Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia

J Dermatol. 2013 Nov;40(11):874-80. doi: 10.1111/1346-8138.12265. Epub 2013 Sep 20.


Staphylococcus aureus is frequently found in patients with atopic dermatitis (AD) and contributes to disease exacerbation. The objective of this study was to evaluate the efficacy and safety of bleach baths as an adjunctive treatment in AD patients. Patients between 2 and 30 years old with moderate to severe AD were enrolled in a prospective, randomized, placebo-controlled study. Patients soaked in diluted bleach or distilled water baths for 10 min, twice a week for 2 months. Efficacy assessments included the Eczema Area and Severity Index (EASI) scores and S. aureus density was determined using quantitative bacterial cultures. Patients in the treatment group showed significant reductions in EASI scores. A 41.9% reduction in S. aureus density from baseline was seen at 1 month further reducing to 53.3% at 2 months. Equal numbers of patients in both groups experienced mild side-effects. This study demonstrates that diluted bleach baths clinically improved AD in as little as 1 month. No patient withdrew from the treatment arm because of intolerance to the baths.

Keywords: Staphylococcus aureus; atopic dermatitis; bleach baths; sodium hypochlorite.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Baths / adverse effects
  • Baths / statistics & numerical data*
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / complications
  • Dermatitis, Atopic / microbiology
  • Dermatitis, Atopic / therapy*
  • Disinfectants / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Malaysia
  • Male
  • Prospective Studies
  • Sodium Hypochlorite / therapeutic use*
  • Staphylococcal Skin Infections / complications
  • Staphylococcal Skin Infections / therapy*
  • Treatment Outcome
  • Young Adult


  • Disinfectants
  • Sodium Hypochlorite