The Right Way to Take a Shower or Bath When You’re Managing Atopic Dermatitis

Follow this guide before, during, and after bathing to soothe, rather than irritate, eczema-prone skin.
The Right Way to Take a Shower or Bath When You’re Managing Atopic Dermatitis
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Updated on June 6, 2024
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Showering is such a basic part of your daily routine that you might not think much about it. But if you’re living with atopic dermatitis, the most common type of eczema, it’s crucial to make sure you’re taking steps to ensure your showering habits won’t make your symptoms worse.

“In general, washing your skin is necessary for good hygiene; however, people with eczema have a compromised skin barrier and are at greater risk for bacterial colonization and skin infection,” says Adam Wulkan, MD, the director of laser and cosmetic dermatology at Lahey Hospital and Medical Center in Burlington, Massachusetts.

Skin care is vital to eczema treatment, and bathing is vital to skin care — but just as the right bath products can soothe skin, the wrong ones can irritate it and bring on a flare-up. Even the temperature of the water you use may be triggering.

Here’s why showering or bathing the right way matters when you have atopic dermatitis, plus what you need to know to make it a pleasant, healing experience.

Why Washing Up Is Important When Managing Eczema

The benefits of bathing are twofold for people with eczema.

For one, bathing then moisturizing directly afterward can quench dry skin.

Secondly, water gets rid of bacteria and allergens that might otherwise linger on your skin, causing eczema flare-ups.

“Getting water on the skin is an important aspect of eczema skin health,” says Dr. Wulkan.

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Shower vs. Bath: Which Is Better for Eczema-Prone Skin?

It depends. But in general, showering may pose less of a flare-up risk than a bath.

Part of the reason is that baths tend to be longer than showers, and for people with eczema, it’s important to keep your time in the water short.

“Excessive water exposure can strip away the natural oils and sebum,” Wulkan says. Sebum is a mixture of fatty substances produced by your sebaceous glands that helps prevent water loss on your skin.

That’s not to say showers can’t also irritate skin. “I recommend no longer than a 10-minute shower — and ideally less,” says Wulkan.

A too-hot shower can also pose problems for eczema. “While our heads may love hot showers, our skin does not — long exposures to water, particularly hot water, can strip the skin of essential oils, disrupting the outer skin layer,” says Joshua Zeichner, MD, a dermatologist and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City.

Be sure to bathe with lukewarm water, which is typically 98.6 degrees Fahrenheit (though you can simply go by feel, or base it on room temperature). “The dangers come in when the showers or baths are long and too hot,” says Wulkan.

QUESTION OF THE DAY:

How do you keep oozing skin from sticking to bedding and clothing?

How Often Should You Shower When Managing Eczema?

Your skin may be more prone to eczema flare-ups when it isn’t clean.

 Showering daily will remove all the day’s dirt and grime.

Still, there are some differing philosophies on the topic, says Wulkan. “I agree with both the American Academy of Dermatology and the National Eczema Association, who feel that showering or bathing once daily is a good idea,” says Wulkan. “The critical part is the time, water temperature, products used and post-treatment moisturization,” he adds.

Indeed, research shows that bathing daily is effective for soothing eczema symptoms, as long as you moisturize right after.

 This is what’s known as the “soak and seal” method.

What Is the Soak and Seal Method?

“The soak and seal method involves getting your skin wet via a bath or shower followed by sealing the water in with a moisturizer,” explains Wulkan. “Explaining this to patients allows them to understand that showering and bathing can actually hurt the skin unless you moisturize and seal in the water,” he says.

For the record, the National Eczema Association, too, recommends this post-bathing approach for people with eczema.

Ready to give your bathing routine an overhaul, and try the soak and seal method? Here’s a guide to getting your shower time right.

Before Showering

  • Have an eczema-friendly towel at the ready. “Ensuring that laundry detergents are free of dyes and fragrance is essential, and this is true for all laundry — not only towels,” says Wulkan. “There are fragrance-free fabric softeners and dryer sheets as well, but these are nonessential for washing clothes, so it’s often wise to forgo fabric softeners and dryer sheets altogether,” Wulkan adds.
  • Have your products at the ready. Make sure your moisturizer and any treatments for your eczema (as recommended by your doctor) are handy in the bathroom, because you’re going to need them as soon as you get out.
  • Test the water temperature. Draw your bath (if you’re taking one) or get the water going for your shower, and test the water to make sure it’s lukewarm.

While Showering

  • Keep the clock in mind. Bathe for 10 minutes max to avoid drying out your skin.
  • Skip any shower tools that scrape your skin. That includes loofahs, washcloths, or sponges.

     Lather with your hands instead.
  • Avoid irritating exfoliating products, advises Dr. Zeichner. Those would be granular salt and sugar scrubs that often include a fragrance.
  • Use a gentle, soap-free cleanser on the skin. “True soaps have an alkaline pH and can disrupt the outer skin,” Zeichner adds. The American Academy of Allergy, Asthma, and Immunology recommends, for example, the Cetaphil Gentle Skin Cleanser and CeraVe Hydrating Cleanser Bar, neither of which includes the word “soap” on its label.

  • Lock moisture into the room. Consider keeping the bathroom door closed when you shower to trap humidity in the air, suggests Zeichner. Low humidity (meaning dry air) can dry out your skin.

After Showering

  • Gently pat your skin dry. “Rubbing can further interrupt an already compromised skin barrier that can lead to an eczema flare,” says Wulkan.
  • Apply your treatment. This may include your topical medicine, like a corticosteroid cream (as approved by your doctor), to eczema-affected areas if you have them.
  • Whip out your moisturizer. Don’t wait any longer than three minutes after getting out to apply moisturizer.

     You’ll want to lock in that H2O, stat. Apply your moisturizer liberally using downward strokes rather than stroking up and down or in circles.

  • Let the moisture seep in. After applying your moisturizer, wait a few minutes before putting on clothes.

  • Put on eczema-friendly clothing. As far as fabric goes, opt for 100 percent cotton, bamboo, or silk, which may be most comfortable for people with eczema.

Tips for Selecting Bath and Shower Products for Eczema

It’s easy to grab whatever soap or shampoo is on sale at the grocery store, but you should consider your bath products more carefully than that. Here are some things to keep in mind.

Skip Soap-Based Products

As mentioned, these can cause irritation for eczema-prone skin. “Many soaps can be harsh and drying,” says Wulkan. One reason is that soap has a higher pH value than the skin (10 versus 5.5), and to keep flare-ups to a minimum, you want to use a cleanser that is of a similar pH level.

 “Gentle cleansers without fragrance, such as CeraVe or Cetaphil, are the best,” says Wulkan.

Avoid Anything With Fragrance or Labeled as Antibacterial

You’ll want to stay away from products with fragrance or that are antibacterial, Wulkan adds. “Keep in mind that ‘unscented’ may still have fragrances, so ensure that any products you buy say ‘fragrance-free’ and ‘sensitive skin,’” says Wulkan. Beware of big health claims on the bottle, too. “Just because something is ‘natural’ doesn't mean it's gentle on the skin,” Wulkan adds.

Opt for Oil in Your Moisturizer

When it comes to choosing an eczema-friendly moisturizer, the oilier the better. “An ointment, such as Vaseline, is the ultimate moisturizer — the problem is that it can be too greasy for many patients to apply to their entire skin,” says Wulkan. “Therefore, I typically recommend a cream, which is the next best thing,” he says.

Meanwhile, lotions are often less oily, and not as effective for people with eczema, so the American Academy of Dermatology advises skipping them. They advise buying moisturizers that are dye-free and fragrance-free, too.

Special Baths That Can Help Soothe Eczema Symptoms

Interested in taking a special bath to help your eczema even further? Ask your doctor if one of these soaks may be a good fit for you.

Bleach Baths

A bleach bath sounds harsh, but adding just a small amount of bleach may help with eczema symptoms. Bleach can kill bacteria on the skin as well as reduce itching, redness, and scaling.

The Mayo Clinic advises adding ¼ cup to ½ cup of bleach to a 40-gallon bathtub of water, depending on whether you have a half-full or full tub (and remember to make sure that the water isn’t hot). Stay in for a maximum of 10 minutes — soaking from your neck down — and repeat no more than three times a week. Also, if it’s irritating to your skin, rinse and pat dry with a towel.

Oatmeal Baths

You know it as a breakfast food, but oatmeal also acts as a soothing treatment for eczema. You could add colloidal oatmeal (which is oatmeal that is finely ground) to your bath, or put it on your skin in the form of a paste.

 You can also find ready-made oatmeal soaks in stores.
Research has found that eczema creams containing 1 percent colloidal oatmeal may help repair the skin barrier and could be a beneficial therapy for those with atopic dermatitis.

Baking Soda

If you’re taking a bath and have an uncomfortable itch, try adding a handful of baking soda, which can be calming to the skin.

Natural Oils

While not all oils are helpful for people with eczema, certain ones can be added to your bath for a little bit of eczema relief. Consider pouring a small amount of eczema-friendly natural oil into your bath to reduce skin irritation caused by the water. Some oils with benefits include virgin coconut oil, virgin sunflower seed oil, and jojoba oil — but olive oil may be irritating for people with eczema because of its fatty acids.

Also, these oils can make the bottom of the tub super-slippery, so exit your bath with caution.

The Takeaway

Showering or bathing daily and moisturizing immediately afterward are crucial steps to help keep eczema symptoms at bay. Be sure to use lukewarm water, keep your showers or baths to 10 minutes max, and use fragrance-free and non-soap products. When in doubt, ask your dermatologist, who can give you suggestions for the best shower and bath products, as well as share advice on natural remedies to try and ones to avoid.

Meet Our Experts
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Ross Radusky, MD

Medical Reviewer
Castle Connolly Top Doctor

Ross Radusky, MD, is a practicing board-certified dermatologist at the Dermatology Treatment and Research Center in Dallas. Originally from New York City, he graduated summa cum laude from the City University of New York and then received his MD from the New York University School of Medicine. There, he was inducted into the Alpha Omega Alpha Honor Medical Society and served as chapter president for two years. He completed his residency in dermatology at NewYork-Presbyterian Hospital and Weill Cornell Medical Center, and at Memorial Sloan Kettering Cancer Center.

Dr. Radusky practices general and cosmetic dermatology with a focus on the early detection of skin cancer, and provides patients with a personalized approach to looking their best at any age. He has authored articles and textbook chapters on the clues that our finger- and toenails may provide us about internal disease, as well as on comprehensive therapies for cosmetic dermatology and reversing the signs of skin aging.

Complementing his medical practice, Radusky has a strong passion for the cultural arts, particularly in expanding access to youths and seniors. He previously served as an artist instructor for the Rockaway Artists Alliance, a New York City nonprofit arts and education organization, and then served as both a board director and treasurer of the organization throughout his medical school training.

Radusky enjoys spending time outdoors with his wife Robyn, son Oliver, and poodle Lucy, where he can usually be found preventing photoaging and reducing the risk of skin cancer beneath an umbrella in a wide-brimmed hat. He is also the proud inventor of Sunshotz, the world’s only sunscreen measuring cup, designed to help patients of all ages apply the proper amount of sunscreen needed to enjoy all the sun without the burn.

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Leslie Barrie

Author
Leslie Barrie is a health and nutrition writer and editor who loves running marathons and attempting to cook healthy meals for her family (even if they don’t always turn out as planned). She received her bachelor of science degree at UCLA and her master of science degree at the Columbia University Graduate School of Journalism. She has written and edited for publications like Health magazine, Seventeen, and Woman’s Day. Leslie won a Hearst Spotlight Award for her work in 2018 at Woman’s Day, and helped plan the Woman’s Day Red Dress Awards, an event honoring changemakers fighting to end heart disease in women.

When she isn’t writing, Leslie loves chasing her daughter and son around outside, going on family hikes, and starting her day with a big bowl of muesli.
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Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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