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Salt baths for eczema treatment

The National Eczema Association recommends salt baths for eczema.  Many eczema sufferers report a decrease in itching, inflammation and redness. These same individuals may also find relief enjoying a soak at the ocean.

Salt is natural and therapeutic and has a cleansing effect.  If your baby or child suffers from eczema, salt baths can be a natural and effective way to successfully treat their eczema. Salt baths must be accompanied with daily skin maintenance. See below for salt bath instructions for a child with eczema.

  1. Choose your salt: table salt, sea salt or epsom salt.
  2. Prepare a warm tub.
  3. Add the salt:  2 cups for a full bath, 1 cup for a half bath, and an 1/8 cup for a baby bath.
  4. Soak your baby or child in the warm salt bath for 10-20 minutes.
  5. Remove the child from the tub and pat dry – do not rub.
  6. Immediately apply an eczema emollient.
  7. Dress the child in eczema clothing.  Eczema clothing stops the itch and keeps emollients in place for effective treatment.

This process should be done daily.  You will need to be patient, salt baths take 10 days to see a difference in the skin.

Evidence
There is no high quality evidence as yet showing that salt water baths are beneficial for atopic eczema sufferers.
There is one small clinical trial from Japan which compared two different types of salt water, but we are aware of none
that compares salt water versus ordinary water. However, there is a lot of anecdotal evidence suggesting that salt
water baths may be helpful in clearing up eczema, especially if it is oozing a lot or where secondary infection is
common. A number of UK dermatologists recommend regular salt baths to their patients with atoptic eczema as part
of their treatment plan. It is certainly something that our team at QMC have witnessed some benefit from. It is also a
very common experience in our clinic for parents to tell us that their child’s eczema improved when they swam in the
sea on holiday. Although this could easily be due to the change of climate and diet etc., the swimming in the sea
seems to be a particular feature that is highlighted in these conversations. Sea water is a weak antiseptic and may
well have a role in reducing the secondary infection which so commonly occurs in atopic eczema. It is possible that
the salt water also helps to draw out excess fluid that has accumulated into little water blisters in the skin, as well as
helping to heal any minor cuts and scratches.
We would not recommend salt water baths as a first line treatment in atopic eczema, but if you are struggling to control
your child atopic eczema it may be worth trying, especially if infections are a common problem. We do not really know
how strong the salt needs to be in the absence of a controlled trial (which we hope to do int eh near future), but we
would recommend that you try and mimic the concentration of sea water as closely as possible. Sea salt can be quite
expensive and it is important that you shop around to get the best bulk buy as you will need to use quite a lot of salt
in order to get a decent concentration in the bath. It is unclear whether daily bathing or whether weekly bathing is the
best and perhaps as a compromise a salt water bath twice a week could be managed by most who wish to undertake
this approach to treatment. It should be emphasised that the salt water bathing is only part of the whole treatment of
atopic eczema and that other treatments such as short bursts of topical steroid creams prescribed by your doctor,
regular and liberal use of moisturisers and avoidance of soap etc should be continued.
Making up the salt solution
You will need to use around a 20 fluid ounce jug of sea salt per 3 gallon bucket of water in order to achieve a similar
concentration to sea water. It is usually easier to pour the salt into the bottom of the bucket and dissolve it in a little
warm water before pouring it into the bath. Around 3 buckets will usually be enough for your child to soak in.
If your child has lots of broken skin the salt water (or indeed any type of water), can cause temporary stinging. It is
important that the broken skin is first treated with steroid creams and moisturisers before introducing the bathing. If
your child hates the bathing process then there is little point in persisting with it as you will simply create resentment