Tina has had Atopic Dermatitis, commonly known as “skin asthma,” ever since she was a little girl. She’s been on and off topical steroid treatment for years. When her rashes flare, she tries her best not to scratch. Instead, she takes long showers with hot water just to relieve her itchiness. Sometimes, she takes a bath up to three times a day just to soothe her dry, itchy skin. She likes trying different kinds of soaps, ranging from popular anti-bacterial bar soaps to expensive body washes. And even though she has dry skin, she hates applying lotion. She complains that it’s too sticky, especially in our hot tropical weather. But her rashes seem to be getting worse. “What am I doing wrong?” she wonders.

Tina needs a strong wake-up call. Her current routine is drying out her skin and sadly, making her eczema even worse.

For patients with atopic dermatitis or any kind of eczema, controlling dry skin is essential in treating their skin condition. This is achieved by following a routine that aims to heal, repair, and restore the skin. A proper skin care routine consists of two important steps: bathing and applying moisturizer.

Bathing is an important part of our daily routine. Not only does bathing cleanse our skin of dirt, grime, and oils, but it also hydrates our skin. However, it is important to remember that excessive bathing is bad for our skin as well. Bathing, without the immediate application of a moisturizer, will dry the skin even more as water evaporates from the skin. That's why it's essential to apply moisturizer in order to seal in the water that is absorbed by our skin through bathing. Bathing and applying moisturizer are two important steps that go hand in hand in treating patients with eczema.

Here are some important bathing dos and don'ts for you to follow:

DOs:

1. DO take short baths or showers daily. No more than 5 minutes would be ideal.

2. DO use a mild, fragrance-free, dye-free body wash or cleanser.

3. DO use a wash or cleanser with a low ph (less than 5.5). Most bar soaps have an average ph of 9.5-10, which may be too harsh for your sensitive skin. Use cleansers with a ph that is closer to our skin’s ph of 4 to 5.5.

4. DO take a bleach bath 2 to 3 times a week, if you are prone to bacterial infections. This is an effective way to reduce bacterial colonization of the skin. To prepare a bleach bath, mix ¼ cup of household bleach with lukewarm water in your bathtub. Soak for 10 minutes. After soaking, rinse off with lukewarm or cool water.

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5. DO apply a moisturizer on your entire body (and not just on affected areas) immediately after taking a bath. Apply the moisturizer three minutes after bathing.

6. DO apply your topical medication after bathing. If you apply it on damp skin, it will increase the absorption of your medication. Be sure to apply your moisturizer on top of the topical medicine.

DON’Ts:

1. DON’T use hot water for when taking a bath. Use lukewarm, tepid or cool water instead.

2. DON’T use abrasive loofahs or rough washcloths to scrub your skin. Your cleanser is strong enough to rid your skin of dirt and oils. Don’t rub your skin.

3. DON’T use perfumed or multi-colored cleansers. Avoid cleansers with grains or scrubs that may irritate your skin.

4. DON’T use soap for your whole body if your eczema is severe and extensive. You should use soap only on specific areas that need it like the armpits, groin, and feet.

5. DON’T completely dry your skin with a towel after bathing. It is important to leave your skin damp before applying your lotion or moisturizer to seal in the water in your skin. This will help make your skin less dry and itchy.

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