Water Baths As Effective As Bleach Baths for Eczema

Water baths are as good as bleach baths for treating eczema, and they are safer, finds a new Northwestern Medicine study.

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,” says senior author Dr. Jonathan Silverberg, 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, in a news release. “The water baths appear to be doing most of the heavy lifting. If bleach is adding any benefit, it’s quite modest.”

The study appears in the journal Annals of Allergy, Asthma and Immunology.    

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

Soap may not be necessary during water baths because it can be hard on sensitive skin, and Silverberg says 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 bacterial infection.

Bleach baths can sometimes lead to asthma flare-ups in certain patients with eczema.

“Patients with eczema have much higher rates of asthma than non-eczema patients,” Silverberg says. “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 patients used soap or the types of soap they used in water baths.

The study was funded by the Agency for Healthcare Research and Quality, grant number K12 HS023011, and the Dermatology Foundation. Other authors include Rishi Chopra, Paras Vakharia and Ryan Sacotte, research fellows in the department of dermatology at Feinberg.