Eczema is a subject close to my heart. When I was a child, I had it really badly… to the extent that I’d scratch my arms and legs so much that they would bleed. It has frustrated me to see the misinformation around it multiply for years. So, when I first came across bleach baths as a treatment, my instinct was scepticism because, let’s be honest, it sounds pretty strange. However, the evidence is more interesting than the name suggests.
Up to 80% of people with eczema or atopic dermatitis have significant Staphylococcus aureus colonisation on their skin, and this bacterial overgrowth is strongly associated with flares and worsening severity. A bleach bath, where sodium hypochlorite is diluted in bathwater to around the same concentration as a swimming pool, was originally designed to reduce this bacterial load. Interestingly, more recent research suggests the benefit may also involve a direct anti-inflammatory effect on the skin, since bacterial counts don't always fall even when symptoms improve.
A 2022 systematic review and meta-analysis of 10 randomised controlled trials found that bleach baths probably improve eczema severity by around 22% relative to control, with roughly one in ten patients achieving a 50% improvement. An earlier review was more cautious, finding no significant difference over plain water baths in pooled analysis. The honest summary is that the evidence is real but modest, and we need larger trials. Despite this, bleach baths appear in the guidelines of the American Academy of Dermatology and are recommended by the National Eczema Association. This will be in part because they are cheap, accessible, and carry very little risk when used correctly.
They are suitable for adults, children, and infants, though paediatric use should be discussed with a doctor. The main people who should be cautious are those with poorly controlled asthma (as the fumes in a poorly ventilated bathroom can be a trigger) and anyone with active open or weeping skin. The infection should be addressed first before starting bleach baths.
To do it safely for both adults and children, you can review the guidance provided by the National Eczema Association.
It is not a cure, and it should not replace topical steroids or other prescribed treatments. But for moderate-to-severe eczema with recurrent infections, it is a cheap and reasonable thing to try, ideally after a discussion with your doctor.
👋 For the new joiners: I’m Suraj, also known as Dr Sooj - a primary care doctor & health content creator. I love navigating the complex world of health and wellness and breaking down complicated concepts.
Every Sunday, I share something interesting that weaves together science and medicine with real life. The aim is to help you live happier and healthier, without any fear-mongering!
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Suraj (Doctor Sooj)
References:
1. Gong JQ, et al. Skin colonisation by Staphylococcus aureus in patients with eczema and atopic dermatitis. Br J Dermatol. 2006;155(3):583. PMID: 16882175
2. Paller AS, Beck LA. Bleach baths for atopic dermatitis: evidence of efficacy but more data are needed. Ann Allergy Asthma Immunol. 2022;128(6):617–8. PMID: 35618389
3. Bakaa L, et al. Bleach baths for atopic dermatitis: a systematic review and meta-analysis. Ann Allergy Asthma Immunol. 2022;128(6):660–668. PMID: 35367346
4. Chopra R, et al. Efficacy of bleach baths in reducing severity of atopic dermatitis: a systematic review and meta-analysis. Ann Allergy Asthma Immunol. 2017;119(5):435–40. PMID: 29150071
5. Eichenfield LF, et al. Guidelines of care for the management of atopic dermatitis. J Am Acad Dermatol. 2014;71(1):116–32.
6. National Eczema Association. Bleach bath therapy. Available from: https://nationaleczema.org
7. Bleach baths for atopic dermatitis. National Eczema Association. https://cms.nationaleczema.org/wp-content/uploads/2025/10/NEA_Factsheets_BleachBath_D01.pdf