People with eczema can bathe daily or weekly without worsening their symptoms, a new randomised controlled trial has suggests.
The findings, published in the British Journal of Dermatology, show no difference in symptoms between people who bathed six or more times per week and those who bathed just once or twice.
Researchers from the University of Nottingham and Nottingham University Hospitals NHS Trust noted that one of the most common questions asked by patients with eczema is how often is best to have a bath or a shower.
Yet these very practical aspects of care are very rarely looked at in randomised controlled trials, they added, which has led to inconsistency in guidelines on the best approach.
To determine a real-world answer to this question, the researchers worked closely with people living with eczema to design a trial, which was funded by the National Institute for Health and Care Research (NIHR) and randomly tested daily or weekly bathing.
A total of 438 adults and children aged one year and over with self-reported eczema across the UK took part.
Participants were allocated using minimisation, balancing on eczema severity (Patient Oriented Eczema Measure, POEM), age and usual method of bathing, to either the weekly bathing group (n=220), which involved having a bath or shower once or twice a week, or to the daily bathing group (n=218) in which they bathed six or more times per week.
#They recorded their eczema symptoms each week for the duration of the four-week trial, during which time they were allowed to continue using their normal treatments.
The primary outcome was participant reported eczema symptoms using the POEM range of 0 to 28 in which higher scores are more severe.
Participants who completed at least one follow-up questionnaire were included in the primary analysis, which included 195 participants (89%) allocated to daily bathing and 193 (88%) to weekly bathing.
The adjusted difference in mean POEM score over four weeks for weekly versus daily bathing was -0.4 (95% confidence interval -1.3 to 0.4, p = 0.30).
The researchers reported no difference in eczema symptoms between the two groups, suggesting that patients have the freedom to choose the bathing frequency that suits them best.
‘One less thing to worry about’ for people with eczema
Lucy Bradshaw, lead author and senior medical statistician at the Nottingham Clinical Trials Unit, said: ‘The findings of our study are great news for people living with eczema – it means they can choose a frequency of bathing that suits them.
‘Together, we’re starting to answer questions about living with eczema that haven’t had enough attention in research until now.’
Amanda Roberts, an eczema patient and carer and co-chief investigator of the trial, said: ‘There are so many things in everyday life which have the potential to affect eczema. It is good to know frequency of bathing or showering is not one of them. One less thing to worry about.’
Professor Marian Knight, scientific director for NIHR infrastructure, said: ‘By working with people who live with eczema, the research team has been able to answer a question that has affected people’s quality of life for years. The research shows that how often you bathe does not make a difference to symptoms, giving people the freedom to make the choice that is best for them.’
The Eczema Bathing Study represents the first completed trial in the five-year Rapid Eczema Trials programme, which was launched in 2022.
Led by the University of Nottingham and Nottingham University Hospitals NHS Trust and delivered in collaboration with the universities of Southampton, Bristol, Birmingham City and Imperial and the Nottingham Clinical Trials Unit, the research project aims to answer practical questions that matter most to people living with eczema.
The next study will explore how long steroid creams should be used to manage flare-ups.
This article was originally published by our sister publication Hospital Healthcare Europe.
