Water baths as good as bleach baths for treating eczema

November 15, 2017 by Kristin Samuelson, Northwestern University
Water baths as good as bleach baths for treating eczema
Credit: Northwestern University

For patients suffering from eczema (atopic dermatitis), dermatologists will sometimes recommend bleach baths to decrease bacterial infection and reduce symptoms. But a new Northwestern Medicine study found no difference in the effectiveness of a bleach bath compared to regular water baths. In addition, bleach baths can cause stinging and burning of skin, and occasionally even trigger asthma flare-ups in patients.

"I don't know if it throws the baby out with the bathwater, but bleach baths lack the evidence to support how commonly they are being recommended," said senior author Dr. Jonathan Silverberg. "The baths appear to be doing most of the heavy lifting. If bleach is adding any benefit, it's quite modest."

Silverberg is an assistant professor of dermatology at Northwestern University Feinberg School of Medicine, a dermatologist at Northwestern Medicine and director of Northwestern Medicine's Multidisciplinary Eczema Center.

The study was published in the journal Annals of Allergy, Asthma and Immunology Nov. 13.

The results should encourage patients with eczema to bathe regularly, Silverberg said. Many shy away from bathing for fear that it will dry out their skin, he noted.

A bleach bath is a bath with warm or cool water mixed with a small amount of bleach. Patients are instructed to submerge in the bath from the neck down and to avoid exposure of bleach near the eyes. Water baths contain only warm or cool water, and patients can use a bleach-free washcloth to wash their face.

Soap may not be necessary during water baths because it can be hard on sensitive skin, and Silverberg said soaking for 10 minutes in only water will effectively "wash away most the germs and crud from your skin." After the bath is complete, patients are encouraged to apply ample moisturizer.

The study, a systematic review and meta-analysis of all available studies comparing bleach and water baths (four in total), showed water baths were just as effective as bleach baths at reducing the severity of the visible signs and extent of eczema and .

Bleach is an additional expense for patients, another reason water baths are a better alternative. Bleach also can stain towels, linens and other clothing, sting or burn the eyes and open sores on the skin, and Silverberg has seen some patients experience asthma flare-ups from the bleach fumes.

"Patients with eczema have much higher rates of asthma than non-eczema patients," Silverberg said. "Everyone's home setting is going to be different, and many bathrooms don't have great ventilation, so a warm bath that causes the bleach to fume can be the perfect setup to potentially have an asthma flare-up."

The study also highlights flaws and inconsistencies in current bleach bath studies. Many of the studies in the review did not control for whether patients immediately moisturized after the bath to prevent dryness. They also did not take into account if used soap or the types of soap they used in water baths.

"This study provides a blueprint for improving future bleach bath studies," Silverberg said.

Explore further: Eczema cases rising among US children

More information: Rishi Chopra et al, Efficacy of bleach baths in reducing severity of atopic dermatitis: A systematic review and meta-analysis, Annals of Allergy, Asthma & Immunology (2017). DOI: 10.1016/j.anai.2017.08.289

Related Stories

Eczema cases rising among US children

November 24, 2014
(HealthDay)—A growing number of children are being diagnosed with the allergic skin condition eczema—but it can usually be eased with topical treatments, according to a new report.

Eczema can take a toll on adults

July 27, 2017
(HealthDay)—The itchy, rashy skin condition eczema sometimes takes a heavier toll on adults than children, an expert says.

Eczema's effects more than skin deep

July 29, 2016
(HealthDay)—People dealing with the itchy skin condition known as eczema may have other medical conditions to cope with as well, including heart disease, a dermatologist says.

Inflammatory skin damage in mice blocked by bleach solution, study finds

November 15, 2013
Processes that age and damage skin are impeded by dilute bleach solution, according to a new study by researchers at the Stanford University School of Medicine.

Eczema woes not just skin deep

January 15, 2015
Eczema wreaks havoc on its sufferers' lives with health problems that are more than skin deep. Adults who have eczema—a chronic itchy skin disease that often starts in childhood—have higher rates of smoking, drinking ...

Recommended for you

A synthetic approach to helping the immune system thwart infections

February 22, 2018
Yale researchers have developed a set of synthetic molecules that may help boost the strength of a key, virus-fighting protein.

Scientists find molecular link between Vitamin A derivative and mouse intestinal health

February 22, 2018
New research shows that all-trans-retinoic acid (atRA), the active form of vitamin A, regulates immune system responses in the mouse intestine by controlling expression of the protein HIC1 in cells known as innate lymphoid ...

Animal study shows how to retrain the immune system to ease food allergies

February 21, 2018
Treating food allergies might be a simple matter of teaching the immune system a new trick, researchers at Duke Health have found.

Preventive treatment for peanut allergies succeeds in study

February 20, 2018
The first treatment to help prevent serious allergic reactions to peanuts may be on the way. A company said Tuesday that its daily capsules of peanut powder helped children build tolerance in a major study.

'Icebreaker' protein opens genome for T cell development, researchers find

February 20, 2018
Almost all cells in the human body have identical DNA sequences, yet there are 200-plus cell types with different sizes, shapes, and chemical compositions. Determining what parts of the genome are read to make protein and ...

Infection site affects how a virus spreads through the body

February 20, 2018
A person is more likely to get infected by HIV through anal intercourse than vaginal, but no one knows quite why. A new study by scientists at the Gladstone Institutes shows that infection sites could affect the immune system's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.