Bleach baths in patients with skin infections

Introduction

Bleach baths are recommended in patients with frequent skin infections to reduce colonization of the skin by pathogen bacteriaparticularly Staphylococcus aureus. Bleach baths have been reported to reduce the severity of atopic dermatitis and to reduce the need for current steroids and antibiotics.

Skin infections

Staphylococcal infections of the skin and Soft fabric they are common, especially in children, and can be serious. Despite treatment, more than 20% of patients with skin and soft tissue infections have reappearance within three months Primary Staphylococcal skin infections include:

• Impetigo
• Boil

• Folliculitis

Secondary staph infections include:

• Infected eczema

• Infected wounds, including surgical wounds and trauma.

Predisposing factors for skin and soft tissue infections include:

• Bacterial colonization of the patient's skin with S. aureus
• Colonization of the skin of a family member.
• Colonization with resistant methicillin S. aureus (MRSA)

• Dermatitis, particularly atopic eczema, discoid eczema and venous stasis eczema.

How can you decolonize the skin?

attempts to reduce S. aureus By decolonization of the skin are included combinations of:

• Bleach baths or showers

• nasal mupirocin ointment

• Oral antibiotics (eg, flucloxacillin, rifampicin, doxycycline)
• Chlorhexidine solution as an antiseptic bath or shower cleanser
• General hygiene and wound care.

What is a bleach bath?

Bleach baths are dilutions of household bleach with water in a bath. The chlorine concentration is similar to that of a swimming pool. Have antimicrobial action.

• The active compound in commercial household bleaches is sodium hypochlorite (NaOCl).
• The bleach contains 3–6% available chlorine (Cl₂), approximately 0.5–1.5% sodium hydroxide (NaOH) as stabilizer, small amounts of surfactants, and perfume.
• TO pH 11-13, is an alkaline aqueous solution with important oxidizing properties.
• Sodium Hypochlorite 0.0006% is also available as a convenient wash suitable for use in a shower.

Why use a bleach bath?

Combined with other decolonization methods, bleach baths reduce decolonization rates. recurrent primary and secondary skin and soft tissue infections.

Bleach baths have a broad spectrum of action against:

• Bacteria (Gram-positive and Gram-negative)

• fungi and spores

• Virus

Microbial resistance to sodium hypochlorite has not been reported. The effect of bleach baths on the decolonization of the patient's skin is only temporary, so it must be repeated regularly.

Bleach baths also appear to reduce inflammation and itching in eczema.

How to use a bleach bath

Mix 2 ml of 2.2% household bleach for every 1 liter of water to obtain a 0.005% solution. Brands vary in strength, so check the label. If the concentration is higher, use less bleach, and if the concentration is lower, use more bleach.

• Soak the trunk and limbs in the bath for 10-15 minutes. Do not submerge your head.
• Rinse with warm tap water and towel dry. Avoid sharing towels.
• Apply topical steroids and moisturizers if prescribed.
• Bleach baths are recommended at least twice a week.
• Keep bleach out of the reach of children.

What are the adverse effects of a bleach bath?

Exposure to bleach baths can lead to:

• Dry Skin
• Eruption/ dermatitis / skin irritation
• Asthma exacerbation
• nasal irritation

These symptoms are often due to the addition of perfumes or detergents to the bleach. If it's problematic, try another brand. Do not apply the bleach directly to the skin.

Toxicity or poisoning is rare but potentially very serious. It is usually due to ingestion of undiluted solution. Keep bleach in its original container with a child-resistant cap and make sure small children cannot open it.

Ingestion of small volumes can lead to:

• irritation of the oropharynx,
• Burning sensation in the mouth and throat.
• Thirst
• Nausea
• Vomiting
• Hematemesis (vomiting blood).

Ingestion of large amounts or more concentrated solutions may lead to:

• corrosion of the mucous membranes
• chest and abdominal pain
• watery diarrhea
• Melaena (blood in stool)
• Ulceration or drilling of the esophagus or stomach
• Hemorrhage and shock.