Why is mild cleanser use important in helping to manage eczema?

The regular use of mild cleansers is an important aspect of optimal eczema management. Not only is cleansing an essential part of basic hygiene, but it also removes dirt, sweat, bacteria, and exfoliated cells, which better prepares the skin to receive topical medications and improves drug absorption.

• Eczematous lesions are commonly colonized with microbes; Staphylococcus aureus (S. aureus) being one of the most common causes of bacterial skin infections. Routine cleansing can encourage antimicrobial activity against S. aureus and decrease the chances of infection.
• Care must be taken to minimize any further weakening of the skin barrier during cleansing. The use of improper techniques and unsuitable cleansing agents on the face or body can initiate flares or worsen existing lesions.
• The use of anionic detergents (i.e., soaps) can alter the pH of skin, resulting in increased sensitivity to irritants and conditions that can promote bacterial growth.
• While removing excess sebum, cleansers can also inadvertently damage intercellular lipids, which can lead to further impairment of the barrier function and cause dry skin.
• Cleansers that are suitable for eczematous skin are generally based on mild synthetic surfactants that cause minimal barrier disturbances.
• Non-ionic surface-acting agents (e.g., silicone and polysorbate) are less likely to cause irritation and are pH-compatible with the skin.
• Silicone surfactants, such as dimethicone, are effective at eliminating surface debris without completely stripping away protective oils.
• Emollients contained in cleansers can minimize barrier damage by emulsifying dirt and oil for easy removal, while at the same time replacing lipids that are lost during the washing process.

Back to Eczema Treatment Index    |    Top of this page