Detergents and your eczema, good or bad?

The first and primary recommendation is that people suffering from eczema shouldn't use detergents of any kind unless absolutely necessary. The current medical school of thought is that people wash too much and that eczema sufferers should use cleansers only when water is not sufficient to remove dirt from skin.

Avoid detergents and soaps

Another point of view is that detergents are so ubiquitous in modern environments and so persistent in tissues and surfaces, safe soaps are necessary to remove them in order to eliminate the eczema in a percentage of cases. Although most recommendations use the terms "detergents" and "soaps" interchangeably, and tell eczema sufferers to avoid both, detergents and soaps are not the same and are not equally problematic to eczema sufferers. Detergents increase the permeability of skin membranes in a way that soaps and water alone do not. Sodium lauryl sulfate, the most common household detergent, has been shown to amplify the allergenicity of other substances.

Detergent use has rocketed.

The use of detergents in recent decades has increased dramatically, while the use of soaps began to decline when detergents were invented, and leveled off to a constant around the '60s. Complicating this picture is the recent development of mild plant-based detergents for the natural products sector.

Unfortunately there is no one agreed upon best kind of cleanser for eczema sufferers. Different clinical tests, sponsored by different personal product companies, unsurprisingly tout various brands as the most skin friendly based on specific properties of various products and different underlying assumptions as to what really determines skin friendliness. The terms "hypoallergenic" and "doctor tested" are not regulated (according to Consumer Reports), and no research has been done showing that products labeled "hypoallergenic" are in fact less problematic than any others.

Dermatological recommendations in choosing a soap generally include:

Avoid harsh detergents or drying soaps.
Choose a soap that has an oil or fat base; a "superfatted" soap is best.
Use an unscented soap.
Patch test your soap choice, by using it only on a chosen area until you are sure of its results.
Use a non-soap based cleanser.

How to use soap when one must

Bathe in warm water, not hot.
Use soap sparingly.
Avoid using washcloths, sponges, or loofahs.
Use soap only on areas where it is necessary.
Soap up only at the very end of your bath.
Use a fragrance free barrier type moisturizer such as vaseline or aquaphor before drying off.
Never use any kind of lotion, soap, or fragrance unless your doctor tells you to or it's allergen free
Never rub your skin dry, elsewise your skin's oil/moisture will be on the towel and not your body.