NEW YORK (Reuters Health) - New research shows that a regimen of dilute bleach baths and antibiotic nasal ointment can improve symptoms in children with eczema, a common, often itchy, skin condition that can become infected with skin microbes.
“We and others have found anecdotally the addition of dilute (bleach) baths to be helpful in decreasing infection rates and disease severity” in children with eczema, Dr. Amy S. Paller and associates, from the Feinberg School of Medicine in Chicago, note. The current study, however, is the first to compare this strategy with an inactive “placebo” approach.
The study in the journal Pediatrics included 22 patients ages 9 months to 17 years with allergy-related eczema and bacterial skin infections. On average, one third of body surface area was affected and, in most cases, the infection was due to Staphylococcus aureus.
Nine patients were assigned to the treatment arm, and they bathed in a dilute bleach solution for 5-10 minutes twice a week; the dilution was 0.5 cup of 6 percent bleach in 40 gallons water. Additional plain-water baths were not restricted. In this group, mupirocin ointment was applied inside the nose twice daily for 5 consecutive days per month. The purpose of this treatment was to eliminate Staphylococcus aureus, which can be carried in the nose.
The remaining 13 patients were assigned to the placebo group, bathing in plain water and using petroleum jelly instead of mupirocin.
The treatment group experienced significantly greater improvements in eczema severity than did the placebo group. Moreover, at 3 months, the body surface area affected by eczema fell by 23.7 percent in the treatment group versus by just 3 percent in the placebo group.
The tolerability of the dilute bleach baths was “excellent,” the authors say, although early on, infected lesions were made more painful.
One patient who complained of skin irritation stopped the baths. However, after he developed a drug-resistant skin infection that sent him to the hospital, he resumed treatment, with no reported side effects.
Active treatment with dilute bleach baths and the nasal antibiotic did not eradicate Staphylococcus aureus, however, leading Paller and her team to suggest that longer treatment may be necessary.
SOURCE: Pediatrics, May 2009.