https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/milton-bleach-baths-for-children-and-young-people-with-epidermolysis-bullosa-eb/
Milton (bleach) baths for children and young people with epidermolysis bullosa (EB)
This information sheet provides information about the benefits, tips, and safety of Milton baths for patients with epidermolysis bullosa (EB).
Why are baths important for children with EB?
Bathing is an important part of everyday life for all children as it maintains good health. For children and young people with EB, baths provide the additional benefit of helping protect from infection and illness by reducing bacteria or “germs” on the skin.
What’s a Milton bath?
Milton sterilising fluid is a form of diluted bleach, containing 2 percent sodium hypochlorite. It can be bought in most supermarkets and pharmacies. Milton baths use a gentle mixture of diluted bleach and water, very similar to the chlorine used in swimming pools.
What’s the benefit of a Milton bath?
Milton baths help to reduce the level of a bacteria called staphylococcus. Staphylococcus is found on everyone’s skin in small amounts, but often there is too much on EB skin which increases the risk of infection due to open wounds.
Having a Milton bath once or twice a week is a safe way for children with EB to reduce inflammation and the risk of developing recurrent skin infections by safely decreasing bacteria on the skin and wounds.
Sounds odd! Should I be worried?
Milton baths sound a bit odd (even a bit scary), but when used properly, the dilution rate gives a similar effect to the chlorine dilution in a swimming pool. Milton does not contain colouring agents or perfumes, therefore it’s less likely to cause stinging or irritation. Used alongside your regular skincare routine, Milton baths can be an effective way of keeping wounds and blisters clean and reducing recurrent infections.
How do I make a Milton bath?
- Run the bath to the preferred temperature. Don’t add any scented bubble bath as this can dry out the skin. You can use Octenisan Wash or Dermol 500 instead.
- Add 125ml of bleach in a full bathtub of water or 60ml in a half full tub. Mix well.
- Soak for five to 15 minutes. It’s okay to get hair wet but make sure that the water does not get into eyes. You can use your usual emollient cream to cleanse the skin.
- Always rinse off with plain water, then gently pat dry and moisturise with your chosen cream/ ointments.
- Redress and relax!
If you notice any signs of irritation during the soaking stage, rinse the skin with fresh water immediately.
Safety tips
- Do not use Milton baths for children who have a known contact allergy to chlorine.
- Never use undiluted bleach directly on the skin.
- Make sure the water is comfortably warm, but not too hot, to avoid drying out the skin.
- Avoid any swallowing or splashing in the eye. If this happens, wash immediately with plenty of fresh water and seek medical advice by calling NHS 111.
- Always keep bleach in its original child-proof bottle.
- Always keep the bottle out of reach of children.
- Milton baths can potentially cause dryness or irritation. If this happens, empty the bath and rinse off with fresh warm water.