Healthy Bathing

Bathing Tips for Eczema

Bathing can play a role in eczema in many different ways

young baby playing with toys while taking a bath
Credits: "Dean Wissing at Flickr.com"
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People with atopic dermatitis (eczema) can often struggle with finding the right products or lifestyle habits that work best to manage the skin condition they deal with on a regular basis. Generally speaking, people tend to figure out what works best for them over time, but it is possible that certain remedies may provide relief at one point in time and then work poorly at other times, or vice versa. 

Within the eczema community, hygiene is a common topic of discussion. Ideal bathing habits can be especially difficult for people with eczema to determine because no technique works for everyone, and each method of cleanliness can affect these patients in different ways. The length of time, the purpose, the products used during or after, and even the water itself may influence the symptoms. 

 

Intent

Bathing is often more than just cleanliness. Even the purpose of bathing can be much more than one would initially think by considering the psychological connections to eczema. Emotional stress and anxiety are associated with itch and flares in people with eczema,[1-3] so if the purpose and result of the bath are stress reduction, it is possible that these people may receive more benefits from bathing than simply cleansing.

 

Bathing Habits

How often, for how long, and at what temperature should one with eczema bathe? The answer is that those factors should be tailored to each individual, but there are some general patterns to consider. Two studies found that the severity of the condition is not related to the frequency of bathing,[4,5] but may be associated with a longer duration of bathing.[4] Higher temperatures affect eczema too. Water set to 113 degrees F (similar to a very warm bath or shower) can worsen itching in those with eczema.[6]

On the other hand, short baths in warm mineral-rich water may be helpful. Researchers showed that a twice daily, 10-minute soak in a hot spring bath that was 107 degrees F improved skin symptoms in 76% of patients with eczema.[7]

 

Bath Products

The products used in or during the bath can also make a difference. This can include products used on the skin when in the bath, as well as the products added to the bath itself. 

The products used on the skin can have dramatic effects on the symptoms of eczema. Some people can be sensitive to the dyes, fragrances, and scents that are added to some products.[8] A study found that hand washing practices showed that the group using soap had the largest worsening in symptoms, followed by high pH solutions, then sanitizer.[9] An evaluation of general hygiene habits found that patients with eczema are more likely to use bath oils than soap because the bath oils may be gentler on the skin.[10] 

The products used in the water can also improve or worsen the symptoms of eczema. A common product used in baths by patients with eczema is a small amount of chlorine bleach in the water to create a dilute bleach bath. Chlorine is the base for most types of bleach. A randomized, placebo-controlled study found that patients with eczema who soaked in a dilute bleach bath for 10 minutes twice per week showed a significant reduction in symptoms.[12] 

Bath salts, like those found in Epsom salt (magnesium sulfate) and the magnesium-rich dead sea salts, can improve water loss, skin hydration, and redness in patients with eczema.[13]

Essential oils are commonly added to bath water for many reasons, but they can have the potential to help or harm, depending on the essential oil. Certain essential oils like lavender, for example, carry a higher risk to cause skin allergies,[8] while others can be very soothing. Oils of Retama raetam, Artemisia princeps, and Matricaria recutita can all reduce itchiness.[14]

 

The Water

The water used for the bath may make a difference in eczema symptoms and possibly even change the chances of developing eczema later in life. Exposure to hard water early in life may increase the risk of developing childhood eczema later in life,[15,16] though water softeners do not necessarily provide any additional benefit to those who already have eczema.[17]

In conclusion, bathing can play a role in eczema in many different ways. Each bathing approach should be evaluated on an individual level, as the results of each treatment can vary between patients.

 

Check out our free Guide to Managing Eczema in Children eBook. 

 

* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.

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References

  1. Oh SH, Bae BG, Park CO, et al. Association of stress with symptoms of atopic dermatitis. Acta Derm Venereol.2010;90(6):582-588; PMID: 21057740 Link to research.
  2. Schut C, Kupfer J. [Itch and psyche]. Hautarzt.2013;64(6):414-419; PMID: 23760541 Link to research.
  3. Arck P, Paus R. From the brain-skin connection: the neuroendocrine-immune misalliance of stress and itch. Neuroimmunomodulation.2006;13(5-6):347-356; PMID: 17709957 Link to research.
  4. Koutroulis I, Pyle T, Kopylov D, et al. The Association Between Bathing Habits and Severity of Atopic Dermatitis in Children. Clin Pediatr (Phila).2016;55(2):176-181; PMID: 26149842 Link to research.
  5. Koutroulis I, Petrova K, Kratimenos P, et al. Frequency of bathing in the management of atopic dermatitis: to bathe or not to bathe? Clin Pediatr (Phila).2014;53(7):677-681; PMID: 24634423 Link to research.
  6. Fruhstorfer H, Hermanns M, Latzke L. The effects of thermal stimulation on clinical and experimental itch. Pain.1986;24(2):259-269; PMID: 3960572 Link to research.
  7. Kubota K, Machida I, Tamura K, et al. Treatment of refractory cases of atopic dermatitis with acidic hot-spring bathing. Acta Derm Venereol.1997;77(6):452-454; PMID: 9394980 Link to research.
  8. Giordano-Labadie F, Rance F, Pellegrin F, et al. Frequency of contact allergy in children with atopic dermatitis: results of a prospective study of 137 cases. Contact Dermatitis.1999;40(4):192-195; PMID: 10208505 Link to research.
  9. Wolfe MK, Wells E, Mitro B, et al. Seeking Clearer Recommendations for Hand Hygiene in Communities Facing Ebola: A Randomized Trial Investigating the Impact of Six Handwashing Methods on Skin Irritation and Dermatitis. PLoS One.2016;11(12):e0167378; PMID: 28030544 Link to research.
  10. Hon KL, Leung TF, Wong Y, et al. A survey of bathing and showering practices in children with atopic eczema. Clin Exp Dermatol.2005;30(4):351-354; PMID: 15953066 Link to research.
  11. Draelos ZD, Ertel K, Hartwig P, et al. The effect of two skin cleansing systems on moderate xerotic eczema. J Am Acad Dermatol.2004;50(6):883-888; PMID: 15153888 Link to research.
  12. Wong SM, Ng TG, Baba R. Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia. J Dermatol.2013;40(11):874-880; PMID: 24111816 Link to research.
  13. Proksch E, Nissen HP, Bremgartner M, et al. Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin. Int J Dermatol.2005;44(2):151-157; PMID: 15689218 Link to research.
  14. Kobayashi Y, Takahashi R, Ogino F. Antipruritic effect of the single oral administration of German chamomile flower extract and its combined effect with antiallergic agents in ddY mice. J Ethnopharmacol.2005;101(1-3):308-312; PMID: 15964726 Link to research.
  15. Chaumont A, Voisin C, Sardella A, et al. Interactions between domestic water hardness, infant swimming and atopy in the development of childhood eczema. Environ Res.2012;116:52-57; PMID: 22591883 Link to research.
  16. McNally NJ, Williams HC, Phillips DR, et al. Atopic eczema and domestic water hardness. Lancet.1998;352(9127):527-531; PMID: 9716057 Link to research.
  17. Thomas KS, Koller K, Dean T, et al. A multicentre randomised controlled trial and economic evaluation of ion-exchange water softeners for the treatment of eczema in children: the Softened Water Eczema Trial (SWET). Health Technol Assess.2011;15(8):v-vi, 1-156; PMID: 21324289 Link to research.