Sodium hypochlorite washes

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Sodium hypochlorite washes are skin cleansers formulated with sodium hypochlorite (NaOCl) and surfactants. These cleansing liquids or gels are lathered onto wet skin and rinsed off. They are recommended for inflammatory skin conditions (eczema, atopic dermatitis and radiation dermatitis), microbial driven skin disorders (folliculitis, acne, ring worm, skin infections and staph colonization) and body odor. [1]

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Sodium hypochlorite bath

Sodium hypochlorite baths became an acceptable treatment of atopic dermatitis due to a 2009 landmark study by JT Huan. [2] The use of sodium hypochlorite in the form of a bleach bath, has been reported to improve atopic dermatitis severity in children with moderate-to-severe dermatitis or eczema. [3] [4]

Solutions of 0.05–0.06% NaOCl are considered safe and still maintain bactericidal activity against Staphylococcus aureus. [5] [6] Bleach bath dilution can be achieved by adding approximately 1/4 cup of household bleach (6% or 8.5%) to a ½ bathtub (13 gallons) of water. [7] A person would then submerge themselves, from the neck down, or the affected area in the bath for 10 to 30 minutes. Significant reduction in eczema severity was demonstrated in 31 Staphylococcus aureus infected atopic dermatitis patients after 3 months of using dilute bleach baths twice a week, in a randomized, single-blind, placebo-controlled trial. [4] [8] In another clinical trial, Wong evaluated 36 moderate-to-severe atopic dermatitis patients with clinical skin infection and reported improved disease severity with the use of twice-weekly dilute bleach baths. [3]

In addition to having bactericidal activity, sodium hypochlorite baths have been shown to have a direct effect on suppressing NF-κB signaling in the outermost layer of skin in mice, and reduced dermatitis severity in a mouse model of radiation dermatitis. [9] Findings suggest that sodium hypochlorite baths may have a direct suppressive effect on the inflammation. The same investigators demonstrated an anti-aging effect of bleach bath in mice. [9]

Some cases of severe burns have been reported for using too much bleach within the water. [10] Using too little bleach may not be effective and the American Academy of Dermatology recommends using regular strength bleach, not concentrate. [11]

Sodium hypochlorite cleansers

A sodium hypochlorite cleanser is used to cleanse and soothe skin that is prone to infection and conditions such as eczema, atopic dermatitis, folliculitis and other skin conditions. [12] The idea for cleansers came from bleach baths which were used to kill bacteria to prevent infections and treat infections after they occurred. Cleansers were formulated into body washes for a gentle, convenient use in the shower as opposed to having bath treatments. [12]

A 2013 study with 18 children (6 months of age and older), showed positive responses using a sodium hypochlorite-formulated body wash called CLn BodyWash to treat atopic dermatitis. [13] The study used an Investigator Global Assessment (IGA) score and measured the body surface area affected by the dermatitis. [13] Patients saw an overall IGA improvement with a mean reduction of 14.8% in affected body surface area. [13] A 2014 study led by Dr. Adelaide Herbert showed a decrease in severity scores of 23–35% within 2 weeks and 35–45% reduction in severity scores after 6 weeks using this same wash. [14]

Related Research Articles

Dermatitis Inflammation of the skin

Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can vary from small to covering the entire body. Dermatitis is often called eczema, and differentiation between those terms is not standardized.

<i>Staphylococcus aureus</i> Species of Gram-positive bacterium

Staphylococcus aureus is a Gram-positive round-shaped bacterium, a member of the Firmicutes, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe that can grow without the need for oxygen. Although S. aureus usually acts as a commensal of the human microbiota it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. S. aureaus is one of the leading pathogens for deaths associated with Antimicrobial resistance and the emergence of antibiotic-resistant strains such as methicillin-resistant S. aureus (MRSA) is a worldwide problem in clinical medicine. Despite much research and development, no vaccine for S. aureus has been approved.

Sodium hypochlorite Chemical compound

Sodium hypochlorite is a chemical compound with the formula NaOCl or NaClO, comprising a sodium cation and a hypochlorite anion. It may also be viewed as the sodium salt of hypochlorous acid. The anhydrous compound is unstable and may decompose explosively. It can be crystallized as a pentahydrate NaOCl·5H
2O, a pale greenish-yellow solid which is not explosive and is stable if kept refrigerated.

Irritant diaper dermatitis Medical condition

Irritant diaper dermatitis is a generic term applied to skin rashes in the diaper area that are caused by various skin disorders and/or irritants.

Boil Medical condition

A boil, also called a furuncle, is a deep folliculitis, infection of the hair follicle. It is most commonly caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue. Boils which are expanded are basically pus-filled nodules. Individual boils clustered together are called carbuncles. Most human infections are caused by coagulase-positive S. aureus strains, notable for the bacteria's ability to produce coagulase, an enzyme that can clot blood. Almost any organ system can be infected by S. aureus.

Nummular dermatitis Medical condition

Nummular dermatitis is one of the many forms of dermatitis. it is characterized by round or oval-shaped itchy lesions. The name comes from the Latin word "nummus," which means "coin."

Atopy Predisposition towards allergy

Atopy is the tendency to produce an exaggerated immunoglobulin E (IgE) immune response to otherwise harmless substances in the environment. Allergic diseases are clinical manifestations of such inappropriate, atopic responses.

Dyshidrosis Human disease

Dyshidrosis is a type of dermatitis that is characterized by itchy blisters on the palms of the hands and bottoms of the feet. Blisters are generally one to two millimeters in size and heal over three weeks. However, they often recur. Redness is not usually present. Repeated attacks may result in fissures and skin thickening.

Desonide

Desonide (INN) is a low-potency topical corticosteroid anti-inflammatory that has been available since the 1970s. It is primarily used to treat atopic dermatitis (eczema), seborrheic dermatitis, contact dermatitis and psoriasis in both adults and children. It has a fairly good safety profile and is available as a cream, ointment, lotion, and as a foam under the tradename Verdeso Foam. Other trade names for creams, lotions, and ointments include Tridesilon, DesOwen, Desonate. It is a group VI corticosteroid under US classification, the second least potent group.

Atopic dermatitis Long-term form of skin inflammation

Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thickens over time. While the condition may occur at any age, it typically starts in childhood, with changing severity over the years. In children under one year of age, much of the body may be affected. As children get older, the areas on the insides of the knees and elbows are most commonly affected. In adults, the hands and feet are most commonly affected. Scratching the affected areas worsens the symptoms, and those affected have an increased risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma.

Flucloxacillin Penicillin

Flucloxacillin, also known as floxacillin, is an antibiotic used to treat skin infections, external ear infections, infections of leg ulcers, diabetic foot infections, and infection of bone. It may be used together with other medications to treat pneumonia, and endocarditis. It may also be used prior to surgery to prevent Staphylococcus infections. It is not effective against methicillin-resistant Staphylococcus aureus (MRSA). It is taken by mouth or given by injection into a vein or muscle.

Eczema herpeticum Medical condition

Eczema herpeticum is a rare but severe disseminated infection that generally occurs at sites of skin damage produced by, for example, atopic dermatitis, burns, long-term usage of topical steroids or eczema. It is also known as Kaposi varicelliform eruption, Pustulosis varioliformis acute and Kaposi-Juliusberg dermatitis.

A skin infection is an infection of the skin in humans and other animals, that can also affect the associated soft tissues such as loose connective tissue and mucous membranes. They comprise a category of infections termed skin and skin structure infections (SSSIs), or skin and soft tissue infections (SSTIs), and acute bacterial SSSIs (ABSSSIs). They are distinguished from dermatitis, although skin infections can result in skin inflammation.

Prurigo nodularis Medical condition

Prurigo nodularis (PN), also known as nodular prurigo, is a skin disease characterised by pruritic (itchy) nodules which usually appear on the arms or legs. Patients often present with multiple excoriated lesions caused by scratching. PN is also known as Hyde prurigo nodularis, Picker's nodules, atypical nodular form of neurodermatitis circumscripta, lichen corneus obtusus.

Skin flora

The term skin flora, also commonly called skin microbiota, refers to microbiota that reside on the skin, typically human skin.

Staphylococcal infection Medical condition

A staphylococcal infection or staph infection is an infection caused by members of the Staphylococcus genus of bacteria.

Topical steroids are the topical forms of corticosteroids. Topical steroids are the most commonly prescribed topical medications for the treatment of rash, eczema, and dermatitis. Topical steroids have anti-inflammatory properties, and are classified based on their skin vasoconstrictive abilities. There are numerous topical steroid products. All the preparations in each class have the same anti-inflammatory properties, but essentially differ in base and price.

Folliculitis decalvans Medical condition

Folliculitis decalvans is an inflammation of the hair follicle that leads to bogginess or induration of involved parts of the scalp along with pustules, erosions, crusts, ulcers, and scale. It begins at a central point and spreads outward, leaving scarring, sores, and, due to the inflammation, hair loss in its wake. No permanent cure has been found for this condition, but there is promise in a regimen of dual therapy with rifampin 300 mg twice daily and clindamycin 300 mg twice daily. This new treatment can be used to control the condition, and tests have indicated that after 3 to 5 months long uninterrupted courses of treatment, many patients have seen limited to no recurrence.

Hand eczema Skin condition

Hand eczema presents on the palms and soles, and may sometimes be difficult or impossible to differentiate from atopic dermatitis, allergic contact dermatitis, and psoriasis, which also commonly involve the hands. Even a biopsy of all these conditions may not result in a definitive diagnosis, as all three conditions may demonstrate spongiosis and crusting on the hands.

Sapienic acid is a fatty acid that is a major component of human sebum. Sapienic acid is a sebum fatty acid that is unique to humans. The equivalent fatty acid in mouse sebum is palmitoleic acid. Sapienic acid salts, esters, anion, and conjugate base are known as sapienates.

References

  1. ↑ Polin, Richard A.; Ditmar, Mark F. (2015). Pediatric Secrets. Elsevier Health Sciences. ISBN   978-0323315807. OCLC   698080046.[ page needed ]
  2. ↑ Goddard, Allison L.; Lio, Peter A. (15 July 2015). "Alternative, Complementary, and Forgotten Remedies for Atopic Dermatitis". Evidence-Based Complementary and Alternative Medicine. 2015: 676897. doi: 10.1155/2015/676897 . PMC   4518179 . PMID   26257817.
  3. 1 2 Wong, SM; Ng, TG; Baba, R (20 September 2013). "Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia". The Journal of Dermatology. 40 (11): 874–80. doi:10.1111/1346-8138.12265. PMID   24111816. S2CID   45914389.
  4. 1 2 Huang, JT; Abrams, M; Tlougan, B; Rademaker, A; Paller, AS (12 May 2009). "Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity". Pediatrics. 123 (5): e808–14. CiteSeerX   10.1.1.318.6231 . doi:10.1542/peds.2008-2217. PMID   19403473. S2CID   8334911.
  5. ↑ McKenna, PJ; Lehr, GS; Leist, P; Welling, RE (September 1991). "Antiseptic effectiveness with fibroblast preservation". Annals of Plastic Surgery. 27 (3): 265–68. doi:10.1097/00000637-199109000-00011. PMID   1952753. S2CID   26235653.
  6. ↑ Coetzee, E; Whitelaw, A; Kahn, D; Rode, H (17 November 2011). "The use of topical, un-buffered sodium hypochlorite in the management of burn wound infection". Journal of the International Society for Burn Injuries. 38 (4): 529–33. doi:10.1016/j.burns.2011.10.008. PMID   22100425.
  7. ↑ Gibson, Lawrence E. "Can a bleach bath treat chronic eczema?". Mayoclinic.org. Retrieved 8 November 2015.
  8. ↑ Huang, JT; Rademaker, A; Paller, AS (February 2011). "Dilute bleach baths for Staphylococcus aureus colonization in atopic dermatitis to decrease disease severity". Archives of Dermatology. 147 (2): 246–47. doi:10.1001/archdermatol.2010.434. PMID   21339459.
  9. 1 2 Leung, TH; Zhang, LF; Wang, J; Ning, S; Knox, SJ; Kim, SK (15 November 2013). "Topical hypochlorite ameliorates NF-κB-mediated skin diseases in mice". The Journal of Clinical Investigation. 123 (12): 5361–70. doi:10.1172/JCI70895. PMC   3859383 . PMID   24231355.
  10. ↑ Meddows, David (26 August 2015). "Bleach bath burns: Mum's horrific injuries after alleged skin care advice from doctor" . Retrieved 8 November 2015.
  11. ↑ "Eczema: Bleach bath therapy". American Academy of Dermatology. Retrieved 8 November 2015.
  12. 1 2 "Treating Skin Conditions Like Acne & Eczema". Bloomberg. Retrieved 8 November 2015.
  13. 1 2 3 Ryan, Caitriona; Shaw, Richard E.; Cockerell, Clay J.; Hand, Shari; Ghali, Fred E. (30 May 2013). "Novel Sodium Hypochlorite Cleanser Shows Clinical Response and Excellent Acceptability in the Treatment of Atopic Dermatitis". Pediatric Dermatology. 30 (3): 308–15. doi:10.1111/pde.12150. PMC   3666086 . PMID   23617366.
  14. ↑ Herbert, Adelaide. "Improved Clinical and Quality of Life Assessments and Decreased aureus Colonization in Pediatric Subjects with Moderate to Severe Atopic Dermatitis". UTHealth. Retrieved 8 November 2015.
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