When it comes to showering or bathing there is actually very little research that confirms best practices. Most research out there is for showering practices as related to those with eczema and the elderly.
What we do know is that the longer you spend in the water, the more your skin may start to dry out. It’s best to try to limit the length of the shower and to apply moisturizers immediately after to lock some hydration into the skin.
Hotter showers will strip our skin of it’s natural oils leading to a higher risk of itchy dry skin. This is particularly an issue as we get older. Our skin is our barrier that allows us to regulate our body temperature relative to the environment. As we get older our skin thins considerably making it harder to do so. If you take hot showers, this only further strips moisture away from the skin making it even harder to regulate our body temperature and it also makes us pretty itchy!
When I give talks at retirement homes on skin care and the elderly, the most common concern my audience has is their itchy back! If you think about that hot water beating down on your back from those hot showers, you can see how it can really dry out the skin to make it even itchier! Taking a lukewarm shower can really help soothe this and avoid making it worse.
We do need to spend enough time in the shower to clean our skin and hair and scalp however. This would mean just enough time to wash with water and soap if needed. If you tend to have very dry skin, it helps to limit soap use to the face, underarms, groin, hands and feet. Most patients with eczema tend to flare on the back, arms and legs as the winter starts. It helps to reduce the tendency towards dryness by limiting soap use here. Soap itself can dry out our skin further if used too much!
Remembering to wash our scalp and not just the hair is important as well. There can be quite a bit of build up on the scalp that can feel greasy, itchy and even sore at times. It’s important to fully wash out shampoo as any residual shampoo left behind can start to really irritate the scalp.
It can be hard to strike the right balance! By not washing, dead skin cells called keratin can start to build up on the skin and scalp. The key is to shower when needed, limit the time to the amount needed to gently cleanse your skin and hair, keep the temperature on the lukewarm to cool side, and moisturize when finished. An effective shower can likely be complete within 5-10 minutes.
I like to tell my patients to think of their skin cells as like a cobblestone street. The mortar that holds their skin cells together can break down with excess hot water and soap. This will make them far more sensitive to the environment resulting in itchy and eczema prone skin. By limiting time, soap and temperature, as well as sealing your skin with a moisturizer afterwards you will only support your skin’s barrier function more effectively!