The Importance of Washing When Treating Eczema Symptoms
Washing is essential to remove triggers but needs to be done correctly to avoid new flare-ups.
We cover a host of expert tips for washing with eczema.
Eczema is a chronic skin condition characterized by periodic acute flares, marked by red, itchy, and inflamed skin. The severity and duration of an acute eczema flares are influenced by three main factors:
However, washing too much or with the wrong soaps or detergents can introduce new irritants and allergens or dry the skin out, triggering a new flare.
Here, we explore the importance of washing for those with eczema and provide guidance on selecting the right products and techniques to minimize irritation and flare-ups.
Choosing The Right Soap For Eczema
As discussed in the ceramides page, ceramides provide the suppleness and impermeability of the skin barrier. The skin is naturally acidic which aids in protecting against infection. The pH varies from 4 to 6.5, depending on the specific body part.
Soaps, on the other hand, are often alkaline and designed to break down oils, including ceramides, so they can be easily rinsed off the skin's surface. Consequently, soaps can be quite drying, particularly for skin already prone to dryness such as when there is a deficiency in long chain ceramides.
Face Wash For Eczema
Selecting an appropriate face wash for eczema-prone skin is critical since the wrong product can trigger inflammation and worsen the symptoms.
It's important to choose a gentle, fragrance-free cleanser specifically formulated for sensitive skin. Look for products containing soothing ingredients like colloidal oatmeal which helps reduce itching and inflammation.
Avoid products containing harsh chemicals, such as sulfates, artificial fragrances, artificial colors, are strongly alkaline, or contain alcohol, as these can exacerbate eczema symptoms by causing further irritation and disrupting the skin's natural barrier.
Hand & Body Soap for Eczema
Frequent handwashing is essential for maintaining hygiene. But individuals with eczema should prioritize using a mild, hydrating hand soap. Opt for soaps that are:
Sulfate-free - Sulfates can strip the skin's natural oils, leading to dryness and irritation.
Fragrance-free and dye-free - Artificial fragrances and dyes can cause allergic reactions and exacerbate eczema symptoms.
Are not strongly alkaline and do not contain alcohol
Moisturizing - you might even use a moisturizer as the soap. See below for more.
Laundry Detergent for Eczema
Laundry detergent residue on clothes, bedding, and other fabrics can cause skin irritation for those with eczema. It's crucial to use a laundry detergent designed for sensitive skin, which should be:
Free of dyes and fragrances - These additives can trigger allergic reactions and worsen eczema symptoms.
Hypoallergenic - These products are less likely to cause irritation or allergic reactions.
Eczema Treatment Soap
In some cases, a dermatologist may recommend a medicated soap for eczema treatment. These soaps typically contain active ingredients like:
Coal tar - Known to have anti-inflammatory, antifungal, and antipruritic properties, coal tar can help alleviate itching and inflammation.
Salicylic acid - This ingredient aids in the removal of dead skin cells, reducing scaling and promoting smoother skin.
Zinc pyrithione - With its antimicrobial and anti-inflammatory properties, zinc pyrithione can help reduce itching and inflammation.
Simple Home Surface Cleanser
You may need to make your own at some point! Here's a simple recipe for an all-purpose cleaning surface solution using vinegar, baking soda, and essential oils:
1/2 cup white vinegar
2 cups water
1 tablespoon baking soda
[Optional] 10-15 drops of your favorite scent (e.g., lemon)
In a small bowl, mix the baking soda and water until the baking soda is dissolved.
Slowly add the white vinegar to the baking soda mixture. The combination will cause a temporary fizzing reaction as the vinegar reacts with the baking soda. Wait for the fizzing to subside before proceeding.
Add your preferred scent to the mixture. A squeeze of lemon not only add a pleasant scent but can also provide antimicrobial properties.
Pour the mixture into a clean spray bottle, preferably one made of glass, as some plastic can degrade over time.
Shake well before each use to ensure the ingredients are well mixed.
This all-purpose cleaner can be used on various surfaces such as countertops, sinks, and appliances. However, avoid using it on porous surfaces like natural stone or unsealed wood, as the vinegar can damage these materials. Also, test the cleaning solution on a small, inconspicuous area before applying it to a larger surface to ensure it doesn't cause any discoloration or damage.
Remember that anything has a possibility of being irritating to the skin, especially for those with eczema or sensitive skin. If you're prone to skin reactions, use gloves when handling the cleaning solution.
Expert Tips For Washing With Eczema
Using hot water can strip the skin of its natural oils, leading to increased dryness and irritation. Cold water can tighten the skin and allow triggers to penetrate. To avoid exacerbating symptoms, use lukewarm water when washing your face, hands, or body.
Excessive washing can strip the skin of its natural oils and disrupt the skin's barrier function, resulting in increased dryness and irritation. To strike the right balance, wash your face no more than twice a day, and shower or bathe every other day, if possible. Always listen to your skin and adjust your washing frequency based on its needs.
Gentle Washing Techniques
Aggressive scrubbing can cause further irritation and damage the skin barrier, making eczema symptoms worse. To minimize the risk of exacerbating your eczema, adopt the following gentle washing techniques:
Moisturize delicate skin before washing.
Some moisturizers can be used to wash with, as they dry the skin less while still functioning like a soap.
Use your fingertips or a soft washcloth instead of abrasive scrubbers or exfoliating brushes.
Apply cleansers and soaps using circular motions, avoiding any harsh rubbing or tugging on the skin.
Do not use loofahs or textured sponges, as these can be too rough for eczema-prone skin.
Wear rubber gloves to protect your hands when washing other items, such as dishes or a car.
Effective Rinsing Methods
Proper rinsing is crucial to ensure as much of the soap or cleanser is removed from the skin as possible. Residual product ingredients can cause irritation and dryness.
Follow these steps for effective rinsing:
Spend extra time rinsing the skin, especially in areas where soap may accumulate, such as skin folds and creases.
Use your hands or a soft washcloth to gently help remove soap and cleanser from the skin.
Dab with the towel rather than rub.
Be mindful of water pressure, as high-pressure showers can also irritate sensitive skin. Opt for a gentle, steady stream of water while rinsing.
Moisturize once your skin is dry.
Showering with Eczema
Showering can be a stressful activity for those with sensitive skin or skin discomforts, but it is an important mechanism for cleaning and preventing infection. Showering can also be used to remove sweat, irritants, and allergens from the skin after exposure, such as after exercising outdoors during pollen season.
Showering can be a double-edged sword for individuals with eczema; while it's essential for hygiene, it can also strip the skin of natural oils and exacerbate symptoms. To make showering more eczema-friendly, follow these tips:
Keep showers short and sweet - Limit your showers to 10-15 minutes to minimize the loss of natural oils and reduce skin irritation.
Moisturize before you wash
Use a gentle, hydrating body wash - Opt for a body wash specifically formulated for sensitive skin. Like face washes, they should be free of sulfates, artificial fragrances, and dyes, and contain soothing ingredients like colloidal oatmeal or aloe vera.
Avoid harsh scrubbing - Use your hands or a soft washcloth to gently cleanse your body. Steer clear of loofahs, textured sponges, and abrasive scrubbers.
Pat dry, don't rub - After showering, gently pat your skin dry with a soft, clean towel. Rubbing your skin can cause further irritation and damage.
Apply moisturizer immediately - Lock in moisture by applying a fragrance-free, hypoallergenic moisturizer within three minutes of stepping out of the shower. This practice, known as the "soak and seal" method, can help maintain the skin's natural barrier and reduce dryness
Consider a blast of cold water at the end of the shower - the cooling effect can be soothing
If your skin is particularly sensitive, it may be worth avoiding showering too often to let the skin recover. In this instance, consider doing a flannel wash:
Wet the areas of skin you want to clean.
Use a flannel, warm water, and your choice of sensitive soap to lightly wash the areas.
Rinse off and dab dry with a towel.
If exposed to sweat, irritants, and allergens, try to shower as soon as you can to reduce the time your skin is exposed.
Bathing with Eczema
Bathing can provide a stable environment to wash and even treat the skin by soaking in beneficial ingredients.
For those who prefer baths over showers and are dealing with eczema, it's crucial to adapt your bathing routine to be more eczema-friendly:
- Moisturize any delicate areas of skin before bathing.
- Run the bath with lukewarm water to avoid hot water, which can strip the skin of its natural oils and exacerbate dryness.
Limit bath time to no more than 15-20 minutes to minimize skin irritation.
Add soothing ingredients to the water, such as colloidal oatmeal, Epsom salts, or baking soda, to enhance the therapeutic effects of your bath. These ingredients can help soothe the skin, reduce itching, and promote relaxation.
Avoid bubble baths and bath bombs, as many of these products contain harsh chemicals, fragrances, and dyes that can worsen eczema symptoms. Stick to gentle, eczema-friendly bath additives instead.
Wash with chosen sensitive soaps during the bath.
Rinse off, and consider using cold water as this can soothe inflamed skin.
Dab dry with a soft towel rather than rubbing the skin, which can cause further irritation.
Apply a fragrance-free, hypoallergenic moisturizer within three minutes of exiting the bath to lock in moisture and maintain the skin's barrier function. Use an occlusive emollient for the best results.
Allow the moisturizer to soak in before getting fully clothed.
There are some ingredients that can be added to a bath to provide further benefits for the skin. This table summarizes the key information:
Bath Ingredient per typical 100-150 L bath
Salt (Table, Epsom, or Magnesium)
1 cup salt (250 g)
The salt absorbs into the skin and increases their moisture retention, therefore reducing water loss [CAR 2018][YOO 2020]
Anti-caking or fragrance additives
Up to 30 mins [D]
10 ml or 1 cup of oatmeal in a mesh bag or ground up to a dust
“The high concentration of starches and beta-glucans in oat are responsible for its protective and water-holding functions” [PAZ 2012].
15 - 20 minutes
Neutralizes skin acidity, soothes itching, and gently exfoliates.
15 - 20 minutes
A Word About Vinegar or Bleach Baths
The above table omits two other types of bath supplements: vinegar and bleach.
Your skin needs a healthy microbiome to control inflammation. It is not good to harm it.
Both vinegar and bleach baths are intended to kill the microbiome. Bleach and vinegar will kill indiscriminately all or most of the members of the microbiome.
Always follow your doctor’s advice. In the absence of doctor’s advice though, we cannot recommend vinegar or bleach baths.
While you might think “hitting the reset button” seems like a good idea, understand that doing so sort of makes your body like a post-apocalyptic wasteland. Who runs the wasteland in every movie you have seen? It is usually not the nice guys. The same is true here - in challenging environments, pathogenic bacteria are more likely to rise. By using harsh chemicals like these, you risk giving room to pathogenic bacteria to rise and create more inflammation later.
That said, we are including the below for reference, along with the evidence in support of these tools. We leave it to you and your doctor to determine what is right for your situation as during an acute flare, it is possible that there is an overgrowth of bacteria.
2 to 4 cups of apple cider vinegar
The natural acidity of the vinegar complements the acidity of your skin to aid in managing a healthy skin microbiome. Use 2 to 3 times a week. Some studies suggest that vinegar baths may help reduce skin infections, but more research is needed.(SCH 2011)(LEE 2018)
¼ to ½ cup of bleach
Some studies support the use of bleach baths for eczema patients with frequent skin infections, but results are mixed. Always consult your doctor before trying bleach baths, as they may not be suitable for everyone.(BYR 2018)(ALY 1996)
No more than 3 times a week
Laundry for Eczema
As covered in the environment page, the clothing, bedding and the chemicals they are washed come into contact with your skin can trigger eczema to flare.
If there are irritants in the laundry detergent or excessive bacteria in the fabric, this can disrupt the microbiome and damage the skin. Standard detergents can contain various fragrances and colorings to make the laundry smell and look appealing. These ingredients can be problematic for sensitive skin.
Managing eczema symptoms requires special attention to your laundry practices, as clothing, bedding, and towels are in constant contact with the skin. To create an eczema-friendly laundry routine, consider the following guidelines:
Laundry Products and Materials
Use a gentle laundry detergent: Choose a detergent specifically designed for sensitive skin that is hypoallergenic, dermatologist-tested, and free of dyes and fragrances.
Avoid fabric softeners and dryer sheets: These products often contain fragrances and chemicals that can irritate eczema-prone skin. Use wool dryer balls or fragrance-free, hypoallergenic fabric softeners instead.
Opt for natural fabrics: Choose clothing and bedding made from natural, breathable materials like cotton, bamboo, or linen, which are less likely to cause skin irritation than synthetic fabrics such as polyester or nylon.
Things to Avoid in a Gentle Laundry Detergent
Dyes and coloring
Drying laundry in the presence of airborne allergens
Laundry Techniques and Practices
Rinse thoroughly: Ensure your washing machine rinses your items adequately to remove all detergent residue. If necessary, use an extra rinse cycle.
Wash new clothing before wearing: New items may contain chemicals or residues from the manufacturing process that can irritate sensitive skin. Always wash new clothing, bedding, and towels before using them for the first time.
Keep clothes clean and allergen-free: Regularly wash your items to minimize exposure to allergens like dust mites, pet dander, and pollen. Wash sheets and pillowcases once a week, and blankets and comforters every two to four weeks.
Be mindful of laundry storage: Store laundry properly to prevent mold and mildew, which can irritate eczema-prone skin. Ensure items are completely dry before storing them, and consider using a dehumidifier in your laundry area to reduce moisture levels.
Wash above 120 degrees, if necessary, to eradicate dust mites.
Personal Considerations and Precautions
Conduct patch or elimination testing to determine if you have an allergy or intolerance to laundry detergent ingredients.
Stick to a detergent that works for you once you find it.
If you share a laundry machine with others, ask them to use your detergent or rinse the machine before you use it to remove any triggering suds.
Be aware of the characteristics of contact eczema and take necessary precautions.
Consider the laundry detergent used by your significant other or anyone you are in close contact with.
Creating a Customized Eczema Washing Routine
By assessing your individual needs, adjusting product choices and techniques as needed, and maintaining consistency in your washing routine, you can create an effective and customized approach to managing your eczema symptoms.
Remember that patience and perseverance are key, and always consult your dermatologist if you have concerns or questions about your skincare routine.
Assessing Individual Needs
Identify your triggers - Keep a journal or log of your eczema flare-ups, noting any potential irritants, such as specific products, environmental factors, or stressors. This information will help you pinpoint which factors may be contributing to your symptoms.
Consult a dermatologist - If you're unsure about your skin type or the best products for your eczema, consult a dermatologist for professional advice and recommendations.
Adjusting Product Choices and Techniques as Needed
Trial and error - Introduce new products one at a time and observe how your skin reacts. If a product causes irritation or worsens your eczema, discontinue its use and try a different option.
Adapt to changes in your skin - Your skin's needs may change over time due to factors such as age, hormonal fluctuations, or seasonal weather changes. Be prepared to adjust your washing routine and product choices accordingly.
Experiment with techniques - As you develop your personalized routine, you may find that certain washing techniques, such as patting versus rubbing or using a washcloth versus your hands, work better for your skin. Don't be afraid to try different approaches to find what suits your skin best.
Consistency in Routine
Establish a daily routine - Consistency is key to maintaining healthy skin and minimizing eczema flare-ups. Develop a daily washing routine that includes cleansing, moisturizing, and other skincare steps as needed.
Stick to your routine, even during flare-ups - Maintaining your washing routine during eczema flare-ups is crucial for symptom management. If a flare-up is particularly severe, consult your dermatologist for guidance on adjusting your routine or incorporating additional treatments.
Be patient - It may take time to see improvements in your skin, so be patient and persistent in following your personalized washing routine.
Managing eczema requires paying special attention to various aspects of your daily life, including showering, bathing, and laundry practices. To effectively manage this complex skin condition, remember to keep showers and baths short, use lukewarm water, and choose gentle, hypoallergenic products for both personal care and laundry. Opt for natural fabrics and ensure proper laundry storage to minimize irritation from allergens and chemicals.
We encourage you to explore other factors and treatments by engaging with our other content, as a comprehensive approach is key to effectively managing this complex skin condition.
Share your experiences with us! Tell us what has and hasn’t worked for you. What did we miss in this article that you've found personally impactful? Your insights can help others better understand and manage their eczema.