Sodium Hypochlorite Body Wash in the Management of S. aureus–Colonized Moderate to Severe Atopic Dermatitis | PracticeUpdate

Published in Dermatology

Journal Scan / Research · May 02, 2019

Sodium Hypochlorite Body Wash in the Management of S. aureus–Colonized Moderate to Severe Atopic Dermatitis

Pediatric Dermatology

TAKE-HOME MESSAGE

• A total of 50 participants (aged 6 months to 17 years) with moderate to severe atopic dermatitis (AD) and S. aureuscolonization who were treated with diluted sodium hypochlorite (NaOCl 0.006%) body wash once daily for 6 weeks, along with their current medications, were examined. At weeks 2 and 6, NaOCl wash led to improvement in all endpoints such as IGA, EASI, and BSA compared with baseline. There was a 36.5% reduction in topical corticosteroid use at 6 weeks. At 2 weeks, 64% continued to have positive S. aureus colonization.

• The results showed significant improvements in moderate to severe AD with S. aureuscolonization in pediatric patients using diluted sodium hypochlorite body wash. NaOCl 0.006% wash may have effects other than antimicrobial properties and may be a preferred method over bleach baths.

– InYoung Kim, MD, PhD

Abstract

OBJECTIVES

A cleansing body wash containing diluted sodium hypochlorite (0.006% NaOCl) was evaluated for management of moderate-to-severe Staphylococcus aureus-colonized, atopic dermatitis in children.

METHODS

A 6-week, prospective, open-label study was conducted with 50 evaluable participants (ages 6 months to 17 years) who had moderate-to-severe atopic dermatitis with S aureus skin colonization documented by culture. Participants were instructed to continue using their current medications while using the study product, 0.006% NaOCl body wash, 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. Secondary outcome measures were the Visual Analog Scale for pruritus, Family Dermatology Life Quality Index, and Patient Satisfaction Questionnaire for Problem Areas. A subject daily diary and a six-item subject questionnaire that provided information on preferences for bleach bath vs body wash were secondary outcome measures.

RESULTS

Daily use of the 0.006% NaOCl 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 subjects, 32/50 (64%) were still positive at 2 weeks. A 36.5% decrease in subject's daily record of topical corticosteroid application at end of study compared to baseline was found. Participant surveys indicated preferences for the body wash over bleach baths.

CONCLUSIONS

Sodium hypochlorite (NaOCl) body wash improved all outcome measures for moderate-to-severe S aureus-colonized AD in infants, children, and adolescents. The limited reduction in S aureus further suggests that sodium hypochlorite has ameliorative effects other than antimicrobial actions.

Pediatric Dermatology

Sodium Hypochlorite Body Wash in the Management of Staphylococcus aureus-Colonized Moderate-To-Severe Atopic Dermatitis in Infants, Children, and Adolescents

Pediatr Dermatol 2019 Apr 15;[EPub Ahead of Print], S Majewski, T Bhattacharya, M Asztalos, B Bohaty, KC Durham, DP West, AA Hebert, AS Paller 

http://www.practiceupdate.com/content/sodium-hypochlorite-body-wash-in-the-management-of-s-aureus-colonized-moderate-to-severe-atopic-dermatitis/82740

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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