Individuals with atopic dermatitis (AD) have used bleach baths to treat superinfections, although their mechanism of action is not well understood. The ClinicalTrials.gov, National Eczema Association, and PubMed databases were searched for studies that investigate the role bleach plays in modulating AD. Fifteen studies were included in this review. Bleach bath improves clinical symptoms of AD and restores surface microbiome by eradicating bacteria, most notably Staphylococcus aureus. Many studies have noted that this antimicrobial effect has reduced the need for topical corticosteroids or topical antibiotics. In addition, bleach seems to have strong anti-inflammatory and antipruritogenic effects. Lastly, bleach baths seem to be safe on human skin, without disrupting epidermal barrier function. Although the effects of bleach are promising, studies that investigate the long-term use of bleach alone, without concomitant AD treatment modalities, are needed. The emergence of new bleach-containing products warrants future investigations to examine their effects on cutaneous microbiome, epidermal barrier function, and immunity.
From the *College of Medicine and
†Department of Medicine, Division of Dermatology, University of Arizona, Tucson.
Address reprint requests to Vivian Y. Shi, MD, Dermatology Division, 1515 N Campbell Ave, PO Box 245024, Bldg #222, Levy Bldg, 1906E, Tucson, AZ 85724. E-mail: firstname.lastname@example.org.
V.Y.S. is a stock shareholder of Dermveda, a paid advisor for Menlo Park Therapeutics and the National Eczema Association, and has received educational honorarium from Novartis, Sanofi, and Pfizer. M.M. has no funding or conflicts of interest to declare.