Baths are good; more baths are better. Despite popular belief, dry skin does not lack oil, it lacks water. Baths put the water back into the skin, soften scale so it can be scrubbed off without too much difficulty, and are also great splashy playtimes for you and your little one. Keep in mind that soaps rob skin of essential oils, so they should be used sparingly or avoided altogether. Speak to your dermatologist about how much soap you should use. Some types of ichthyosis respond better to the steam in a comfortably warm shower than to complete immersion in a bath. Experiment to see what works best for your child.
You might also consult your dermatologist about which bath additive might be best for your child’s skin. Doctors often recommend oatmeal-based additives, which you can buy at the grocery store or drugstore, or make at home if you have a food processor to finely grind whole oats. For patients who are at risk for infection, doctors sometimes recommend adding a few drops of antibacterial soap or even bleach (e.g. Clorox®) to the bath. Although the precise measurement of the mixture varies from person to person, it is recommended to use approximately 1 to 2 teaspoons per gallon of water. Also, some shampoos can help reduce scale on the scalp.
If your baby has large raw areas on his or her skin (as many babies with EI do), put a dab of petroleum jelly on the raw areas before the bath. This helps alleviate the pain of the first contact with the bath water.
Once your child has had time to play and soak, scrub the loose skin off gently with your palms, a wash cloth, or a specially made product designed to loosen skin cells. (Nail salons often carry several kinds of nail filing blocks that are gentle to the skin.) You can also try a loofah or a pumice stone if your child has thick calluses. You will learn with experience how much to scrub. Moderation is the key. If too much skin is removed, there will be tender (sometimes very red or even raw) skin beneath. It is especially important not to overdo scrubbing off the scale in babies. Some topical medications may be absorbed internally if the skin is overly abraded or raw. Excessive scrubbing can also cause blisters in children with EI. And scrubbing of any type is not recommended in Netherton syndrome.
After a bath, thoroughly dry the creases under the neck, under arms and in the diaper area to guard against maceration, which are sores resulting from over-moisturized skin increases and folds. Only pat dry the rest of the body to keep the skin moist. Immediately apply cream or lotion to seal in that precious moisture.
How often should you give your child a bath? It depends on the condition of the skin and the weather. If you live in a climate with dry, windy, or cold weather, you may have to give your child more frequent baths. If your child is in air-conditioned environments, he or she may also need more frequent baths. For more information on bathing, see FIRST’s Skin Tip & Tools: Bathing & Exfoliation.
Members Offer Travel Tips for Bathing
(FIRST Members shared these tips for coping with their ichthyosis or related skin types on FIRST’s Facebook Group pages. FIRST does not endorse or recommend any treatment regimens, diets, medications, or products.)
Traveling with children can certainly present its own unique set of challenges. Add in the fact that most FIRST families are also coping with children who are affected with a rare skin condition and the challenges become even trickier – particularly when it comes to bathing. FIRST for Parents Facebook Group weighed in, offering their very best advice for traveling with kids and ichthyosis.
- Bring along a blow up baby tub. It’s easy to pack and you don’t need to use the hotel tub.
- Bring a big Rubbermaid container to pack things, and then use it as a tub as well when you are at your destination.
- Magic erasers and bleach wipes could also do the trick for a bath.
- Bring antibacterial wipes with you when you travel. You can use them for cleaning stations and bathtub.
- Consider switching to showers when traveling and resign yourself to the fact that kids may look a little “rough around the edges” without their same bath routines, whatever surface your child will contact.
- It is recommend to keep the regular bath routine while on vacation, particularly if there are swimming pools involved. It will be easier to transition back to your routine when you arrive back home.
Tips for the Tub: How to Enter and Exit Safely
Baths are a critical element of skin care for many people with ichthyosis. But slips and falls in the bath are common and can lead to injury. To promote independence in bathing for all ages, we recently sat down with an occupational therapist to better understand tips for bathing safely.
First, be sure to have a bathmat outside of your bathtub to reduce slipping when entering and exiting the tub. You also may want to purchase a nonslip mat for inside the bathtub, depending on your comfort and personal preference.
When entering the bathtub, use the wall to steady yourself as needed. You may also want to consider entering the bathtub sideways. Put both hands against the wall and step one leg in at a time. Depending on your level of mobility, personal comfort, and physician suggestions, you may also sit on the ledge of the bathtub, gently swing one leg over at a time, then lower yourself into the tub. For even more security, consider installing grab bars within your bathtub.
When you are ready to exit the tub, you may want to consider turning onto your knees and standing up. This promotes balance and steadiness in a slippery environment. You can also use your hands to push yourself up. If it works better for you and your personal comfort, use the ledge of the bathtub to sit on and then swing your legs out of the bathtub.
These tips from a board-certified occupational therapist are appropriate for children and adults. Please contact your physician if you have specific concerns.
This information is provided as a service to patients and parents of patients who have ichthyosis. It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents. Neither FIRST, its Board of Directors, Medical & Scientific Advisory Board, Board of Medical Editors nor Foundation staff and officials and sponsoring foundations endorse any treatments or products reported here. All issues pertaining to the care of patients with ichthyosis should be discussed with a dermatologist experienced in the treatment of their skin disorder.