Should You Use Bleach Baths to Treat Atopic Dermatitis (Eczema)?

When it comes to atopic dermatitis (commonly known as eczema) and other skin conditions, a diluted solution of an everyday cleaning product known for whitening clothes may be part of an effective treatment plan.

Back in 2009, researchers from the Northwestern University Feinberg School of Medicine in Chicago decided to look into just how well diluted bleach baths reduced rashes and flare-ups in individuals with eczema. Their study, published in the journal Pediatrics, involved 31 patients, ages 6 months to 17 years, with moderate to severe atopic dermatitis and clinical signs of bacterial infections.

The scientists found that patients receiving bleach baths had a reduction in eczema severity that was 5 times greater than those treated with placebos over one to three months.

Since that time, the home remedy has grown in popularity as a possible therapy to decrease scratching, lower the risk of infection, and improve quality of life for children and some adults as well.

“I don’t necessarily recommend bleach baths to every patient with eczema or psoriasis; however, I do find that for patients who tend to have recurrent infections, bleach baths can be very helpful,” says Dawn Marie Davis, MD, a dermatologist and division chair of clinical dermatology with Mayo Clinic in Rochester, Minnesota.

Bleach Baths May Protect Against Infection

Atopic dermatitis tends to produce an overgrowth of certain bacteria, fungi, and other microorganisms on the skin, particularly a type of bacteria called Staphylococcus aureus. If the skin breaks (through scratching, for example), the bacteria can gain access to underlying tissues or the bloodstream and cause an infection.

“Your skin is like a brick wall, and any time that brick wall is degraded a little bit, cracks open and allow microbes to go in the body and establish themselves more readily,” says Dr. Davis.

Infections of the soft skin tissue can lead to boils (sometimes called furuncles) or cellulitis and cause discoloration, swelling, and pain.

If the bacteria gets into the blood, infection can lead to pneumonia or even sepsis, an overwhelming and life-threatening response that may result in tissue damage, organ failure, and death.

A bath with diluted bleach can help heal atopic dermatitis rash and skin infections caused by staph. For some, a soak in diluted bleach also reduces the need for topical steroids and antibiotics.

“We don’t say to only do bleach baths, but it’s certainly one of the tools we have in our toolbox to help patients with atopic dermatitis,” says Whitney High, MD, director of dermatopathology at University of Colorado School of Medicine in Anschutz. While the treatment can help patients of all ages, it may work best with children who more frequently get staph infections of the skin.

In addition to treating eczema, a diluted-bleach bath can help with psoriasis when the skin becomes scaly or dry and cracked, as this can harbor a lot of infection-causing microorganisms as well, according to Davis.

How to Prepare a Bleach Bath for Eczema

The American Academy of Dermatology offers instructions on how to prepare a therapeutic and safe bleach bath.

1.  Use regular strength (6 percent) bleach for the bath. Do not use concentrated bleach.
2. Use a measuring cup or measuring spoon to add the bleach to the bath. Precision is important; adding too much bleach to the bath can irritate the skin, while adding too little may not help.
3.  Know how much bleach to add to the bath. For a full bathtub of water, use a half-cup of bleach. For a half-full tub of water, add a quarter-cup of bleach. For a baby or toddler bathtub, add 1 teaspoon of bleach per gallon of water.
4.  Never apply bleach directly to skin. While the tub is filling, pour the bleach into the water. Be sure to wait until the bath is fully drawn and bleach is poured before entering the tub.
5.  Talk with your dermatologist about how long you should soak in the tub. Most dermatologists recommend a 5- to 10-minute soak, and not going beyond 15 minutes. Sitting in the solution for longer could damage skin. Davis advises patients to do the bath two days a week but not consecutively — leaving two to three days between each treatment.
6.  Pat skin dry after the bath. If on an eczema medication, apply that immediately after the bath and then moisturize the skin. “You can try to counterbalance the stripped or dry skin feeling after a bleach bath by using extra moisturizer, creams, or lotion,” Davis says.

The National Eczema Association also says to use water that is not excessively hot or too cold, to not add anything else to the water, to not submerge head or face under the water, and to consult with a healthcare provider first before trying a bleach bath or giving one to your child for the first time.

Dr. High notes that fewer living spaces seem to have bathtubs nowadays, so if soaking is not an option, applying a very weak bleach solution via spray bottle, wash cloth, or cloth wrap might work — although it can be more difficult to get the correct ratio of bleach to water when mixing small amounts.

Is Bleach the Only Solution?

Many people know bleach as an effective cleaning product because it can kill bacteria, fungi, and viruses, and that same antimicrobial action works on the skin as well.

For those who do not like bleach (for the smell or other reasons), Davis says alternatives like a salt bath or a vinegar bath, as detailed by the National Eczema Association, may produce similar results.

“Ultimately, what they all have in common is they alter the pH [acidity] of the water and help cleanse the skin,” she says.

Could a Soak in Warm Water Help Even Without Bleach?

High warns that some research looking at the effectiveness of bleach baths has been mixed and warm water might be just as helpful.

A paper published in 2017 in the Annals of Allergy, Asthma, and Immunology evaluating results from five previous studies found that bleach baths do not appear to be more effective than water baths alone.

“We can't separate out if it is the bleach water or the bathing regimen that is contributing to better outcomes,” says High, stressing that more research is needed.