Cleanliness and atopic eczema

author/source: DrB



Does bathing frequency matter with atopic eczema?


A recent thoughtful review highlights a lack of agreement.

Because unprotected contact with water can lead to dry skin and an impairment of the epidermal barrier, infrequent bathing - less than once a day - may be recommended.

However the result can then be relatively poor control of atopic eczema, and sometimes complicating skin infection.

On the other hand, frequent bathing - at least once a day - may be recommended, with use of emollients and other measures incorporated.

Then it seems possible to keep the skin soft and flexible, with an intact epidermal barrier and good control of eczema, without risk of infection.



Cardona et al (2016)  Does bathing frequency matter in paediatric atopic dermatitis?

Ann Allergy Asthma Immunol 117  9-13




With The Combined Approach we recommend:


  • wash at least once a day 
  • have clothing ready beforehand to get into quickly afterwards
  • apply a preferred emollient thinly everywhere immediately before and immediately after washing
  • use a soap substitute to wash with
  • avoid use of any abrasive object, such as a brush, or loofah
  • avoid hot water
  • limit time spent in contact with water - a few minutes only is adequate
  • avoid leaving children unsupervised: distract and divert from any scratching  
  • consider use of a shower rather than a bath - contact with water can then be minimised
  • pat - rather than rub - the skin dry, with a soft towel
  • once dressed children may need diversion with pleasurable activity to avoid risk of scratching 






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