To bathe or not to bathe?
For decades, there has been the question as to whether the frequency of bathing or showering has any effect on the extent or severity of atopic eczema.
Some dermatologists advocate infrequent bathing, whilst others encourage regular or daily bathing. The question has never been subject to a randomised trial, and it is a frequent question posed by sufferers.
To address this, a recent randomised control trial of weekly versus daily bathing in atopic eczema was conducted. A total of 438 people with self-identified eczema were randomised between late January and July 2024 in the UK. Minor eczema, hand eczema only, and stasis eczema sufferers were excluded. Patients were over the age of one, with the majority being over 16 years of age.
Patients were randomised into either daily or weekly bathing or showering. Their bathing or showering regime and use of emollients or soap substitutes remained the same as they had used in the lead in period, and no other therapy changes were made during the assessment period. The majority of participants had no preconceived opinion as to whether bathing frequency had an effect on their eczema activity.
A Patient-Orientated Eczema Measurement score was undertaken on a weekly basis over four weeks by the participants.
The trial found no evidence of a clinically important difference in eczema symptoms between those bathing or showering weekly versus daily. There was a slightly reduced use of topical steroids in the weekly bathing group.
The results are helpful as patients with eczema can choose with confidence whichever ablution regime suits them best in terms of convenience and personal preferences without having a significant impact on their eczema.
Dr Ian Coulson, Dermatologist and DermNet Editor-in-Chief
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