Eczema (atopic dermatitis) is a chronic inflammatory skin condition characterized by cycles of dry, itchy, and inflamed skin. The compromised skin barrier makes the skin highly susceptible to bacterial colonization, which can trigger and worsen flare-ups. Dermatologists sometimes recommend adjunctive therapies to manage acute periods and reduce the risk of secondary infections. Diluted bleach baths are a safe, simple, and effective method when specific safety protocols are followed.
The Role of Bleach in Eczema Management
The skin of many individuals experiencing eczema flares is heavily colonized by the bacterium Staphylococcus aureus. This bacterial overgrowth forms biofilms and produces toxins that stimulate inflammation and intensify eczema symptoms. Historically, the primary hypothesis was that the diluted bleach solution acted as a topical antiseptic to reduce this bacterial load.
Current research suggests the mechanism is more complex than simply killing bacteria. Studies indicate that the low concentration of sodium hypochlorite may help by reducing inflammation and improving skin barrier function. This effect appears to reduce redness, itching, and scaling, offering relief from persistent flare-up symptoms. The practice has been shown to reduce the severity of eczema symptoms in many patients.
Identifying the Appropriate Household Bleach
The only product suitable for a therapeutic bath is regular, plain, unscented household chlorine bleach. Check the label to confirm the main active ingredient is sodium hypochlorite, typically present in concentrations ranging from 5% to 8.25%. Avoid all varieties advertised as “splash-less,” “gel,” “color-safe,” or those containing added scents or detergents, as these chemicals can irritate sensitive skin.
Highly concentrated or industrial-strength bleach products should never be used because they make accurate and safe dilution nearly impossible. If the bleach concentration is at the higher end of the standard range (e.g., 8.25%), the amount added to the bathwater should be slightly reduced to maintain the correct final concentration. Ensure the product is fresh, as the concentration of sodium hypochlorite decreases over time once the bottle is opened.
Guidelines for Safe Bleach Bath Preparation
Measuring and Dilution
Safe preparation requires precise measurement to ensure the final concentration of sodium hypochlorite is extremely low, generally aiming for about 0.005%. For a standard full-sized bathtub (approximately 40 gallons of water), the recommended amount is no more than one-half cup (about 118 milliliters) of regular-strength household bleach. For a half-full tub (about 20 gallons), this measurement should be reduced to one-quarter cup. Use a dedicated measuring cup to ensure accuracy, as mismeasuring the bleach is the most common cause of irritation.
Bath Procedure
Fill the tub with lukewarm water, as hot water can dry out the skin and worsen eczema symptoms. Add the measured bleach and stir the water to ensure the sodium hypochlorite is thoroughly dispersed before entering the bath. The soak time should be limited to 5 to 10 minutes, and should not exceed 15 minutes. Avoid submerging the head or face in the water, and ensure adequate ventilation to minimize the inhalation of chlorine fumes.
Post-Bath Care
After soaking, the skin must be thoroughly rinsed with clean, plain lukewarm water to remove any residual bleach solution. This rinsing step is necessary for safety and comfort. Gently pat the skin dry with a soft towel, avoiding rubbing, which can aggravate the eczema. Immediately follow the bath with a generous application of prescribed emollients or moisturizer to lock in hydration while the skin is still slightly damp. Bleach baths are typically used only two or three times per week.
Recognizing Adverse Reactions and When to Stop
While generally safe when properly diluted, some individuals may experience adverse reactions. The most common side effects include increased stinging or burning sensations, especially if the skin is cracked or raw from scratching. Excessive dryness (xerosis) or an increase in redness (erythema) can occur if the concentration is too high or if the bath is taken too often.
Individuals with a known allergy to chlorine or respiratory conditions, such as asthma, should exercise caution, as the fumes can be irritating. If any signs of severe irritation, blistering, or a worsening of the eczema rash occur, the practice should be stopped immediately. Always consult a healthcare professional before beginning this treatment, and seek medical advice if symptoms persist or show signs of infection.