Episode 31 - Bathing frequency and eczema trial

In this episode of BJD Talks, Sam and Meera discuss the article ‘Weekly versus daily bathing for people with eczema: results of the Eczema Bathing online randomized controlled trial’ by Bradshaw et al. The full article can be accessed at https://doi.org/10.1093/bjd/ljaf417 

*This podcast was generated by an AI tool created by 67Bricks for the British Association of Dermatologists* 

Transcript

SPEAKER_00 0:00

Welcome to BJD Talks, the official podcast of the BJD. I'm Sam.

SPEAKER_01 0:04

And I'm Mira. In this episode, we will be discussing the article by Lucy Bradshaw et al. Weekly versus daily bathing for people with eczema. Results of the eczema bathing online randomized controlled trial from November 2025 and included in the March 2026 issue.

SPEAKER_00 0:23

This study addresses the long-standing debate in eczema care. How often should people with eczema have a shower or bath? Despite its simplicity, this has been a major concern for patients and carers. Guidelines vary internationally, but robust research supporting specific recommendations has been lacking. Until now.

SPEAKER_01 0:43

This was a two-arm, randomised controlled trial comparing daily bathing, six or more times a week, to weekly bathing, defined as one or two baths a week. The study included 438 participants aged one or older with all severities of eczema, most being moderate to severe eczema.

SPEAKER_00 1:02

Participants were randomly assigned to one of the two groups for a four-week period. The main outcome measure was changes in eczema symptoms using the patient-oriented eczema measure or POEM. And the results, depending on your perspective, were surprising.

SPEAKER_01 1:17

Exactly. The study found no significant difference between the daily and weekly bathing groups. Over the four weeks, average eczema severity scores were nearly identical. The weekly group had a slight improvement, but it was not clinically meaningful.

SPEAKER_00 1:32

On a practical note, adherence to the routines varied for both groups. Those in the daily bathing group cited time constraints and skin irritation, while weekly bathers reported feeling unclean and struggling with routine changes.

SPEAKER_01 1:46

Yes, and this study thoughtfully captured those challenges. Process evaluations highlighted how real-life factors, like busy schedules and perceptions of cleanliness, affect self-management. It adds an insightful, qualitative dimension to an otherwise quantitative trial.

SPEAKER_00 2:02

Another noteworthy aspect was the citizen science approach. This trial was co-produced with the eczema community. From its conception to the sharing of findings, patients and carers played an integral role throughout the process.

SPEAKER_01 2:15

Absolutely. Their involvement shaped practical aspects like study length, accessible online materials, and effective follow-up reminders. It's a sterling example of patient-centred research tailored to chronic conditions like eczema.

SPEAKER_00 2:30

Let's not overlook the secondary findings. The Weekly Bathing Group reported a slight reduction in topical steroid use. While not groundbreaking, it's an intriguing observation that merits further exploration.

SPEAKER_01 2:42

True. Of course, there were limitations. The trial lasted just four weeks. And seasonal effects, it was winter, alongside limited participant diversity, may impact how widely we can apply these results.

SPEAKER_00 2:58

Even so, this research is a relief for many. One participant captured it well, saying it gives people the freedom to choose a bathing routine that works for them without fear of exacerbating symptoms.

SPEAKER_01 3:09

Indeed, the findings help end the years of conflicting advice. Professionals can now emphasize individualized guidance, knowing that daily versus weekly bathing has minimal impact on eczema severity.

SPEAKER_00 3:22

So, in summary, this study advances evidence based medicine and empowers patients. It fills a knowledge gap while demonstrating the value of co produced research. Ultimately, it's about personal preference and what fits best for each individual.

SPEAKER_01 3:37

A significant step forward. That's it for today's discussion on BJD talks. Thank you for listening and we'll see you next time.