Skin Care Tips and Routines
Reviewed by: HU Medical Review Board | Reviewed June 2022
Since atopic dermatitis (eczema) is a chronic and relapsing skin condition, treatment strategies include treating and preventing flares. A critical part of treating and preventing relapses of atopic dermatitis is good routine skin care. Routine skin care involves bathing and moisturizing the skin, as well as avoiding skin irritants and scratching.
Bathing with eczema
While some doctors have proposed that bathing too often may dry out the skin even more, most dermatologists agree that bathing can help hydrate the skin as well as remove any bacteria or other microorganisms that can cause infection. People with atopic dermatitis are at a greater risk of infection due to the damage to the skin barrier and scratching, which can further break the skin and introduce microorganisms. 1,2
Tips for bathing or showering
Daily bathing or showering should be done using lukewarm water. Short showers or baths for less than 10-20 minutes are recommended to rehydrate the skin. Cleaning the skin should be done with a mild moisturizing soap that is fragrance-free and with a neutral or low pH, or with a non-soap cleanser, as harsh soaps can trigger atopic dermatitis. 3
Bleach baths for skin infections
For people with atopic dermatitis who have repeated skin infections, bleach baths can be helpful to decrease the amount of bacteria on the skin’s surface and reduce the chance of infections. Bleach baths involve adding 2 teaspoons of bleach per gallon of water. (A typical bathtub holds between 25-40 gallons of water.)1 Before attempting a bleach bath, check with your doctor to see if this alternative option is right for you!
Regularly moisturizing the skin
The regular use of moisturizers is one of the most important aspects of caring for skin with atopic dermatitis. Moisturizers are one of the basic necessities for people with atopic dermatitis, regardless of the severity of their disease.
Types of moisturizers
There are different types of moisturizers that may be used by people with atopic dermatitis, including:
- Humectants, which attract and bind water from deeper layers of the skin
- Emollients, which contain lipids (fats) naturally found on the skin and smooth skin by lubricating the skin
- Occlusives, which form a hydrophobic film to reduce the loss of water from the skin 4
How to decide which moisturizer is best
The choice of moisturizer is usually determined by several factors, such as individual preference, safety, effectiveness, and the absence of fragrances or other chemicals that may cause sensitivity.4 Most often, a cream or ointment will be recommended given that they are more moisturizing.
Wet wrap therapy
With or without topical corticosteroids, wet-wrap therapy is another technique that can help moderate to severe atopic dermatitis. Wet-wrap therapy involves applying the medication (if using) and wrapping the affected area in a layer of wetted gauze, cotton, or bandages, followed by a layer of dry bandages. Wet-wrap therapy helps improve the moisture of the affected skin, improves the penetration of the topical medicine, and provides a physical barrier against scratching. 10 Only use wet wrap therapy under the direction of your doctor, they will be able to instruct you on the proper dosage and frequency of using wet-wrap therapy.
Irritants are substances that irritate the skin. People with atopic dermatitis are more sensitive to irritants because atopic dermatitis damages the skin’s natural barrier.
Common eczema irritants
- Wool clothing
- Man-made or synthetic fibers, such as rayon, acrylic, nylon, polyester, spandex, or modacrylic (often used in children’s sleepwear to be flame-resistant)
- Soaps or bubble bath, particularly those that change the skin’s natural pH
- Some laundry detergents
- Cleaning solutions, including dish soap, disinfectants, or surface cleaners
- Chemicals like chlorine, mineral oil, or solvents
- Dust or sand
- Cigarette smoke 5-7
It may take some experimentation, such as switching brands of soaps or laundry detergent, to identify an individual’s personal sensitivity to irritants that trigger their atopic dermatitis. Avoiding irritants may involve wearing clothes from natural fibers, avoiding certain perfumes or cosmetics, and wearing rubber gloves when cleaning with detergents. 8
Itching and scratching
The itch associated with atopic dermatitis is the most prevalent and distressing symptom, and both the symptom of itching and the scratching it provokes significantly contribute to the burden of atopic dermatitis. People with atopic dermatitis are advised to avoid the triggers for itch, including dry skin, hot baths or showers, sweat left on the skin, emotional stress, and irritants. There are also medications that can help reduce inflammation.9