Bathing or showering weekly makes no difference to eczema symptoms compared to washing daily, according to a large trial.
The researchers said their findings would help healthcare professionals deliver consistent messaging on bathing frequency, which should be to give patients the freedom to choose a schedule that suited them best.
They conducted an online randomised controlled trial of 438 UK patients with eczema who either washed weekly (bath or shower once or twice a week) versus daily (bathing at least six times a week) over a period of four weeks.
Participants were asked to keep everything else to do with the management of their eczema the same and, if possible, to refrain from starting new treatments.
The study included patients (25% children, 66% female) with a self-reported diagnosis living in the UK, excluding those with very mild symptoms. They were asked to self-report their symptoms weekly using the Patient Orientated Eczema Measure (POEM) – a 0-28 score with 28 representing highest severity.
Findings published in the British Journal of Dermatology [link here] showed the adjusted difference in the average POEM score of the study period was -0.4 (-1.3 to 0.4; p-value = 0.30) for weekly versus daily bathing.
The two groups also had similar improvement of POEM scores of at least 3 points, itch intensity, eczema control, global change in eczema and quality of life scores.
No serious adverse effects were reported, although the weekly group appeared to use less topical steroids, which was equivalent to half a day less per week.
The researchers also collected information on the participants’ experiences of changing their bathing routines, finding barriers in the weekly group included feeling unclean, sports and exercise and reported itching or worsening of eczema, while those in the daily group included lack of time and tiredness/lack of energy.
The findings have since been added to the UK’s Eczema Care Online resource, with the researchers urging healthcare professionals involved in eczema care to point to their study and give a consistent message on bathing frequency.
“This is the first large trial to explore the effect of frequency of bathing on eczema symptoms and has begun to address one of the many questions patients and carers have around self-management of eczema,” the researchers said.
“The finding of no clinically important difference in eczema symptoms between weekly and daily bathing gives people with eczema the freedom to choose how often to bathe, and provides evidence to healthcare professionals in order to give a consistent messages about frequency of bathing.”