“In general, washing your skin is necessary for good hygiene; however, people with eczema have a compromised skin barrier and are at greater risk for bacterial colonization and skin infection,” explains Adam Wulkan, MD, the director of laser and cosmetic dermatology at Lahey Hospital and Medical Center in Burlington, Massachusetts. Also known as atopic dermatitis, eczema is a chronic skin disease that causes a variety of symptoms, including itchiness, swelling, redness, and scaling, according to the Mayo Clinic. Skin care is vital to eczema treatment, and bathing is vital to skin care — but just as the right bath products can soothe skin, the wrong ones can irritate it and bring on a flare-up. Even the temperature of the water you use may be triggering. Use these tips to make your shower a pleasant, healing experience. For one, bathing then moisturizing directly afterward can quench dry skin, according to the National Eczema Association (NEA). Secondly, water gets rid of bacteria and allergens that might otherwise linger on your skin, causing eczema flare-ups, according to the Cleveland Clinic. “Getting water on the skin is an important aspect of eczema skin health,” says Dr. Wulkan.
Shower vs. Bath: Which Is Better for Eczema-Prone Skin?
It depends. But in general, showering may pose less of a risk for a flare-up than a bath does. Part of the reason for that is baths tend to be longer than showers, and for people with eczema, it’s important to keep your time in the water short, advises the NEA. “Excessive water exposure can strip away the natural oils and sebum,” Wulkan says. Sebum is a mixture of fatty substances produced by your sebaceous glands that helps prevent water loss on your skin, notes the Cleveland Clinic. That’s not to say showers can’t also irritate skin. “I recommend no longer than a 10-minute shower — and ideally less,” says Wulkan. A too-hot shower can also pose problems for eczema. “While our heads may love hot showers, our skin does not — long exposures to water, particularly hot water, can strip the skin of essential oils, disrupting the outer skin layer,” says Joshua Zeichner, MD, a dermatologist and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Be sure to bathe with lukewarm water, which is typically 98.6 degrees Fahrenheit (though you can simply go by feel, or base it on room temperature), notes the Baylor College of Medicine. “The dangers come in when the showers or baths are long and too hot,” says Wulkan.
How Often Should You Shower When Managing Eczema?
Your skin may be more prone to eczema flare-ups when it isn’t clean, according to the Cleveland Clinic. Thus, the hospital recommends showering daily to get off all the day’s dirt and grime. Still, there are some differing philosophies on the topic, says Wulkan. “I agree with both the American Academy of Dermatology as well as the National Eczema Association, who feel that showering or bathing once daily is a good idea,” says Wulkan. “The critical part is the time, water temperature, products used and post-treatment moisturization,” he adds. Indeed, an article published in July 2016 in the Annals of Allergy, Asthma & Immunology found that bathing daily is effective for soothing the dry skin that can come along with eczema, as long as you do the “soak and seal” method. Ready to give your bathing routine an overhaul, and try the soak and seal method? Here’s a guide to getting your shower time right.
Before Showering
Have an eczema-friendly towel at the ready. “Ensuring that laundry detergents are free of dyes and fragrance is essential, and this is true for all laundry — not only towels,” says Wulkan. “There are fragrance-free fabric softeners and dryer sheets as well, but these are nonessential for washing clothes, so it’s often wise to forgo fabric softeners and dryer sheets altogether,” Wulkan adds.Have your products at the ready. Make sure your moisturizer and any treatments for your eczema (as recommended by your doctor) are handy in the bathroom, because you’re going to need them as soon as you get out.Test the water temperature. Draw your bath (if you’re taking one) or get the water going for your shower, and test the H2O to make sure it’s lukewarm.
While Showering
After Showering
Gently pat your skin dry. “Rubbing can further interrupt an already compromised skin barrier that can lead to an eczema flare,” says Wulkan.Apply your treatment. This may include your topical medicine, like a corticosteroidcream (as approved by your doctor), to eczema-affected areas if you have them.Whip out your moisturizer. Don’t wait any longer than three minutes after getting out to apply moisturizer, according to the National Eczema Association. You’ll want to lock in that H2O, stat. Apply your moisturizer liberally using downward strokesthe NEA notes, rather than stroking up and down or in circles.Let the moisture seep in. After applying your moisturizer, wait a few minutes before putting on clothes, the NEA advises.Put on eczema-friendly clothing. As far as fabric goes, opt for 100 percent cotton, bamboo, or silk, which may be most comfortable for people with eczema, according to the National Eczema Society.
Skip Soap-Based Products
As mentioned, these can cause irritation for eczema-prone skin. “Many soaps can be harsh and drying,” says Wulkan. One reason, the Eczema Foundation says, is that soap has a higher pH value than the skin (10 versus 5.5), and to keep flare-ups to a minimum, you want to use a cleanser that is of a similar pH level. “Gentle cleansers without fragrance, such as CeraVe or Cetaphil, are the best,” says Wulkan.
Avoid Anything With Fragrance or Labeled as Antibacterial
Also, you’ll want to stay away from products with fragrance or that are antibacterial, Wulkan adds. “Keep in mind that ‘unscented’ may still have fragrances, so ensure that any products you buy say ‘fragrance-free’ and ‘sensitive skin,’” says Wulkan. Beware of big health claims on the bottle, too. “Just because something is ‘natural’ doesn’t mean it’s gentle on the skin,” Wulkan adds.
Opt for Oil in Your Moisturizer
When it comes to choosing an eczema-friendly moisturizer, the oilier the better. “An ointment, such as Vaseline, is the ultimate moisturizer — the problem is that it can be too greasy for many patients to apply to their entire skin,” says Wulkan. “Therefore, I typically recommend a cream, which is the next best thing,” he says. Meanwhile, lotions are often less oily, and not as effective for people with eczema, so the American Academy of Dermatology advises skipping them. The American Academy of Dermatology also suggests buying moisturizers that are dye-free and fragrance-free, too.
Special Baths That Can Help Soothe Eczema Symptoms
Interested in taking a special bath to help your eczema even further? Ask your doctor if one of these soaks may be a good fit for you.
Bleach Baths
A bleach bath sounds harsh, but adding just a small amount of bleach may help with eczema symptoms, the Mayo Clinic notes. Bleach can potentially kill bacteria on the skin as well as reduce itching, redness, and scaling, they add. The Mayo Clinic advises adding ¼ cup to ½ cup of bleach to a 40-gallon bathtub of water, depending on whether you have a half-full or full tub (and remember to make sure that the water isn’t hot). Stay in for a maximum of 10 minutes — soaking from your neck down — and repeat no more than three times a week. Also, if it’s irritating to your skin, rinse and pat dry with a towel.
Oatmeal Baths
Research has found that compounds in colloidal oatmeal help ease inflammation and reduce itch, and could be a beneficial therapy for those with atopic dermatitis.
Baking Soda
If you’re taking a bath and have an uncomfortable itch, try adding a handful of baking soda, which the American Academy of Dermatology notes can be calming to skin.
Natural Oils
While not all oils are helpful for people with eczema, certain ones can be added to your bath for a little bit of eczema relief. The NEA suggests pouring a small amount of eczema-friendly natural oil into your bath to reduce skin irritation caused by the water. Some oils with benefits include virgin coconut oil, virgin sunflower seed oil, and jojoba oil — however, the group notes that olive oil may be irritating for people with eczema because of its fatty acids. Also, these oils can make the bottom of the tub super-slippery, so exit your bath with caution.
One Last Thing About Bathing When Living With Eczema
Even though showering — or bathing — may seem complicated for someone with eczema, if you keep things consistent, it will likely become as easy as your previous showering routine. And when in doubt, ask your dermatologist, who can give you suggestions for the best shower and bath products, as well as share advice on natural remedies to try and avoid.
