Frequent and Infrequent Bathing Regimens in Pediatric Atopic Dermatitis: A Randomized Clinical Trial

A clinical trial has shown that frequent “soak-and-seal” (SS) baths, when combined with immediate moisturizer application, offer significantly greater short-term improvement in moderate-to-severe pediatric atopic dermatitis (AD) than infrequent bathing.

The randomized, single-blind, crossover-controlled study, published recently, evaluated 42 children aged 6 months to 11 years with moderate-to-severe AD. Participants were assigned to either the dry method (DM)—twice-weekly SS baths for up to 10 minutes over two weeks—or the wet method (WM)—twice-daily SS baths for 15 to 20 minutes over two weeks—before crossing over to the other regimen. All patients used the same moisturizer, cleanser, and low-potency topical corticosteroid (TCS).

Significant Reduction in Disease Severity

WM produced a mean 21.2-point reduction in SCORing Atopic Dermatitis (SCORAD) index compared with DM (95% CI, 14.9–27.6; P < .0001). More than 30% improvement in SCORAD scores was significantly more common with WM than DM (P = .0030). Caregivers also reported notable improvement, with Atopic Dermatitis Quickscore (ADQ) decreasing by 5.8 points (95% CI, 1.8–9.7) under WM.

Other outcomes, such as Staphylococcus aureus colonization, skin hydration, and moisturizer/TCS usage, showed no significant differences between the two methods.

Implications for Practice

The findings suggest that, as an acute intervention, twice-daily SS baths are more effective than infrequent bathing in reducing AD severity in children. This could help guide clearer recommendations for parents, who often receive conflicting advice about bathing frequency in eczema care.