Using Bleach Baths to Treat Skin Conditions

Diluted bleach baths are sometimes used to treat serious skin problems, including hard-to-control eczema and/or methicillin-resistant Staphylococcus aureus (MRSA) infections. The idea of pouring household bleach into bathwater can understandably raise eyebrows, particularly if it's for young children for whom you would assume it's too harsh. But this popular, old-time remedy has been gaining popularity as an adjunct treatment.

Eczema is one of the most common skin disorders in children and one that can be made dramatically worse with MRSA. While antibiotics have long been used to treat these conditions, increasing concerns about antibiotic overuse have led some healthcare providers to embrace bleach baths as a complementary form of therapy despite a lack of solid clinical evidence.

Effectiveness: What the Research Says

Sodium hypochlorite (NaOCl), a key component of bleach, has been in use as a disinfectant and antiseptic since the early 18th century and was widely used during World War I to prevent wound infections in injured soldiers.

In recent years, scientists have taken a fresh look at the effectiveness of bleach baths in both children and adults with recurrent skin disorders.

Among the studies conducted:

• A 2018 review from the University of Arizona found bleach baths were effective at reducing symptoms of atopic dermatitis as well as restoring the skin's normal microbiome (the collection of microorganisms normally found on healthy skin) by reducing Staph. It also found that bleach baths did not disrupt the skin's barrier function.
• A 2011 study from Washington University showed that daily bleach baths, when given with an intranasal antibiotic, eradicated 71% S. aureus infections after four months.
• A 2014 article published in Clinical Infectious Diseases found twice-weekly bleach baths helped reduce the recurrence of staph infections.

Despite these positive results, the relatively small number of participants in these studies limits any interpretation one can make. Of them, only one—the smallest—has been a randomized trial. No large-scale study has yet been conducted.

Some other research suggests that bleach baths aren't very effective at treating eczema at all.

A review published in the Annals of Allergy, Asthma, and Immunology found that bleach baths were no more effective at healing eczema than plain water baths. The short-term use was noted, and using bleach baths for a longer period of time may garner different results.

At least one study, published in 2019, found that bleach used at the dilution level used in a bath was not effective at killing Staph. This was done in vitro (in a lab) rather than on actual human skin, though. According to researchers, this doesn't necessarily mean bleach baths aren't effective, just that there may be another mechanism at work besides antimicrobial action.

How Bleach Baths Are Used

Bleach baths are used to treat acute eczema flareups and to prevent future flareups, in cases of chronic eczema that isn't improving with other treatments. They're also recommended in cases of Staph or MRSA skin infections, with or without eczema.

Bleach baths aren't meant to be used as a sole treatment for eczema. In fact, if you use bleach baths alone and do not properly moisturize skin afterward, eczema may actually worsen.

Instead, bleach baths are meant to be used as complementary treatments alongside conventional eczema medications and routine moisturizing therapies.

Warnings and Safety Tips

Always get a recommendation and advice from a physician before using bleach baths to treat any skin condition. They are not recommended for everyone, and in some cases undergoing the treatment may worsen rather than improve the condition.

There are a few key steps to remember when preparing a bleach bath:

• Follow your healthcare provider's instructions exactly, including the ratio of bleach to water and the length of soaking time.
• Never use bleach undiluted on the skin.
• Do not add more bleach to the water than is recommended, or use bleach baths more often than is recommended. Doing so will not help clear eczema up any faster and may, in fact, cause irritation or a worsening of symptoms.
• Always keep undiluted bleach out of reach of children.

Bleach baths can be done when the skin is cracked or fissured and, in fact, may help heal them. However, bleach baths can sting or burn any open skin. If the stinging is intolerable, or if fissures are exceptionally deep, call your healthcare provider for further advice.

While bathing:

• Avoid getting bleach water into the eyes or nose, as this can cause irritation.
• Don't dunk the head under the water.
• Watch to make sure your child doesn't drink the bathwater.

If you notice any irritation or worsening of eczema, stop giving bleach baths and call a healthcare provider. Also, don't hesitate to call your physician if you have any questions regarding your or your child's treatment.

Respiratory Concerns

Keep the bathroom well-ventilated during bathtime, with either an open window or running a fan, to help dissipate any fumes. While the amount of bleach used in the bathwater is very dilute and does not produce an abundance of fumes, bleach can be irritating to the respiratory system and some people are more sensitive to the fumes than others.

If you or your child develop burning of the nose or throat, coughing, or other respiratory issues, stop the bleach baths and let your healthcare provider know.

Bleach baths are generally contraindicated for those with asthma because of the risk of fumes triggering an attack.

How to Give a Bleach Bath

If your physician or child's pediatrician recommends bleach baths, make sure to follow their guidelines for the bath. In general, instructions for a making a dilute bleach bath is as follows:

• As your doctor for the recommended ratio of bleach to bathwater you should use.
• Bathe for about five minutes. Unless your healthcare provider instructs otherwise, the entire body (not just the affected area) should be bathed in the bleach water solution. This helps reduce infecting-causing bacterial colonies across the skin's surface.
• Gently rub a moisturizer on the skin within three minutes of getting out of the bath.
• Repeat the dilute bleach bath twice a week until your physician tells you to stop.

If there is any skin irritation, speak with your healthcare provider about other home treatments that may help. Some dermatologists recommend washing with chlorhexidine cleanser (Phisohex, Hibiclens) as an alternative to bleach baths.

Diluting a bleach bath further won't help as the lower concentration would unlikely be able to neutralize the bacteria fully.

A Word From Verywell

Bleach baths sound a bit odd (and maybe even a bit scary) at first blush. Rest assured, when used properly the dilution rate of a bleach bath gives is similar to the chlorine dilution in a properly maintained pool.

That said, bleach baths are only meant to be used in specific circumstances. While generally safe when used as instructed, you should always get advice from a healthcare provider before using bleach baths a treatment for any skin condition. Remember, too, that bleach baths are only effective when used alongside your current eczema treatment routine.