Your eczema flare toolkit: Bleach baths, oatmeal baths and wet wraps

Moisturising is the foundation

For most people with eczema, moisturising is not optional; it is core treatment. Aim for frequent, liberal application to keep skin soft and reduce itch and cracking.

People who suffer with eczema tend to lose moisture from their skin barrier and one of the most important elements in managing eczema is to keep the skin soft and supple by frequent and liberal use of topical moisturisers, commonly known as moisturisers.

Choosing the right moisturiser depends on your skin type, lifestyle, and preferences.

Ointments have fewer preservatives, making them good for sensitive skin, while creams and gels may need more frequent application unless they contain humectants. Lotions and sprays offer quick, light hydration, and oils are great for all-over moisture. Since you will use it daily, pick one you are comfortable to use.

• All creams, ointments, lotions, bath oils and soap substitutes should be targeted for hypoallergenic, sensitive or eczema prone skins and should be used regularly. These options are widely available for purchase from pharmacies, department stores, grocery outlets and various online stores.

• What suits one person’s skin may not suit another, so experiment with different products to find which sensitive moisturisers work best for your skin.

• Moisturisers can come in many forms, including ointments, creams, lotions, sprays and mousse. Ointments are thicker therefore can be better for dry skins, however they can be very greasy and therefore not be suitable for daytime use especially in warmer climates. For example, many sufferers use a cream by day and then an ointment at night.

• Always aim to apply moisturisers multiple times a day, but after bathing is especially helpful as this will trap the maximum amount of moisture in the skin.

• When bathing or showering it is essential to add a bath oil or a moisturising wash to the water. Water temperature should be tepid to warm rather than too hot, with showers not too long in duration. After bathing always pat the skin dry with a dry cotton bath towel rather than rubbing.

• Consider changing your shampoo, conditioner and shaving products when bathing to sensitive, fragrance free and/or moisture boosting alternatives, as these products often also run down our bodies during our bathing routines.

• Always patch test new products prior to applying it liberally on an area of the face or body.

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Bleach baths

Bleach baths can sound alarming, but when done correctly they are highly diluted and used as a medical strategy to reduce bacterial load on the skin. In eczema, Staphylococcus aureus can drive ongoing inflammation and contribute to infections. We cannot completely eradicate it long term, but we can reduce it. Regular diluted bleach baths have been shown to reduce skin infections and improve eczema control for some people, particularly those who get recurrent infected flares.

When bleach baths may help

• Frequent infected or “weepy” flares

• Recurrent crusting, oozing, or repeated antibiotic courses (under medical guidance)

• Eczema that stays inflamed despite good moisturising and appropriate anti-inflammatory treatment

Bleach baths are most effective as part of an overall plan, not as a stand-alone treatment. They should not sting; if they cause burning, stop and discuss with your GP or dermatologist. If you are treating a baby or small child, get a clinician’s exact dilution advice for the bath size.

Oatmeal baths

Colloidal oatmeal has been often considered a safe and effective ingredient for treating eczema and other inflammatory skin conditions. The compounds found in oats provide anti-inflammatory and moisturising benefits that can significantly reduce itching and irritation during flare-ups.

You can create an oatmeal bath by grinding plain, unflavoured oats into a fine powder and adding it to lukewarm water, then soaking for 10-15 minutes before gently patting your skin dry. Regular oatmeal treatments can help restore the skin’s pH balance and provide a protective barrier that locks in moisture.

Many people find that incorporating oatmeal baths into their routine 2-3 times per week helps prevent flare-ups and maintains healthier skin between active outbreaks.

Wet wrapping or wet wraps

Wet wrapping is a bandaging system used to control the symptoms of eczema. It helps to reduce the amount of itching and in turn helps you or your child to sleep. Wet wraps should be used on red, dry and itchy skin but should never be used on infected skin. People who wish to use wet wraps need to be assessed by their dermatologist, a doctor or by a nurse who has had dermatology training.

Usually wet wraps are suggested as a treatment after other treatments such as moisturisers and topical steroids have been tried and have not worked.

Warm, wet, tubular bandages are put onto the body over lots of moisturiser and sometimes a mild or moderately potent steroid ointment. The type of steroid used will depend upon the eczema and also the doctor who prescribes it. A dry layer of bandage is then put on over the wet layer.

Dermatologists and dermatology nurses sometimes use other bandages or suggest that parents make up their own suit for their child. Two pairs of pyjamas or a T-shirt, leggings and socks can all be used to get the same effect. Older children and adults may find this more comfortable.

Cotton gloves can also be used in older children and adults to treat just the hands; cotton socks can be used to treat the feet. Ready-made garments are now available which include vests and leggings for children from 6 months to 14 years.

Wet wraps should be applied in short, concentrated periods until the eczema is under control and the skin is in a good condition. Your doctor or nurse will be able to tell you how long to use them for.

Wet wraps can be put on twice a day, morning and evening, or used at night only. Wet wraps work at their best for the first 8 hours after you put them on. For this reason, they are best used at night. For children who are at school, or for adults, this may be an easier and less obvious way of using wet wraps than using them during the day.