D2.532 - Does Bathing Frequency Matter in Pediatric Atopic Dermatitis? Insights from Real-Life Practice

Atopic dermatitis (AD) is a common chronic inflammatory skin condition in children, characterized by recurring flare-ups. Bathing practices and moisturizer use play key roles in maintaining skin barrier integrity; however, their relationship with disease severity remains controversial. This study aimed to evaluate the association between bathing habits, moisturizer use, and disease severity in children with AD.

This cross-sectional, observational study included 65 children with atopic dermatitis attending the Pediatric Allergy and Immunology Outpatient Clinic of Istanbul University, Istanbul Faculty of Medicine.

AD was diagnosed based-on Hannifin-Rajka criteria, and patients who were under regular follow-up were included in the evaluation. Demographics, bathing habits (seasonal frequency, duration, water temperature, cleansing products usage), moisturizer use, and disease history were collected with a structured questionnaire.

Disease severity was assessed with the SCORAD index and classified as mild, moderate, or severe. Flare-ups in the past month and past year were recorded as indicators of the disease activity.

There were 35 were female (53.8%), and 30 male (46.2%) patients with the median age of 82 months (IQR 48–104). The median SCORAD score was 25 (IQR 13–35). Atopic dermatitis severity was mild in 44.6%, moderate in 49.2%, and severe in 6.2% of patients.

The summertime bathing frequency was significantly associated with SCORAD scores (p=0.001). Children bathing ≤4 times per week during summer had higher scores than those bathing more frequently. No significant associations were observed between SCORAD scores and other bathing habits such as use of soap, bathing duration, water temperature, or wintertime bathing frequency (p>0.05). Neither the frequency of moisturizer application nor the timing of moisturizer uses after bathing showed significant associations with SCORAD scores (p>0.05). However, the number of flare-ups in the past month and in the past year showed significant positive correlations with SCORAD scores (r=0.550, p<0.001 and r=0.647, p<0.001, respectively).

Lower bathing frequency during the summertime was inversely associated with disease severity in children with atopic dermatitis. These findings suggest that, among modifiable daily care practices, summertime bathing frequency may have a more relevant association with disease severity than other commonly discussed bathing or moisturizing habits.