Why Skin Gets Irritated and Rubs Off During Showers With Eczema

Understanding Eczema and How It Affects Your Skin

Eczema is a common skin condition characterized by dry, itchy, inflamed skin that can sometimes become cracked, scaly, and rough. There are several different types of eczema, but the most common is known as atopic dermatitis. This chronic condition causes the skin to be extra sensitive and prone to irritation from things like chemicals, fabrics, soaps, and changes in temperature or humidity. When the skin's protective barrier is compromised in this way, common triggers can easily flare up the eczema and cause redness, inflammation, oozing, and intense itchiness. Scratching inevitably occurs, leading to further damage of the skin barrier. This allows even more irritants in and creates a vicious cycle of irritation.

Why Skin Can Feel Raw After Bathing with Eczema

For those with eczema, something as simple as taking a shower or bath can actually trigger this cycle and make symptoms worse. There are a few reasons this happens:

• Hot water strips away natural moisturizing oils and dries out the skin.
• Soaps, shampoos, and cleansers contain detergents and chemicals that can further dry and irritate the skin.
• Scrubbing with a washcloth or loofah can cause physical abrasions.
• Hard water contains minerals that deposit on the skin and clog pores.
• Steam and humidity dilate blood vessels, leading to inflammation.
• Towel drying rubs and strips away more moisture from the skin's surface.

All of these effects damage the skin barrier even more and allow external irritants, allergens, and microbes to penetrate and trigger the immune system. This leads to redness, swelling, weeping, cracking, flaking, and intense itching. The itching and scratching further damages the skin, causing parts of the outer layer to physically rub off or come loose.

Tips to Prevent Eczema Flare Ups While Bathing

The key is to avoid anything that will dry out, irritate, or break down the skin barrier further. Here are some tips:

• Take short, lukewarm baths or showers no longer than 5-10 minutes.
• Use gentle, fragrance-free cleansers without detergents or alcohol.
• Apply moisturizers immediately after bathing while skin is still damp.
• Pat skin partially dry with a soft towel instead of rubbing vigorously.
• Use oatmeal bath soak or bath oils to help keep skin moisturized.
• Install a shower head filter to remove chlorine and other chemicals.
• Apply a layer of petroleum jelly before bathing to protect skin from water.
• Wear gloves and minimize contact with shampoos and soaps.

Best Products and Ingredients for Bathing With Eczema Prone Skin

Certain ingredients and products can help restore moisture and protect sensitive eczema-prone skin while bathing.

Cleansers

Look for fragrance-free and soap-free cleansers that won't strip away natural oils or irritate the skin. Recommended options include:

• Cetaphil Gentle Skin Cleanser
• CeraVe Hydrating Body Wash
• Vanicream Gentle Body Wash
• Aveeno Eczema Therapy Soothing Bath Treatment
• Oil-based cleansers like Dove Sensitive Skin Beauty Bar

Moisturizers

The best moisturizers to use on damp skin immediately after bathing include:

• Thicker ointments and creams like Vaseline or Aquaphor
• Ceramide-containing lotions like CeraVe, Cetaphil, or Eucerin
• Products containing colloidal oatmeal such as Aveeno Eczema Therapy

Bathing Additives

Add these products directly to your bath water for extra moisturizing and soothing relief:

• Colloidal oatmeal - Aveeno Soothing Bath Treatment
• Natural oils - Coconut, olive, jojoba, or avocado
• Epsom salts
• Dead Sea salts
• Baking soda (reduces hardness of water)
• Apple cider vinegar (balances pH of water)

Other Helpful Products

• Wet wrap therapy - Cover damp skin with a moist layer then a dry outer layer to lock in moisture.
• Bath gloves/sponges - For gentle cleansing without scrubbing.
• Shower filter - Removes irritants like chlorine from shower water.
• Humidifier - Adds moisture back into the air after bathing.
• Anti-itch creams - Help control urge to scratch.

When to Avoid Bathing

While regular cleansing is important, there may be times to avoid full showers or baths when eczema flares are particularly severe. Itching and inflammation need to be controlled first before exposing skin to water and cleansers.

Signs that warrant avoiding bathing or modifying your bathing routine include:

• Oozing, weeping, or cracked skin
• Severely inflamed or broken skin
• Intense itching that won't stop
• Signs of skin infection like pus, redness, warmth

In these cases, take quick rinses or sponge baths using just water until skin begins healing. Then gradually reintroduce gentle cleansers and bath additives. You may need oral antibiotics or topical anti-inflammatory creams if infections develop.

When to See a Doctor

Consult your dermatologist if:

• Your eczema is severe and not improving with self-care.
• You suspect a skin infection.
• Your skin becomes raw, broken, or bleeds excessively after bathing.
• Eczema is interfering with sleep or your quality of life.

A doctor can help identify triggers, provide prescription anti-itch and anti-inflammatory creams, recommend wet wrap therapy, and discuss advanced treatments like phototherapy if your eczema is difficult to control.

Create an Eczema-Friendly Bathing Routine

While it may require some trial and error, you can find the right bathing regimen that helps you stay clean without aggravating your eczema. The keys are to:

• Bathe less frequently and for shorter durations.
• Use lukewarm water instead of hot.
• Choose gentle, fragrance-free cleansers.
• Moisturize skin immediately after bathing.
• Pat gently when drying off.
• Avoid scrubbing, rubbing, or damaging the skin barrier.
• Listen to your skin and avoid bathing during severe flares.

Over time, you'll find the techniques and products that work best for your skin. Be patient as you work to repair and strengthen your skin barrier. With the right bathing regimen, you can keep your eczema under better control.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.