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From the Clinic #12: Atopic skin and hot water
- To be “in hot water” means to be “in trouble”.
- Hot water is certainly trouble for atopic skin.
With atopy there is a problem with the surface part of the skin, the epidermis. Non-atopic, normal epidermis has an effective barrier function. With atopy this barrier function is faulty.
Atopic skin is characteristically prone to drying out. There is a lack of natural oil that otherwise slows down the loss of water out through the skin. This insulation prevents the skin drying out too quickly.
The natural oils of the epidermis are easily dissolved in water. Add soap to the water and the situation gets worse. Use hot water and the result becomes especially hazardous. Just as washing the grease off dirty dishes is more efficient with hot water - so it is when washing the skin.
The so-called luxury of a good soak in a hot bath, or in taking a long hot shower, is no treat if you have atopic skin.
The protective epidermal oils melt in the heat and run away with the water. The skin is then left unprotected against water loss from below and rapidly dehydrates, leading to the so-called “prune” effect.
The skin surface puckers up, taking on the appearance of dried fruit.
So, to avoid problems washing atopic skin….
- Use an emollient as a soap substitute
- Apply it to the skin before contact with water
- Avoid hot water: warm is hot enough!
- After, pat the skin dry. No rubbing!
- Then apply another thin layer of emollient.