Bleach baths can be beneficial for people with chronic atopic dermatitis (AD). AD causes breaks in the skin’s protective surface, as does scratching, and that provides an opportunity for bacteria that live on the skin’s surface to create infections. Adding a small amount of bleach to the bath can help decrease the amount of bacteria on the skin and reduce the chance of infections.1
The do’s and don’ts of bleach baths
Use regular strength bleach (6%), not concentrated bleach, which would be much stronger than recommended.
Measure to ensure proper dosing: For a full standard size bathtub, use ½ cup of bleach. For a half-full bathtub, decrease the bleach to just ¼ cup. For a smaller bath, use 2 tsp of bleach for every 1 gallon of water.
Soak in a bleach bath for about 5-10 minutes.
After bathing, gently pat the skin dry. Leaving some dampness on the skin is preferable to completely toweling off. After patting the skin dry, a generous amount of moisturizer should be applied.
Use bleach baths up to three times a week.
As with all baths for people with AD, use warm water – not hot, which can trigger AD and worsen itching.
Don’t pour bleach directly onto the skin. Fill the tub to the desired level and add the appropriate measurement of bleach before getting into the tub. (Undiluted bleach is too strong and can irritate the skin.)
Moisturizers help repair the skin barrier, increase the hydration of the skin, and help control itchiness, redness, cracking, and lichenification (thickening of the skin). While bleach baths are beneficial for reducing the bacteria on the skin and reducing the number of infections, they can be drying, which makes the application of moisturizers immediately following bathing critical.1,4,5
Eichenfield LF, Tom, WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis. J Am Acad Dermatol. 2014;71:116-32.
American Academy of Dermatology. Accessed online on 7/10/17 at https://www.aad.org/public/diseases/eczema/atopic-dermatitis#bleach-bath.
Mayo Clinic. Accessed online on 7/10/17 at http://www.mayoclinic.org/diseases-conditions/eczema/expert-answers/eczema-bleach-bath/faq-20058413.
Medscape. Accessed online on 7/10/17 at http://emedicine.medscape.com/article/911574-treatment.
Tollefson MM, Bruckner AL. Atopic dermatitis: skin-directed management. Am Acad Pediatrics. 2014 Dec;134(6):e1735-1744. doi: 10.1542/peds.2014-2812.