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How often should pediatric patients with eczema bathe?

Daily bathing for most children who have eczema is fine, as long as it is followed by the application of a generous amount of moisturizer, according to researchers who conducted a literature review and published their findings in the Annals of Allergy, Asthma and Immunology (July 2016; 117(1):9–13).

“A number of medical groups have commented on the general role of bathing in eczema,” said Dr. Ivan D. Cardona, the lead author of the study, who is an allergist-immunologist in Portland, Maine.

“But they don’t all agree on the best bathing practices. Specifically, many groups don’t comment on bathing frequency. Because parents are confused, and because they often take their questions to their allergist, we wanted to examine the studies that have been published on the topic, and see if there was agreement on just how often children with eczema should be bathed,” added Dr. Cardona, who was quoted in a press release.

The authors noted that those in favour of frequent bathing (defined in the paper as at least once a day) believe the presence of very dry skin requires hydration with daily baths followed by moisturizer. Limited use of pH balanced skin cleansers should also be part of frequent bathing, along with gentle patting dry, and the immediate application of a moisturizer to “seal” in moisture. This process is known as “soak and smear.”

“The smear part is really the most important element, because unless moisturizer is applied immediately, then the skin is likely to dry out even more,” said Dr. Neal Jain, co-author of the paper, who is an allergist-immunologist from Gilbert, Ariz.

“The weight of the evidence in the literature we reviewed and our experience in caring for these patients suggests daily bathing with ‘soak and smear’ is more effective for soothing dry skin from eczema,” said Dr. Jain.

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