Sodium hypochlorite body wash in the management of Staphylococcus aureus–colonized moderate-to-severe atopic dermatitis in infants, children, and adolescents
- Sara Majewski MS1
- Tanya Bhattacharya MD1
- Manuela Asztalos MD11
- Benjamin Bohaty MD2
- Katherine C. Durham MD2
- Dennis P. West PhD1
- Adelaide A. Hebert MD2
- Amy S. Paller MD1
- 1Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- 2Department of Dermatology, The UTHealth McGovern Medical School-Houston, Houston, Texas
CorrespondenceAmy S. Paller, MD, Department of Dermatology, Feinberg School of Medicine, Chicago, IL. Email: firstname.lastname@example.org
- Objectives: A cleansing body wash containing diluted sodium hypochlorite (0.006% NaOCl) was evaluated for management of moderate-to-severe Staphylococcus au- reus–colonized, atopic dermatitis in children.
- Methods: A 6-week, prospective, open-label study was conducted with 50 evaluable participants (ages 6 months to 17 years) who had moderate-to-severe atopic derma- titis with S aureus skin colonization documented by culture. Participants were in- structed to continue using their current medications while using the study product, 0.006% NaOCl body wash, once daily to affected areas for 6 weeks. Primary out- come measures were Investigator's Global Assessment, Eczema Area and Severity Index, and Body Surface Area scores. Secondary outcome measures were the Visual Analog Scale for pruritus, Family Dermatology Life Quality Index, and Patient Satisfaction Questionnaire for Problem Areas. A subject daily diary and a six-item subject questionnaire that provided information on preferences for bleach bath vs body wash were secondary outcome measures.
- Results: Daily use of the 0.006% NaOCl body wash led to improvement for all out- come measures comparing baseline to 2-week and to 6-week evaluations. Of the 50 skin S aureus-positive subjects, 32/50 (64%) were still positive at 2 weeks. A 36.5% decrease in subject's daily record of topical corticosteroid application at end of study compared to baseline was found. Participant surveys indicated preferences for the body wash over bleach baths.
- Conclusions: Sodium hypochlorite (NaOCl) body wash improved all outcome mea- sures for moderate-to-severe S aureus–colonized AD in infants, children, and adoles- cents. The limited reduction in S aureus further suggests that sodium hypochlorite has ameliorative effects other than antimicrobial actions.
atopic dermatitis, bleach, body wash, sodium hypochlorite