Research-Based Tips for Washing Your Child with Eczema

Jan 14

Written By Global Parents for Eczema Research

By Korey Capozza, MPH, Global Parents for Eczema Research

Reviewed by: Ian Myles, MD, MPH

For parents managing a child’s eczema (or “atopic dermatitis”), choosing bathing products often feels like a high-stakes decision - will the product soothe or will it cause a flare? In this blog, we’ll review the evidence and summarize what you need to know about how to approach bathing for eczema, and what products and ingredients you should look out for.

How should I bathe my child with eczema?

You may have heard before that bathing can lead to even drier skin for children with eczema. However, research largely suggests that bathing the correct way can help with eczema management.

The skin barrier in children with eczema is damaged, making it vulnerable to bacteria, environmental allergens, and irritants. Regular bathing, ideally once daily, helps strengthen this barrier and prevent the “invaders” from causing problems.

Hydration: Short baths in lukewarm water allow the outer skin layer (called the stratum corneum) to absorb moisture. This effect is supported when there is immediate application of an emollient (moisturizer) afterward.
Removal of Irritants: Bathing effectively washes away potential triggers such as dirt, environmental pollutants, dust mite antigens, and pollens, minimizing surface contamination and reducing inflammation.1
Reducing Infection Risk: Cleansing may help remove problematic bacteria and germs, like staph aureus bacteria.

Pro tip: Listen to our recent podcast with Dr. Helen Brough to learn more about optimal bathing techniques.

Should I use soap on my child’s skin if they have eczema?

While bathing correctly is important, the question of whether to use a cleanser (soap or body wash) is less easy to answer. The American Academy of Dermatology (AAD) recommends using only a mild, fragrance-free cleanser, applied only to dirty or smelly parts of the body.

Research also suggests that for ordinary cleansing, plain water is highly effective and gentle. Some studies have shown that cleansing with clear water appears comparable to using mild liquid baby cleansers in terms of maintaining the ideal composition of the skin (acid mantle and lipid content). Harsher soaps can damage the natural lipids (oils) the skin needs for optimal health. [reference]

For parents seeking to minimize the chemical load on their child’s fragile skin barrier, the cleansers should be used with care and lukewarm water alone may be the best approach.

What about bath additives for eczema?

Studies have challenged the benefit of adding products to the bath. A systematic review and meta-analysis comparing bleach baths to regular water baths found no significant difference in effectiveness between the two interventions. The benefit observed came mostly from the act of soaking and subsequent moisturizing. Similarly, the large-scale BATHE trial found no evidence of a benefit from adding oil “bath additives” to the standard management of childhood eczema.

Taken together, these studies suggest it is likely not necessary to add any extra products to your child’s bath as the most beneficial outcome comes from simply having them in the water and moisturizing right after.

How do soaps impact skin pH?

Healthy human skin maintains a naturally acidic surface environment known as the acid mantle, with a normal acidity generally ranging from pH 4 to pH 6. This acidity is crucial for controlling the skin “microbiome”, regulating normal skin turnover, and maintaining the health of the outermost layer of skin. In children with eczema, the skin’s pH is often shifted toward an alkaline state (one of higher pH), and this shift may contribute to the associated skin-barrier breakdown because the alkalinity damages the delicate skin barrier through several mechanisms:

Direct Barrier Disruption: The high pH dissolves the lipid ("mortar") structure that holds the skin cells ("bricks") together. Stripping these essential lipids compromises the skin’s ability to prevent water loss and block irritants.
Loss of Natural Moisturizing Factors (NMF): Alkaline substances decrease the levels of these natural moisturizing components in the skin. NMFs are vital compounds responsible for attracting and retaining water, and their breakdown leads to increased dryness and itching.
Activation of Inflammation: The increased pH accelerates the breakdown of filaggrin—a protein considered to be essential for maintaining skin structure and producing NMFs. This process can lead to more inflammation and worsening eczema symptoms.

What are some alternatives to soap for children wth eczema?

Fortunately, there are alternatives to soap and one is Synthetic Detergent (Syndet), often referred to as a "body wash" or "non-soap cleanser." Syndets utilize milder, synthetic cleansing ingredients that can be engineered to maintain a specific pH.13 The most desirable formulations are acidic (pH 4.5–5.5), actively supporting the restoration of the skin’s normal pH balance and protecting the barrier.

The use of acidic syndet formulations has been clinically shown to reduce eczema severity. One study found that 100% of the traditional soaps tested were alkaline, with a pH range of 9.21 to 10.83 while 84.9% of liquid synthetic detergents were acidic (pH 3.59 to 6.64), closely matching the healthy skin's natural state.

Special considerations for Infants (Newborn to 2 Years)

Infant skin is significantly thinner, more fragile, and less resistant to irritants and allergens than adult skin. For this reason, infant skin care should focus on the most conservative and gentle cleansing approach.

Toddlers and Preschoolers (2 to 5 Years): Managing the Dirt Factor

As children become more active, dirt and environmental irritants can be more of an issue. Daily bathing generally becomes more beneficial for this age group to ensure the removal of these triggers.1 The cleansing standard remains the same.

Pro tip: Keep the child's nails clipped short to prevent skin damage and infection caused by scratching.5

School-Age Children (5+ Years): Adherence and Advanced Formulations

For older children, daily bathing or showering is recommended to maintain skin hydration and remove irritants. However, maintaining adherence to a routine can be a challenge!

Regardless of age, consistency is non-negotiable. Eczema is a chronic condition, and proactive management is required even when the skin appears clear. Therefore, the cleansing and moisturizing routine must be viewed as essential maintenance therapy, not merely a treatment for acute flares.5

Pro-tip: Help your school-age child recognize the connection between skin care and eczema flare prevention to increase motivation and adherence.

What should parents look for in a cleanser for kids with eczema and what ingredients should they avoid?

Selecting a cleanser requires some serious detective work. The composition of the product determines whether it will soothe the skin or cause a flare.

Fragrances and Perfumes: This is the primary trigger category to eliminate. Fragrances (including synthetic perfumes and many essential oils) are common contact allergens found widely in skincare and household products, and they significantly increase the risk of initiating eczema flares.24
Sulfates (SLS and SLES): Sodium Lauryl Sulfate (SLS) and Sodium Laureth Sulfate (SLES) are harsh foaming agents.29 They function as aggressive detergents that strip away essential natural oils, drastically raise skin pH, and are known severe irritants.11 Make sure any body wash or shampoo is clearly sulfate-free.29
Preservatives: Certain preservatives are notorious sensitizers and irritants. These include formaldehyde-releasing agents, specific parabens (e.g., methylparaben, propylparaben), and Methylisothiazolinone (MIT).11
Other Common Offenders: Other ingredients to avoid include alcohol (more than 12% ethanol can be dehydrating 43), synthetic colors and dyes, propylene glycol, and Lanolin, the latter of which is a common contact allergen in AD patients.24

Barrier-Building Blocks: Ingredients to Seek

Cleansers for eczema should ideally not only clean gently but also contain components that actively support barrier repair and reduce inflammation. Below are some helpful ingredients to look for:

Ceramides: These are essential lipids, or fats, naturally found in the skin that play an important role in barrier function. Using cleansers formulated with ceramides helps restore the compromised "mortar" of the skin barrier, preventing moisture loss and enhancing skin health.
Colloidal Oatmeal (Avena sativa): This highly soothing ingredient provides significant benefits for eczema-prone skin. It is finely ground oats that act as a humectant (drawing moisture into the skin) and an anti-inflammatory agent, providing relief from itching and forming a protective barrier that retains moisture and shields the skin from irritants.
Humectants: Substances like Glycerin and Hyaluronic Acid attract and bind water to the skin, enhancing hydration.Glycerin, in particular, is frequently incorporated into gentle, high-quality syndet formulations.

Pro tip: Listen to our podcast about bathing.

References and Further Reading

American Academy of Dermatology (AAD). Treating babies and children with eczema.7
Noviello, et al. (2024). A comparative study on the effect of different cleansing methods on pediatric skin barrier function. Cited in Kim, et al. (2024). Bathing and atopic dermatitis: a comprehensive review of guidelines and studies. The Journal of Dermatology.4
Loden, M. (2003). The clinical benefit of a synthetic detergent (syndet) bar in patients with atopic dermatitis. Cited in Draelos, Z. D. (2024). Cleansers, moisturizers, and the skin barrier. Dermatology Times.18
American Academy of Pediatrics (AAP). (2025). Atopic Dermatitis: Update on Skin-Directed Management: Clinical Report. Pediatrics.21
Huang, Y. C., & Lee, C. H. (2024). Hydrogen-ion concentration of skin cleansers and their utility in atopic dermatitis. Annals of Allergy, Asthma & Immunology.10
National Eczema Association (NEA). Seal of Acceptance™ Criteria and Ecz-clusion List.25
Silverberg, J. I., et al. (2017). Association between bleach baths and reduced severity of atopic dermatitis: a systematic review and meta-analysis. Cited in Northwestern Medicine news release.8
Hon KL, et al. (2014). Emollient bath oil as an adjunct to treatment in children with atopic dermatitis: an observer-blind randomized controlled trial. Clinical and Experimental Dermatology.42
Mayo Clinic. Baby eczema: What works?.5
Parente, J., et al. (2022). Surfactants: the good, the bad and the ugly. Clinical, Cosmetic and Investigational Dermatology.13
Royal Children’s Hospital Melbourne (RCH). Skincare for babies.19
German Agency for Quality in Medicine (ÄZQ). Eczema (atopic dermatitis).36
Lee, C. H. (2022). Atopic dermatitis: The role of excess serine protease activity and the use of neutral-to-alkaline soaps. Acta Dermato-Venereologica.15
National Eczema Association (NEA). Bathing basics for eczema.1
Dermatology Times. Cleansers, moisturizers, and the skin barrier.18
Celikoglu, M., Raab, C., Vollert, H. et al. A pilot study on the cutaneous effects of ethanol in a moisturizing cream on non-lesional skin of patients with atopic dermatitis. Sci Rep 15, 32536 (2025).43