EczemaNet Spotlight Article
Bleach Baths May Help Control Atopic Dermatitis

Treating atopic dermatitis (AD) by adding bleach to your bathwater may sound like an old wives’ tale. After all, dermatologists recommend gentle, fragrance-free products for their patients with AD. Bleach hardly falls into this category. A bleach bath, however, may be exactly what your dermatologist orders.

Dermatologists have been prescribing dilute bleach baths for more than 20 years to patients with AD who get frequent skin infections caused by staph. These patients seem to benefit from soaking in a bath that contains a very small amount of bleach — about 4 ounces of bleach added to 40 gallons of water. Regular short soaks seem to reduce staph infections. With fewer staph infections, these patients appear to have less severe AD.

At least, this is what dermatologists have long suspected, but studies never confirmed this belief. To collect scientific data about this low-cost, easy-to-use treatment, dermatologists conducted a 2-year study. This study looked at whether taking dilute bleach baths could reduce staph infections in children with AD.

Study Finds Bleach Baths Effective
Between January 2006 and January 2008, 22 children aged 9 months to 17 years completed this study. These children had moderate to very severe AD and a staph infection when they began.

To clear the staph infection, all children were given cephalexin (an antibiotic) for 14 days. The children were then assigned to 1 of 2 groups. One group received mupirocin (an antibiotic) ointment and a bottle of bleach. The other group received products that do not typically treat infection — petroleum jelly and a bleach bottle that contained only water.

Both groups of parents received the same instructions. Add a few ounces of the liquid in the bleach bottle to the child’s bath twice a week. Apply the ointment just inside the child’s nose for 5 days in a row each month. These instructions were to be followed for 3 months.

During this study, the children continued to receive the topical (applied to the skin) medications and moisturizers they normally used to treat their AD. This helped ensure that changes would be due to the bleach baths and mupirocin.

The changes were significant. The children treated with the dilute bleach baths and mupirocin ointment fared significantly better. At the end of 3 months, they had fewer AD lesions, less skin affected by AD, and the severity of their AD had decreased. The other group did not have such favorable results. At the end of 3 months, most (70%) did not have any change and some (15%) worsened.

This study showed that adding dilute bleach baths and mupirocin ointment to a treatment plan can help control AD if a child gets regular staph infections. This can be very beneficial for people who have AD because staph can cause serious, repeat infections.

This study did not find out if dilute bleach baths and mupirocin ointment are safe and effective when used for a long time. More studies are needed to answer this.

Ask Your Dermatologist
Before trying this easy, cost-effective treatment, be sure to talk with your dermatologist. This treatment is not meant for everyone who has AD and should not be the only treatment for AD. If dilute bleach baths are what the dermatologist orders, these baths would be part of a complete treatment plan.

References:
Huang JT, Abrams M, Tlougan B et al. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics 2009; 123: e808-14.

Huang J, Paller A, Tlougan B et al. “Staphlycoccus aureus suppression with sodium hypochlorite baths and intranasal mupirocin decreases clinical severity of atopic dermatitis.” Presented as a poster (P3026) at the Annual Meeting of the American Academy of Dermatology, March 2009; San Francisco.

All content solely developed by the American Academy of Dermatology