The 'soak and seal' protocol from National Jewish Health in Denver

The following programme is recommended on the National Jewish Health website.

It was brought to our attention by an article in the St Petersburg Times describing the trials of Ethan Russell, a five-month-old baby with terrible bleeding eczema. This was brought under control by a combination of bleach baths and an exaggerated version of the protocol below in which, after the bath (he had three a day) and the application of the moisturisers, Ethan was wrapped in wet pyjamas and then dry pyjamas over the top to seal in the moisture.

Soak and Seal
Dry skin makes the itching and rash of atopic dermatitis, or eczema, worse. Wind, low humidity, soaps, some skin care products, and washing or bathing without proper moisturizing can cause dry skin.

The most important treatment for dry skin is to put water back in it.

Take at least one bath or shower per day
Use warm, not hot, water for at least 10-15 minutes.

Use a gentle cleansing bar or wash and avoid scrubbing your skin with a washcloth.

Gently pat excess water away and immediately apply the recommended medicine or moisturizer to damp skin. Attempt to do this within 3 minutes. This seals in the water. (If you are applying skin medicine, do not apply moisturizer over it.)

Moisturizers and Cleansers
Ask your healthcare provider to recommend a skin cleanser and moisturizer. During the day, apply moisturizer whenever your skin feels dry or itchy. You can save money by asking your pharmacist to order the largest container of moisturizer available.

A skin cleanser is a bar or liquid used to clean the skin. Try products labeled for use with "sensitive skin."

Oil of Olay®

A moisturizer is a skin care product that adds moisture to the skin. Ointments and creams are recommended instead of lotion for people with very dry skin. Products that can help add moisture include:

Aquaphor® Ointment
Eucerin Creme®
Cetaphil® Cream

Tar shampoos, such as T-Gel®, are often helpful for red, itchy scalp. For scalp scaling or flaking, T-Sal® or Head and Shoulders® may be helpful.

June 2010

Click here for more research on the management of eczema

For links to skin and personal care products click here.