It’s helpful to keep in mind that eczema may need to be treated differently when symptoms are minimal compared with when there’s a more serious flare. Because of that, Dr. Mallick suggests reaching out to your pediatrician or pediatric dermatologist for questions or concerns about your child’s routine specifically. However, in general, here are some tactics that can be useful when it comes to bathing children who have atopic dermatitis.
Shorten Bath Time
Even though baths can also be play time for many children, a long session in the water isn’t recommended for kids with this issue, according to Mallick.
“It’s not necessarily the frequency of baths that matters, it’s the duration,” she says. “Baths can occur daily but should be limited to 5 to 10 minutes at the most.” That’s because staying in the water for a longer time may dry out the skin, which can lead to damage to the skin barrier.
Keep Water Lukewarm
Another potential risk to the skin barrier is exposure to hot water, in both baths and showers. That can strip the skin’s natural oils — often resulting in dryness and itching, says Mallick.
On the flip side, water that’s too cold won’t effectively remove bacteria from the skin’s surface. That’s a problem because people with atopic dermatitis tend to have excess bacteria growth on their skin and an increased chance of bacterial skin infections. This creates a Goldilocks situation: You want water that’s not too hot and not too cold but just right.
Bathe Frequently
A common misconception is that bathing a child every day might worsen atopic dermatitis. The opposite is true, according to Jessica Hui, MD, a pediatric allergist and immunologist at National Jewish Health in Denver. “During periods of eczema flares or uncontrolled eczema, bathing at least once daily is recommended, in warm water for about 10 minutes,” she says. “Sometimes even doing two or three baths a day is done with more severe eczema, both in children and adults.”
Moisturize Immediately After Bathing
One of the most important strategies with bathing children who have atopic dermatitis is to lock in the moisture from the bath, says Dr. Hui. This means that after bathing and patting dry (rather than rubbing the skin dry), you should seal in that moisture with emollients or medicated topical ointments.
“A common mistake is to skip this step, when in fact it’s what can really help when it comes to improving atopic dermatitis because it improves the skin barrier,” she adds.
Use Mild, Fragrance-Free Moisturizers and Cleansers
In terms of what to use during a bath and for the important moisturizing session after the bath, Mallick suggests products that are free of fragrances and dyes, since those can sometimes cause an allergic reaction. Also avoid products with alcohol, which may lead to dryness instead of hydration. For example, some lotions may have a water and alcohol base versus creams that tend to be oil based.
In some cases, you may not even need cleansers, adds Hui. “If there’s no soiling or dirt to wash off, a cleansing agent might be unnecessary, and water will be enough,” she says.
