A bleach bath for eczema is a therapeutic technique recommended by dermatologists that involves soaking the body in a highly diluted solution of household bleach and water. This method uses sodium hypochlorite, the active ingredient in bleach, at a very low concentration to help manage the symptoms of moderate to severe atopic dermatitis (eczema). Eczema is a chronic inflammatory skin condition characterized by a damaged skin barrier, making the skin susceptible to irritation and infection. The solution acts as an adjunctive treatment, used alongside standard therapies like topical corticosteroids and emollients, to relieve persistent itching, redness, and scaling.
Addressing Skin Bacteria Colonization
The medical rationale for a bleach bath centers on addressing the compromised skin microbiome frequently observed in people with eczema. Skin affected by eczema is often heavily colonized by the bacterium Staphylococcus aureus (S. aureus), a species not typically found in high numbers on healthy skin. This overgrowth of S. aureus worsens inflammation, leading to more intense itching and potential secondary skin infections. The bacteria produce toxins that act as superantigens, which overstimulate the immune system and drive the inflammatory cycle characteristic of an eczema flare-up.
The diluted sodium hypochlorite solution works to reduce this bacterial load on the skin’s surface, decreasing the colonization of S. aureus and other pathogenic microbes. While it was historically assumed that the bath directly killed the bacteria, current research suggests its benefit may also stem from a strong anti-inflammatory effect. Sodium hypochlorite can neutralize the toxins produced by S. aureus and may also possess properties that reduce overall skin inflammation. This dual action—reducing the microbial burden and calming the immune response—helps to break the cycle of irritation, colonization, and subsequent infection.
Safe Preparation and Administration Steps
The safety and effectiveness of this treatment depend entirely on achieving the correct, highly diluted concentration, similar to the chlorine level found in a public swimming pool. Begin by filling a standard-sized bathtub (about 40 gallons) with lukewarm water; hot water should be avoided as it worsens dryness. Next, measure a precise amount of regular, unscented household bleach, which typically contains between 5% and 8.25% sodium hypochlorite.
For a full, 40-gallon tub, the standard recommendation is to add one-half cup (about 120 milliliters) of bleach to the water. If the tub is only filled halfway or is smaller, use one-quarter cup of bleach, stirring the mixture well to distribute the sodium hypochlorite evenly. The goal is to reach a final concentration of approximately 0.005%, which is safe for the skin. Soak the body from the neck down for a short duration, typically five to ten minutes, taking care not to submerge the head or get the solution into the eyes.
Following the soak, drain the tub and rinse the skin thoroughly with fresh, plain lukewarm water to remove any residual bleach solution. The skin should then be gently patted dry with a clean, soft towel, avoiding rubbing that could cause irritation. The final step is the immediate application of prescribed topical medications and a generous amount of moisturizer to the damp skin, which helps seal in moisture and repair the skin barrier.
Important Safety Precautions and Follow-Up Care
Before starting any bleach bath regimen, consult with a dermatologist, especially when treating infants or young children. A healthcare provider can confirm the correct dilution for your specific tub size and provide personalized guidance based on the severity of the eczema. The treatment frequency is limited to two or three times per week, as excessive use can lead to skin dryness and irritation.
Certain conditions necessitate caution or prohibit the use of a bleach bath. The solution should never be used on skin with open wounds, deep cracks, or active burns, as this causes significant stinging and pain. Individuals with a known allergy to chlorine or those with asthma, where fumes might trigger a respiratory reaction, should also avoid this therapy. If any adverse reaction occurs, such as excessive redness, burning, or increased irritation, discontinue the treatment immediately and contact a medical professional for advice.