LOWER rates of eczema at six months were observed when frequency and intensity of infant bathing was reduced in a feasibility randomised controlled trial, suggesting early life skincare practices may play a role in eczema development.
Eczema is a chronic inflammatory skin condition driven by impaired skin barrier function, typically beginning in infancy and characterised by itch, sleep disruption and recurrent flares. It is the most burdensome skin disease globally, affecting around 15% of infants and 6% of older children. The condition is also closely tied to the broader atopic spectrum, with many children later developing food allergy, asthma or allergic rhinitis. Together, atopic conditions affect around one in three children in the UK and other comparable settings, with substantial impacts on families and health services.
Fewer Baths, Fewer Eczema Cases at Six Months
The feasibility trial screened 261 pregnant women, with 105 randomised either to a reduced bathing intervention or routine postnatal care. Those in the intervention arm were advised to bathe infants no more than once weekly for the first six months, keep baths short, avoid hot water and use plain water where possible.
Adherence was high, with 79.6% of families in the intervention group meeting the bathing target compared with 28.6% in controls. 95% of participants in the experimental group reported the approach as acceptable, and follow-up rates exceeded 80% at six months (89% completed the final questionnaire; 82% attended the final visit), supporting the practicality of the design.
At six months, visible eczema was recorded in 15.8% of infants in the intervention group compared with 29.2% in the control group. Parent-reported and clinician-assessed outcomes showed the same direction of effect, with no notable adverse effects reported.
Implications for Future Eczema Prevention Research
The study was affected by recruitment constraints linked to staffing issues and was not powered to detect statistically significant differences in eczema outcomes. Most cases observed were mild, so caution is required when interpreting the findings and extrapolating to more severe cases of eczema.
Despite limitations, the results support the feasibility of recruiting pregnant women of diverse ethnic backgrounds into bathing-related prevention trials and suggest early skincare practices may warrant further investigation. A larger multicentre trial is now needed to determine whether reduced infant bathing can meaningfully influence eczema development at population level.
Reference
Perkin MR et al. Randomised controlled feasibility trial of an intervention to reduce infant bathing. Br J Dermatol. 2026;DOI:10.1093/bjd/ljag248.
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