An Unusual, but Simple Strategy to Help Ease Eczema
Eczema (or atopic dermatitis) is a common skin condition that affects approximately 15-30% of children and 2-10% of adults. Eczema is the result of multiple genetic and environmental factors that cause hyper-reactive immune reactions. When stimulated by certain triggers (such as staphylococcal bacteria, allergens, food, and irritants), a cascade of immune responses is activated by the body for protection, and it is this overreaction that produces the patches of eczema. Skin areas with active eczema can be characterized by dryness, itching, redness, inflammation, and infection.
Children with Eczema
In 85% of pediatric eczema patients, the first sign of their dermatitis appears before 5 years of age. Skin lesions can often become so itchy that it causes sleep disturbances and creates difficulties in concentration, which is of particular concern in young children. Intense itching can cause scratching that leads to further tissue damage and increases the opportunity for infection. Furthermore, children are especially susceptible to developing social avoidance behaviours due to their self-consciousness of visible lesions and their fear of being teased. Successful ongoing management is crucial amongst younger eczema patients in order to establish normal routines and improve quality of life.
Staphylococcus aureus (S. aureus) is a type of bacteria that commonly lives on healthy skin without causing any harm. In eczema, due to the predisposition for hypersensitive immune reactions, even normal collections can cause flare-ups, as the body attempts to defend against bacteria on the skin’s surface. In addition, breaks in the skin from scratching can lead to secondary infections caused by S. aureusovergrowth. The itch-scratch cycle can result in chronic skin infections that become difficult to treat, especially if methicillin-resistant Staphylococcus aureus (MRSA) is the colonizing microorganism.
Clinical Study on Bleach Baths
The well known properties of bleach include its whitening ability on fabrics and its bactericidal effects. The strong antibacterial effects of bleach make it a useful chemical agent for disinfecting and sterilizing. Regardless of the application, bleach must be used with caution because it is harmful if ingested or inhaled.
Researchers from Northwestern University Feinberg School of Medicine have discovered a novel way to use household bleach that helps eczema sufferers to control bacterial growth, a common complication that causes flare-ups and infections. Simply adding half a cup of regular bleach to bath water produces an antiseptic effect that reduces the number of bacteria living on the skin. [Huang JT, et al. Treatment ofStaphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009 May;123(5):e808-14.]
Before conducting the study, researchers suspected that bleach, which is commonly used in hospitals as a disinfectant to control the spread of MRSA bacteria, could also be employed as a decolonization strategy to reduce S. aureus infections in eczema patients. The study involved 31 patients, who ranged in age from 5 months to 17 years, with moderate to severe eczema and signs of secondary bacterial infection. After 1 to 3 months, patients using the bleach bath regimen (intranasal antibiotic ointment with bleach baths) experienced a 5 times greater reduction in eczema severity than those who received the placebo treatment (intranasal petrolatum ointment and plain water baths). It is also worth noting that study participants in the group using bleach baths also received intermittent intranasal applications of an antibacterial ointment (mupirocin), because the nose is a primary site of colonization by both S. aureus and MRSA.
Highlights from Study Findings
- Study investigators found that giving diluted bleach baths to pediatric patients decreased the signs of infection and improved the severity and extent of the eczema lesions.
- Additional benefits observed included reductions in scratching, infections, and improved quality of life for the affected children.
- Of particular interest is that eczema located on the body, arms, and legs improved significantly with the bleach baths, but the face, which was not submerged in the bath, showed no improvements, further supporting the beneficial effects of diluted bleach baths. Accordingly, the researchers suggest that children who have eczema on their face could close their eyes and mouths and submerge briefly under the water to help improve facial lesions.
- The bleach baths may also be useful for individuals who experience recurrent staphylococcus infections.
- Incorporating bleach baths as part of routine skin care for eczema can be an inexpensive and effective way to control bacterial colonization and reduce the frequency and severity of flare-ups.
- By adding a half cup of household bleach to a full bath, reductions in bacteria counts on the surface of the skin can be achieved.
- The bleach should be added to a bath tub that is then filled with lukewarm water.
- Soak in the bath for 2 to 20 minutes – the exact duration and frequency should be determined by your doctor.
- Rinse off after the bath, pat dry your skin, and apply a bland moisturizer while the skin is still damp to trap moisture in the skin.
- Medicated treatments can then be applied to any areas with eczema.
- Diluted bleach baths are usually restricted to once a week, since they can be irritating to the skin, and should only be included as part of a comprehensive therapeutic program that is guided by your doctor.
For many years, the over and improper uses of oral and topical antibiotics have created increasing bacterial resistance. Bleach baths represent an effective management strategy that can reduce the need for antibiotics and avoid contributing to the rise in resistant strains of staphylococcal bacteria. Furthermore, antimicrobial baths that aid in reducing flares may also limit the need for other drug treatments, such as topical corticosteroids.
Given its chronic nature, the treatment of staphylococcal infections in patients with eczema is a common, but persistent challenge. The majority of eczema patients carry S. aureus on their skin, and coupled with defects in the skin barrier that permit bacteria to penetrate, infections become a common occurrence. Consequently, treatment approaches aimed at controlling bacterial populations are required. The study conducted by Northwestern University researchers demonstrates that diluted bleach baths can inhibit the growth of S. aureus, which reduces the frequency and severity of flare-ups and infections, thereby potentially providing substantial relief to those with eczema.
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