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Sodium Hypochlorite Body Wash in Pediatric AD

All outcome measures for moderate-to-severe Staphylococcus aureus-colonized atopic dermatitis (AD) in infants, children, and adolescents improved with the use of sodium hypochlorite (NaOCI) body wash, a new study found. Researchers conducted a 6-week, prospective, open-label study with 50 evaluable participants aged 6 months to 17 years who had moderate-to-severe AD with S. aureus skin colonized documented by culture. Participants were instructed to continue using their current medications while using the study product once daily to affected areas for 6 weeks. Primary outcome measures were Investigator’s Global Assessment, Eczema Area and Severity Index, and Body Surface Area scores. Among the findings:

  • Daily use of the 0.006% NaOCI body wash led to improvement for all outcome measures comparing baseline to 2-week and to 6-week evaluations.
  • Of the 50 skin S. aureus-positive participants, 64% were still positive at 2 weeks.
  • There was a 36.5% decrease in daily record of topical corticosteroid application at the end of the study compared to baseline.
  • Participants preferred the body wash over bleach baths.

Citation:

Majewski S, Bhattacharya T, Asztalos M, et al. Sodium hypochlorite body wash in the management of Staphylococcus aureus-colonized moderate-to-severe atopic dermatitis in infants, children, and adolescents. [Published online ahead of print April 15, 2019]. Pediatr Dermatol. doi:10.1111/pde.13842.

Commentary:

Sodium hypochlorite (chlorine bleach) in a diluted body wash formulation, was used daily in pediatric AD patients shown to be colonized with staph. Other treatments were continued as needed, including topical corticoids. By 6 weeks, a reduction in use of these topicals of 35% was noted, although two-thirds of the patients still had positive skin cultures of staph. Other parameters of AD activity, such as the EASI score and physician's assessment improved as well. Although much more expensive than a "bleach bath", this body wash product was preferred by patients from an aesthetic standpoint. — Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY