Discussion
pruritus, AD, itch, SC dysfunction
DISEASE
This study demonstrated that the addition of twice-weekly bleach baths in an adult, Our observation that bleach baths significantly reduce disease severity is in accordance with many studies that demonstrated significant improvements in clinical disease after bleach bath treatment [The dominant symptom experienced by AD subjects is pruritus [SC dysfunction in AD is partially due to alterations in lipid composition/conformation [Our results are consistent with other studies that noted improvements in AD with no significant reduction in Gonzalez et al. were the first to analyze the skin microbiome of non-lesional and lesional skin in young children with and without AD and compare changes after treatment with topical corticosteroids alone or in conjunction with bleach baths [Our observation that bleach baths did not significantly alter the AD skin microbiome, despite improving severity, was unexpected. Since our AD subjects were required to be In summary, our study confirms that bleach baths are safe and well-tolerated, corroborates published work demonstrating the ability of bleach baths to improve AD severity and itch, and is the first to show significant improvements in patient-reported outcomes of itch-related QoL, namely sleep, after bleach bath treatment. Importantly, the itch benefit (and EASI) correlated with improvements in skin barrier function and not the quantity of 