Eczema, also known as atopic dermatitis, is a condition which is allows for the skin to first become itchy, then to ultimately rash out into what appears a scaly red rash. The skin of an eczema patient lacks some critical proteins which regulate the barrier and hydration status of these patients.
It is very common in children, especially those younger than five, but fortunately, they tend to outgrow it. There is a percentage of our population who tend to have eczema for life. These become dermatology patients for life as well.
A very interesting study was performed in the area of dermatology, specifically in regards to eczema patients, which revolutionized the way we treat those patients. The study had two groups of patients—a control group which would not receive treatment, and a second study group which would receive treatment. The study looked at what would happen if ½ cup of plain household bleach was poured into a bathtub of water three times per week. The control group did not use any bleach. What was so interesting about this study to me was that the results were so terrific in the bleach bath group that the researchers had to switch all of the patients into the study group for ethical reasons. How could they continue to not offer treatment when the results were so astounding? The bleach bath group had a significant decrease in the number of eczema flares they experienced, thus requiring a lot less medical treatment such as topical steroids or even oral steroids and antihistamines. Plus, the cost of the treatment was so minimal. A ½ cup of bleach costs pennies on the dollar.
Dermatologists around the country immediately began to incorporate bleach bathing into the skincare regimen of their eczema patients. Prior to that time, there was even a question about how frequently these eczema patients should bath in general—not even bleach bathing. The concern was that the more they might bath, the worse the eczema might become. However, the study showed a really important point. The fact that the bleach bathing showed such significant results proved that the higher levels of naturally-occurring bacteria on the skin was somehow worsening or exacerbating the eczema flares. By using the bleach bath, the naturally-occurring bacterial counts were reduced significantly, and therefore there was less flaring of the eczema.
Of course, it is important to note that no matter what, all eczema patients should hydrate their skin daily, especially immediately following bleach bathing, in order to seal in the moisture. Note that daily hydration is mandatory. If these patients skip even one day of hydration using a cream-based, not lotion-based, moisturizer, they will risk an eczema flare. Thus, daily moisturization is a mainstay of treatment.
Other treatments include topical and oral steroids and antihistamines and sometimes keratolytic agents that can smooth the skin in areas where it is more rough and scaly. But, as my grandparents used to say, “An ounce of prevention is worth a pound of cure”. With eczema, this statement holds firm and true.