There is a common perception that bleach baths prevent recurrent infections that are commonly responsible for eczema flares, especially in kids. How true is this? Do bleach baths help? Are they safe?

This excellent review article below discusses these very issues and the pros and cons.

The Gist:

• Bleach baths when administered correctly can be effective in preventing infections, particularly since bleach (Sodium Hypochlorite) is effective against bacteria, fungi, spores etc, is inexpensive, widely available and has no potential for antibiotic resistance.
• However this is not really safe as the concentration of bleach in commercial preparations varies and it is difficult to make up the current safe concentration necessary. More importantly we do not really know the safe concentration.
• Moreover, bleach products also generally contain fragrances and other chemicals that have been shown to be irritants, which may aggravate eczema.Thus irritant reactions and exacerbation of dermatitis are much more likely to occur, outweighing the benefits. Asthmatic attacks may also be triggered.

My Verdict: Until further studies are available bleach baths are best avoided and it is better to stick to antiseptic bath alternatives available (ex: chlorhexidine, povidone iodine, etc), to prevent recurrent infections in kids with eczema.

Barnes, T. M. and Greive, K. A. (2013), Use of bleach baths for the treatment of infected atopic eczema. Australasian Journal of Dermatology. doi: 10.1111/ajd.12015

Abstract

Atopic eczema is one of the most common skin disorders in young children and also affects adults. Staphylococcus aureus infection is the most frequent complication of atopic eczema and is involved in the worsening of the disease. Antibiotic therapy against S.?aureus has been an important component of treatment for atopic eczema but there are concerns about antibiotic overuse and increasing bacterial resistance. This has led some clinicians to recommend the use of homemade remedies such as bleach baths as an adjunctive treatment for patients with infected atopic eczema, despite the fact that there have been few published studies in this area. Balancing safety concerns with efficacious treatment is of particular importance in the paediatric population. This review discusses the historical use of bleach in medicine as well as its recent use for atopic eczema. Further, the chemistry and safety of bleach as well as alternative therapies are examined.