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It is important to reduce the amount of bacteria on the skin surface by washing. However water itself can have an irritant affect.
Water Hardness
It was highlighted that it was agerelated thus primary school children appeared to be more affected by the higher calcium content of the water than secondary school children.
Daily Washing
While most health professionals recommend a daily bath/wash it does depend on the age of the child, ability to get dirty (toddler rather than baby) and the condition of the skin. In some babies over-exposure to water can be more of an irritant than a benefit. As you need to use more soap to raise lather in hard water this increases the potential for irritation and skin failure by removing natural oils.
Soap Substitutes & Bath Oils
Soap substitutes or bath oils can be used effectively to clean and leave a trace of oil on the skin surface to help keep the skin hydrated. It is important to follow the recommendations when it comes to adding bath oil to water to ensure safety from slipping. Some products have special additives e.g. antiseptics that can be useful to reduce surface bacteria but may cause irritation if used in large quantities.
Sore Skin
If the skin is sore and open, getting into the water will sting or cause discomfort so distraction and play is important to enable the child/adult to work through it. Sometimes a light application of soap substitute prior to getting in the water can help.
Washing Hair
It is also suggested that hair is washed separately to prevent shampoo going on to the skin. For babies bath oil or soap substitute are a good substitute for shampoos.
Water Temprature
Temperature of water is important - hot water causes blood vessels to dilate, cooling the skin through evaporation increasing water loss. A bath ideally should be body temperature; babies and children should not be placed in the bath that's suitable for the adults. Hot power showers also can be detrimental to the skin. While it initially feels great and relieves the itchy sensation it can lead to further dehydration of the skin.
Time in the Water
Length of time in the water is also a factor. If the skin becomes water logged the epidermal barrier becomes ineffective and loses more water than it gains - evidenced by white wrinkly lines on the tips of fingers and toes.
Drying the skin
Pat the skin dry afterward, avoiding rubbing, as this can irritate the skin surface and increase body temperature which can stimulate itching. Rubbing is another form of scratching and this can cause the epidermis to thicken to protect itself.
Practical Suggestions
1. Prior to going swimming apply a covering of moisturiser which you then wash off when you get out of the pool (beware of slipping).
2. Avoid direct heat e.g. choose a desk in the classroom/office furthest away from a radiator.
3. Turn the central heating off in the bedroom and reduce by 10 on the thermostat for the whole house (jumpers maybe required).
4. Water consumption should be increased. Alcohol can cause dehydration of the body and skin so for every unit of alcohol drink one pint of water.
5. Decant soap substitute and/or moisturiser to take to school or work to reapply throughout the day.
6. From an early age moisturise more than just your face.
7. Depending on the dryness of the skin reapplication of the moisturiser should be carried out 3-4 times a day to maintain the skin's integrity.