28 April 2009

Bleach treats eczema in kids

It's best known for whitening a load of laundry. But now simple household bleach has a surprising new role: an effective treatment for kids' chronic eczema.


It's best known for whitening a load of laundry. But now simple household bleach has a surprising new role: an effective treatment for kids' chronic eczema.

Chronic, severe eczema can mar a childhood. The skin disorder starts with red, itchy, inflamed skin that often becomes crusty and raw from scratching. The eczema disturbs kids' sleep, alters their appearance and affects their concentration in school. The itching is so bad kids may break the skin from scratching and get chronic skin infections that are difficult to treat, especially from methicillin-resistant Staphylococcus aureus (MRSA).

Researchers from the Northwestern University Feinberg School of Medicine have discovered powerful relief in the form of diluted beach baths. It's a cheap, simple and safe treatment that drastically improves the rash as well as reduces flare-ups of eczema, which affects 17% of school-age children.

The study found giving paediatric patients with moderate or severe eczema (atopic dermatitis) diluted bleach baths decreased signs of infection and improved the severity and extent of the eczema on their bodies. That translates into less scratching, fewer infections and a higher quality of life for these children.

Doesn't create bacterial resistance
The typical treatment of oral and topical antibiotics increases the risk of bacterial resistance, something doctors try to avoid, especially in children. Bleach kills the bacteria, but doesn't have the same risk of creating bacterial resistance.

Patients on the bleach baths had a reduction in eczema severity that was five times greater than those treated with placebos over one to three months, said Prof Amy S. Paller. The study will be published in the journal Paediatrics.

"We've long struggled with staphylococcal infections in patients with eczema," Paller said. She noted more than two-thirds of eczema patients have evidence of staphylococcus on their skin, the bacteria that most commonly causes infection and worsens the eczema. "This study shows that simple household bleach, which we think decreases the staphylococcus on the skin, can help these children."

In the study, Paller and researchers treated 31 paediatric patients (6 months to 17 years old) who had eczema and a bacterial staph infection for 14 days with oral antibiotics. Half of the patients received bleach in their bath water (half a cup per full standard tub), while the other half received a look-alike placebo. Patients were also instructed to put a topical antibiotic ointment or placebo control into their nose (where the staphylococcus can also grow) for five sequential days of each month. All were instructed to bathe in the bleach twice a week, and soak for five to 10 minutes for three months.

Paller said bathing in the diluted bleach bath water was surprisingly odour-free because of the small amount of bleach added. "In our clinics, no one had the just-out-of-the-swimming pool smell," she said.

Rapid improvement
The research team saw such rapid improvement in the kids taking the real bleach baths that they terminated the study early because they wanted the children getting the placebo to get the same relief.

"The eczema kept getting better and better with the bleach baths, and these baths prevented it from flaring again, which is an ongoing problem for these kids," Paller said. "We presume the bleach has antibacterial properties and decreased the number of bacteria on the skin, which is one of the drivers of flares."

Northwestern researchers launched the study to confirm their hunch about the potential of bleach baths, "since bleach has been used by hospitals in the past few years as a disinfectant to decrease MRSA," Paller said.

Interesting finding
One interesting finding in the study was the eczema on the body, arms and legs improved dramatically with the bleach baths, but the face, which was not submerged in the bath, did not improve, further evidence of the positive effect of the bath.

As a result of the study, Paller suggests that kids who have eczema on their face close their eyes and mouths and dunk under the water to help improve the lesions. In her practice, patients have found that even daily bleach baths are well tolerated. The bleach baths may also be useful for individuals with frequent staphylococcus infection, whether related to eczema or not, and in adults with eczema and recurrent infections.

'Eczema beats people down'
"This is a disorder that can drive people crazy," said Dr Peter Lio, director of the Eczema Care & Education Centre and an assistant professor of dermatology and of paediatrics at the Feinberg School. "Eczema beats people down."

Lio said he just worked with an 11-year-old girl who had missed a half-year of school because of her severe eczema. "As we were working with her and demonstrating how to treat her skin, she started weeping," he said. "Between the tears, she said 'I'm crying because I know I'm going to get better.' "

Scientists believe eczema may be triggered by urban pollutants and toxins and/or allergies, and certainly shows a genetic tendency. "We don't have all the answers and are still learning about this disease," Lio said. – (EurekAlert!, April 2009)

Read more:
Eczema and the environment
Eczema in children


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Dr Suretha Kannenberg holds a degree in Medicine and a Masters in Dermatology from the University of Stellenbosch. She is employed as a consultant dermatologist by Stellenbosch University and Tygerberg Academic Hospital, where she is involved in clinical duties and the training of medical students and dermatology residents. Her areas of interest and research include vitiligo, eczema and acne. She also performs limited private practice work in the Northern suburbs of Cape Town in general and cosmetic dermatology.

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