Eczema and sensitive skin

Eczema (atopic dermatitis) is a skin condition that causes skin to become dry, itchy and bumpy. Although health and medical advice is outside of our scope, we have helped thousands of families improve their laundry and as a result lessen eczema flare ups. 

As cloth nappy and laundry specialists, we know how to remove soiling, dirt and grime from clothing, towels and bedding. Washing these items thoroughly ensures skin sits directly against clean fabric. Washing laundry so that it is as clean as possible removes irritants from the environment. When less irritants touch the skin, eczema symptoms often reduce.

At Clean Cloth Nappies, our expertise is washing cloth nappies and laundry. For eczema management advice, please contact your doctor, child health nurse, dermatologist or refer to reputable online resources like The Royal Children’s Hospital (RCH) and DermNet.

Thoroughly wash cloth nappies and laundry

Long warm-hot (40-60ºC) washes with a high-performance laundry detergent is the best way to remove dirt and grime from laundry. Hot (60ºC) washing towels and bedding ensure these items are even cleaner. This might be different to how you currently wash.

Adding laundry booster (oxygen bleach) or chlorine bleach also improves how clean items are.

Each wash cycle is different, the level of soiling is never identical. You might have the same cycle length and water temperature but the the soiling and staining of each load is different. This means you need to be mindful of when to adjust the detergent dose (and chemical factors).

~ Anastasia, Environmental Scientist and founding Facebook group admin

Our Facebook community is full of success stories from families that changed their washing habits and reduced eczema flareups.

One of my girls had horrible eczema from when she was a baby. The one thing that really helped (I tried loads of things) was changing to hot washing and using more, better quality detergent. She went from skin like sandpaper with sores that needed constant attention to perfectly clear skin. We sorted it around age 11 and it has never come back. She’s now 19.

~ Joanna, UK Facebook member

My stepdaughter’s skin has improved dramatically now that both households she lives in are on board with warm washes and Biozet powder.

~ Fiona, Australia

Choosing a suitable detergent 

Modern detergents are fully soluble in water and rinse cleanly at the end of the wash cycle. If your baby wears clothes washed in normal detergent without issue, their nappies can be washed in the same detergent.

In most cases, there is no need to use a hypoallergenic or sensitive detergent.

Choose a detergent with enzymes

Choose a high-performance detergent, preferably containing enzymes. Enzymes have been used in laundry products since the 1950s, are extremely carefully formulated, effective, safe and do not cause skin reactions.

There’s no evidence that using washing powders with enzymes (bio powders) or fabric conditioners will irritate your baby’s skin.

~ NHS – What you’ll need for your baby

The weight of evidence is now convincing that consumer use of enzyme-containing laundry detergent does not pose any greater risk of skin irritation than that of their ‘nonbiological’ variants… and that there is no evidence for enzymes leading to contact dermatitis (allergic or irritant).

~ Enzymes, detergents and skin: facts and fantasies

If using an enzyme-free detergent, hot wash (60ºC) all nappies, clothes and bedding.

Sensitivity to fragrance

Some people are sensitive to fragrances in laundry detergent. In this situation, select a fragrance-free detergent or add an extra rinse to rinse out the last trace of any fragrance.

Fragrance allergy is common and is believed to affect around 1% of adults. Rates in children and adolescents are around 1.8%. 

~ DermNet

High-performing, enzymatic, fragrance-free/low-fragrance detergents

Australasian options

• OMO/ Persil Ultimate Sensitive liquid/ capsules 
• OMO/ Persil Sensitive dilute at home refill/ capsules (note: these variants contain enzymes, but regular powder and liquid do not!)
• OMO/ Persil Professional Fragrance-Free powder (available at Bunnings, Mitre 10 and rural supply stores)
• Earthwise Sensitive laundry liquid
• Biozet Attack powder (low fragrance)

I use Biozet for all our washing (except wool) and the only eczema my son has experienced is on his cheeks from cold air, and a small patch under his arm when we went through a stage of wrapping/ tying a towel around him after bath time and the skin got irritated. 

~ Katie, Australia

North American options

• Persil Free & Sensitive liquid
• Tide Free & Gentle liquid
• Tide Free & Gentle powder

Laundry products to avoid

There are a lot of washing suggestions for eczema online, and many of them are unhelpful. Some suggestions can make eczema worse. Eczema families are often told to use small amounts of detergents. Sometimes they are recommended soap-based detergents, eco-eggs or even make their own detergent. 

These options do not clean well, and this means everyday dirt is not completely removed in the wash cycle. Over time, small amounts of residual dirt build up and form a thin film of grime on the fabric. This grime in direct contact with the skin and makes eczema worse.

Avoid low-quality detergents 

Low-quality detergents contain minimal surfactants and do not clean well. Low-quality detergents contain minimal surfactants and do not clean well. Musty, sweaty, barnyard, or eggwhite smells are signs that your detergent isn’t doing its job. 

If clothes like jeans or towels feel slightly greasy, this can be another sign that oils have not been adequately removed from the fabric. Many alternative products have strong fragrances (which can make inflammation worse) but also hide dirty smells, so be extra vigilant with these.

I have eczema and so does my 2-year-old daughter. We now use plenty of normal detergent with no fragrance (Tide liquid as we are in the US) and bleach in a hot wash for all of our clothes. It’s made such a massive difference in our lives.

For years and years I used a much lower quality detergent, nowhere near enough detergent, and cold water only. My laundry was never truly clean but I couldn’t understand that until it was. All of the changes to medications, lotions, diets, and soaps couldn’t fix what the dirty laundry was causing. Obviously we both still have eczema, but flare ups are much rarer and general day to day eczema isn’t anywhere near as bad. Plus fixing the laundry issue helps you find any other issues much easier!

~ Carissa, US based Facebook group member

Avoid homemade detergents

Homemade detergents are particularly problematic as they do not contain surfactants (cleaning agents) and instead contain washing soda and soap. Not only do homemade detergents have limited cleaning power, due to the soap, they do not rinse fully. They leave soap scum residue on your clothing and inside your washing machine. 

Avoid benzalkonium chloride

Benzalkonium chloride (BAC) is a well-known irritant. Both irritant and allergic contact dermatitis due to BAC are more likely to occur in people with a compromised skin barrier, such as eczema.

Avoid fabric softener

If you or your child has eczema, avoid using fabric softener. These are not necessary, they make the laundry harder to wash next time it’s washed, and are another source of fragrances and potential irritants.

Avoid disposable wipes

Disposable wipes can contain preservatives that irritate skin (methylisothiazolinone or other isothiazolinones). These preservatives are a common cause of skin irritation in babies.

Some medical sources suggest avoiding commercial disposable wipes altogether, due to how commonly they irritate babies’ skin.

Using cloth wipes with plain water avoids having to use disposable wipes at all, and many other benefits. 

Skin reactions to laundry detergent ingredients

If someone reacts to laundry detergents (including unfragranced laundry detergents), the next common causes are specific ingredients. This usually requires advice from a doctor or dermatologist and possibly allergy testing. 

When to see a doctor or specialist

If you are already washing clothes, towels and bedding on long warm-hot washes with enough quality detergent you can (mostly) rule out laundry issues. The good news is this helps to identify other triggers much easier!

Visit your doctor or dermatologist to discuss skin management. They will give you advice, and you can decide if you want to do comprehensive allergy testing.

Our eczema specialist emphasised to us that irritations from detergents etc. were a downstream effect, and if we were treating the bacteria causing the eczema properly, the skin wouldn’t react to an irritant with anywhere near a proper flare up because it could protect itself in the first instance. She said the right treatment for the eczema itself is far more important than managing and mitigating the downstream triggers.

~ Jen, Facebook group member