Bathing Tips for Parents of Children with Eczema

By: Cynthia Abbott, M.D.
Medical, Surgical and Cosmetic Dermatology

Bathing a child with eczema frequently may seem counterintuitive, especially when the child’s skin can become more dry as the water evaporates. But when done right, more frequent bathing can actually be beneficial to your child’s skin.

How Eczema Causes Dry Skin

The problem with eczema is the “glue” holding the cells together. In eczema that glue is less strong.

The environment pulls natural moisture out between the cells, even more so in a child with eczema.  While your child is in the tub or shower, the skin is loving that moisture. It is replenishing moisture in the cells, taking away that ashy, dry scale. 

But when out of the shower, that water evaporates. And in a child with eczema, it all evaporates.

The Right Bathing Routine for Eczema in Children

So to combat this, I recommend sealing in the moisture, right out of the tub. Think of it like a master chef coating a chicken to seal in the flavors. My patients laugh when I tell them to “grease down like a chicken” after bathing, but it’s true . . . (and I should know about fried chicken, growing up in Kentucky.) 

While the body is still damp, keep it moist with a great moisturizer and sometimes a prescription ointment.  The moisturizer can be anything thick and pure if applied immediately after bathing or showering. Something like Aquaphor, Cetaphil, CeraVe or even solid Crisco (not butter flavored though!) would work. Just apply lots of it immediately.

My other suggestion would be to give tepid, lukewarm (not hot) baths and showers. Following this routine twice a day will make a huge difference in as little as a week.

But bathing without the moisturizer could undo several days of “good” therapy because the glue isn’t there to prevent the intracellular water loss. So please use that moisturizer!

My Struggles as a Parent of a Child with Eczema

All the medicine and advice in the world are worth nothing if it doesn’t fit into a patient’s lifestyle. This is true with all dermatologic conditions, not just eczema.

I understand what that’s like. 

I’ve been blessed with my own dermatologic challenge in my youngest twin.  All his life, he has had rashes and itches from eczema.  I’ve often joked that if his mom wasn’t a dermatologist, he would end up in the hospital with infected abrasions from all the scratching. 

He is allergic to dust mites and all things with fur, but dreams about being a veterinarian, bless his heart.  He is allergic to most bug sprays and is sensitive to his own sweat. He doesn’t sleep without antihistamines. 

While he was small, I kept his eczema controlled with one to two baths a day. That was until he grew into the “no bath” stage of childhood.  Being a boy, baths would wash away his “manhood” and he insisted on applying his own moisturizers and medications. 
I would tell him to take a shower, and if he did, the bathroom would be steamy and hot when he finished, instead of tepid like it should be. 

His legs ached from scratching.  He was undoing days of therapy by taking hot showers, which removed the oil on his skin, and drying out by forgetting to apply his moisturizers and medications.  But, when he does what I say, he looks great. It’s amazing how well the creams and medications work when you use them! 

So I understand the challenges of treatment and balancing real life. My goal is to work to find a regime that works for each lifestyle and patient.