Longtime listeners know that I love the advice Grandma had to give out, and grandma loved daily baths for her kids. Scrubbing with wash clothes, soap, and hot water was her recipe for skin health. But today we are going to look at her advice through the lens of modern children’s skin. Very interesting.
What got me started on this subject was a recent article I read about the ideal skin care for children with AD (eczema). I had no idea that the simple task of bathing children was this controversial. I have known for a long time that certain things about bathing are important to children with AD like the following:
Pediatricians are taught that…when bathing a child with AD, the water temperature should not be too hot and the use of soaps, especially with perfumes, is a no-no.
We are also taught that keeping a child’s skin clean with frequent baths is important but shouldn’t be done too frequently.
We are also taught to advise oils and moisturizers be put on just after bathing, because this locks in the moisture of the bath into the skin.
My experience tells me that much of this wisdom is correct. Last winter, I saw a young man who had a severe eczema flare-up on his face. After we discussed his dermatitis, I found out that he loved long hot showers with perfumed soaps and lotions that had lots of fragrance. He had quickly learned that his skin could not tolerate this, especially in the winter when the ambient temperature was low outside. He had removed much of the protective oils his skin had made and then put very allergenic chemicals deep into his skin…and he reacted. Simply reducing the temperature of his bath water, lowering the frequency of his bathing, and stopping the smelly lotions solved his winter skin nightmare.
So, back to the data review article I was reading. These experts were tasked with looking at published research to decide what is the best way to take care of the skin of children with eczema.
Here’s what they found:
- The timing of bathing with application of moisturizers doesn’t have strong evidence of effectiveness.
- In fact, daily bathing is not necessary for children with AD (or most children, in fact).
- Putting moisturizers on frequently to eczema-affected skin does show evidence of help.
- Hydrocortisone topically works but has severe limitations for chronic use…skin atrophy and steroid withdrawal
- Avoiding things that trigger eczema can be helpful and improve overall skin health.
- AD is likely a lifelong skin condition with a tendency to get better with age
- For some children, a weekly bath in diluted Clorox ¼ cup/18 gallons,can improve their eczema
So, it looks like for children with the most sensitive skin, dermatologists believe in a minimalist approach, certainly not the hot water, soap, and daily bathing that grandma advocated. Here are the guidelines from dermatologists for bathing frequency that dermatologists advocate and it is good news for your kids.
American Academy of Dermatologists:
Children ages 6 to 11: Guidelines for bathing
Children in this age group, however, may not need a daily bath. Children aged 6 to 11 need a bath:
- At least once or twice a week, or…
- When they get dirty, such as playing in the mud
- After being in a pool, lake, ocean, or other body of water
- When they get sweaty or have body odor
- As often as directed by a dermatologist if getting treated for a skin disease
Tweens and teens: Guidelines for bathing
Thankfully, most kids want to bathe daily once they hit puberty. Dermatologists tell parents that once puberty starts, kids should:
- Shower or take a bath daily.
- Wash their face twice a day to remove oil and dirt.
- Take a bath or shower after swimming, playing sports, sweating heavily.
Dr.Primmer-resident DocSmo dermatologist recommends when child smells bad
So there you have it: Grandma in the 20th century probably got carried away with bathing, hot water, soaps, and rough wash clothes. This seems to be one of the FEW times when Grandma got it wrong, at least for the children of the 21st century. Grandma was a pretty shrewd cookie, but everyone makes mistakes once in a while. I would love to hear what you do with the skin of your little bundles joy…what works and what doesn’t? Send in those comments through social media or to my blog, www.docsmo.com. This is Dr. Paul Smolen, suggesting that you may not want to be so keen on insisting your children always be so clean. Until next time.