-7394 |
|---|---|
| Phone | +44 (0) 115 84 68631 |
| Laura.Howells1@nottingham.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Allocation | Randomized controlled trial |
| Masking | Open (masking not used) |
| Control | Active |
| Assignment | Parallel |
| Purpose | Prevention, Supportive care |
| Scientific title | Impact of an online intervention to address the itch-scratch cycle on eczema symptoms, quality of life, disease control and patient enablement in children and adults with eczema: two online, superiority, randomised controlled trials |
| Study acronym | Scratch Less Study |
| Study objectives | AIM: To assess the impact of a 3-part online intervention on eczema symptoms compared with usual care over a period of 16 weeks in children and adults with eczema. OBJECTIVES: 1. To assess the impact on eczema symptoms of an online intervention addressing the itch-scratch cycle compared with usual care alone in two populations: 1.1. Children aged 8-12 years 1.2. Adults and young people (aged 13 years and over) 2. To explore barriers and facilitators in using the online intervention and inform routes to implementation. This study is part of the Rapid Eczema Trials project, which aims to answer many questions about how to manage eczema through the delivery of multiple online clinical trials (https://rapideczematrials.org/). An "Eczema Research Community" of people with eczema is helping to prioritise, design and run these studies. This means that the project will answer important questions for people with eczema. |
| Ethics approval(s) |
Approved 27/04/2026, London - Surrey Research Ethics Committee (2 Redman Place, Stratford, London, E20 1JQ, United Kingdom; +44 (0)207 1048088; surrey.rec@hra.nhs.uk), ref: 23/PR/0899 |
| Health condition(s) or problem(s) studied | Eczema in people aged 8 years and older |
| Intervention | INTERVENTION: A 3-part online programme to support management of itch and scratch for people with eczema plus usual care. CONTROL: Usual eczema care alone. The intervention is adapted from the ‘Kids in Control’ intervention developed by Dr Susannah Baron and team at King’s College London (https://ppopderm.org/project/kids-in-control/). Kids in Control uses a combined approach that educates on how to use eczema treatments alongside habit reversal techniques from behavioural psychology (raising awareness of scratching behaviour and replacing the behaviour). The Kids in Control intervention was designed to be delivered by a healthcare professional in an online group setting for 8-12-year-olds. Therefore, to make it suitable for evaluation in this study, we have adapted the intervention (with user testing through think-aloud interviews) to make it suitable for stand-alone self-directed online use and to create a version suitable for older children and adults aged 13+ years. The online programme is divided into 3 parts. It is self-directed, but it is suggested that each part is completed a week apart, with activities completed between sessions to put the learning into practice: Part 1: Individuals learn more about eczema and how to use the two main topical treatments for eczema (emollients and topical corticosteroids). Part 2: Individuals learn about the itch-scratch cycle in eczema and how to become aware of their scratching. They are encouraged to use a scratching diary to track their scratching. Part 3: Individuals learn a series of new activities they can try out to replace their scratching behaviour. They are encouraged to keep tracking their progress. Randomisation will be carried out by the participant using a secure, online system. Participants will be randomised 1:1 to either the intervention group (Scratch Less programme) or control group (usual care alone) separately for the two age groups (8-12 years and 13 years and over) using a minimisation algorithm with a probabilistic element balancing on the following factors: • Eczema severity POEM score (0-7 mild, 8-16 moderate, 17-28 severe) • Age (13+ years group only: 13 to 15, 16 to 25, 26 to 55, > 55 years) • Gender (male, female, other) • Use of systemic treatments or super potent topical corticosteroids (no, yes started less than 3 months ago, yes started 3 months ago or more) Following randomisation, participants in the intervention group will be provided with access to the online programme via an individual user account that will be created for them. Children aged 8-12 years will receive access to the ‘child version’ and use the intervention with parent/carer support. Participants aged 13 years or over will receive access to the 13+ version and use the intervention independently (unless help is required on an individual basis). All participants can use their usual eczema treatments (e.g. emollients and flare control creams) and will remain under the care of their usual healthcare professional during the trial. This is a decentralised clinical trial with screening, e-Consent, data collection and randomisation all taking place online. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
|
| Completion date | 31/08/2027 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 8 Years |
| Upper age limit | 120 Years |
| Sex | All |
| Target sample size at registration | 556 |
| Key inclusion criteria | 1. Aged ≥8 years with self-report of eczema (syn. atopic dermatitis, atopic eczema) 2. Able and willing to participate in the online intervention 3. Usual residence in the UK 4. Able and willing to give informed consent (or parent/legal guardian able and willing to give informed consent for children under 16 years) |
| Key exclusion criteria | 1. Diagnosis unlikely to be atopic eczema: only present on hands (likely to be hand eczema or contact dermatitis); limited to locations where skin is exposed to nickel, e.g. jewellery (likely to be contact dermatitis); eczema only around varicose veins (likely to be varicose eczema) 2. Taking part in another eczema intervention trial 3. Member of household has already agreed to take part in the Scratch Less trial |
| Date of first enrolment | 14/05/2026 |
| Date of final enrolment | 30/04/2027 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
Nottingham
NG7 2RD
England
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be available upon request from Nottingham Clinical Trials Unit (NCTU) (ctu@nottingham.ac.uk) in accordance with NCTU's data sharing procedure. Access to the data will be subject to review of a data sharing and use request by a committee, including the CI and sponsor and will only be granted upon receipt of a data sharing and use agreement. Any data shared will be de-identified. Consent from participants to share data was obtained. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol file | version 5.0 | 18/03/2026 | 13/05/2026 | No | No |
Additional files
Editorial Notes
13/05/2026: Study's existence confirmed by Health Research Authority (HRA) (UK).
