Eczema is a very common condition in young children. Although it is difficult to prove, most of the time it is caused by allergy to certain food. Some children have a few patches of eczema over the elbows, wrists, knees or ankles. Others suffer from more severe problem with red and rough eczema over most parts of the body.

Once the eczema starts, the skin surface is broken. There is a suspicion that other things that trigger allergy can penetrate eczematous skin and enter the body, inducing more allergies in these children. That is probably why many children with asthma also have eczema as a young child.

Research has also shown that the majority of children with eczema have Staphylococcus growing on their skin, especially in and around the eczema. This may explain why eczema is usually red with a rough surface. Occasionally, the bacterial infection can become more severe, with oozing of pus from the skin.

Over time, when eczema turns more chronic, the skin over there is thicker than the rest of the body. It is much harder to reverse the process once the eczema becomes chronic. Steroid cream is the standard treatment for eczema. Over-the-counter steroid preparations are very mild. If eczema is mild, that may be all that one needs. However, if eczema is more severe or more chronic, it is often not effective.

Doctors can prescribe stronger steroid creams that are still very safe, but they need to be used under physician supervision. Overuse of steroid cream can suppress the adrenal glands that produce our stress hormone cortisol; it can also make the skin thinner and transparent.

Many years ago, I heard about bleach bath that was being used by some physician to treat eczema. At first, I was skeptical about this idea. One day, a young baby was admitted to our hospital with head-to-toe eczema, and he was miserable. We tried the bleach bath once, and we were surprised the next day: his eczema improved greatly. Since then, I have many families that have used bleach bath successfully. Recent research has proven the effectiveness as well as the safety of bleach bath.

Common household bleach contains 3-6% sodium hypochlorite. The important ingredient is chlorine inside this chemical compound. Chlorine is very effective in killing germs, whether they are bacteria, viruses, or fungi. As a result, bleach is used in hospitals for disinfection, as well as in swimming pools to reduce bacterial growth. At home, it is used to disinfect cutting surfaces after processing meat and poultry.

When used in bleach bath, the chlorine likely penetrates the skin and kill bacteria like Staphylococcus inside the skin. It is speculated that these bacteria cause inflammation in the eczema, and make the skin itchy. It is almost impossible to stop a young child from scratching. The more he scratches, the more damage he does to the skin, and more Staphylococci can get in to continue the inflammation. When these bacteria are eradicated by bleach bath, the skin has a chance to heal and recover.

Although bleach bath is simple to do, it is important to follow the procedure carefully. Most importantly, you have to buy the right kind of bleach. Only regular household bleach should be used, not any kind of concentrated formulation that is commonly found in supermarkets and hardware stores. Unfortunately, these bottles are often not labelled properly with their concentration.

Mix 1 part of common bleach with 100 parts of warm water. If you use a small baby bathtub that can hold about 5 litres, use one teaspoon (5 ml) of bleach. If you use a regular bathtub, I would suggest that you use 30-50 ml of bleach. Start with the smaller amount of bleach and make sure it doesn’t irritate his skin when he sits in it. There should be no smell of chlorine in this dilution. If you do smell chlorine, likely you have added too much bleach, or you have the concentrated formulation.

Have you child stay in the water for about 10 min. The area with eczema should be completely immersed in water. If his eczema is in his arm or hand, you may want to have some toys that can go underwater for him to play with. If he gets some water in his mouth, or a splash in his eyes, it is too dilute to cause any problem.

When he is finished, you can briefly dab dry the skin, but don’t dry it too well. Quickly put a layer of vaseline over his body, which will seal the water, and likely a little bit of chlorine, inside the skin. This will provide the moisturizing effect that is so important in the treatment of eczema.

If the eczema is severe, it may be necessary to use bleach bath daily until he improves. Then reduce it to every few days. Some parents find it useful to continue the bleach bath this way to keep the eczema at bay. If steroid cream is necessary, it is better to apply it another time of the day instead of right after the bleach bath.

Doing the bleach bath is very different from going to a swimming pool. There is much more chlorine added to swimming pool to keep it clean, and you can smell chlorine in the air. Children with eczema may find the chlorine in swimming pool too irritating, but the concentration that I suggested here should not cause any irritation.