Atopic dermatitis and the swimming pool

Swimming pools are sources of delight, fun and relaxation for most families. Swimming has a positive impact on our bodies, as it preserves the body’s kinetic and functional capacities and improves health and the quality of life. At the same time, it’s an incredibly entertaining activity from which nobody should be excluded and an essential skill that no child should lack. From when I was a child and a teenager, I remember big signs at the swimming pools that read: “Swimming for people with skin diseases is not allowed!” Not to mention the dirty looks and warnings that I received due to my skin, as you can well imagine. All of this came from the belief that each and every skin disease is contagious. Things have changed somewhat today. It’s now allowed for people without contagious skin diseases to swim in the pool, which includes patients with atopic dermatitis and psoriasis.

Swimming is one of the rare activities that involves the entire body and doesn’t irritate the skin of atopic dermatitis patients with sweat in contrast to other sports activities. Cool water also sooths the atopic skin. Seeking pleasant and healthy ways to spend their time, parents of children with atopic dermatitis and adult patients often don’t know whether going to a swimming pool is an appropriate option for them. In the cases where the swimming pools aren’t up to proper hygienic standards, there is namely the danger of developing secondary infections for those whose skin is already damaged by atopic dermatitis. There’s a lot of contradictory information on swimming pools out there for people with atopic dermatitis, so stick to these few essential pieces of advice before taking a plunge.

Atopic dermatitis and chlorinated water

Chlorine is the chemical most often added to pool water for disinfection. In some patients, chlorine can worsen atopic dermatitis symptoms or cause the illness in remission to flare-up again because the chemical an irritant that dries out the skin at higher concentrations. On the other hand, because chlorine is a disinfectant, patients could experience improvement of their condition after swimming. The skin of patients with atopic dermatitis is usually populated by numerous bacteria (mostly Straphylococcus aureus), which deteriorate the state of the atopic skin and function as triggers for atopic dermatitis. Chlorine disinfects the skin, ridding it of harmful bacteria, which often improves the skin’s state after a swim

the skin’s state after a swim. Whether bathing in chlorinated water suits your skin or not is for you to find out. Sadly, there isn’t a single piece of advice that would hold true for all patients, which is why it’s important to prepare yourself for the state of your skin to deteriorate in the swimming pool. If you notice that chlorinated water doesn’t suit you or your child with atopic dermatitis, you can seek out alternatives to chlorinated swimming pools such as salt-water swimming pools.

Other disinfectants may be added to swimming pool water besides chlorine, and you should obtain information on them before going into the water. If you’re worried that you or your child might experience a reaction to chlorine or other chemicals, take a 20-minute break after having doused away the swimming pool water, to see if any deterioration occurs. Likewise, try to limit the time that you spend in a swimming pool.

Skin care for atopic dermatitis patients before and after swimming in a pool

Swimming pool water and swimming pool surfaces can be sources of fungal, bacterial and virus infections when improperly cleaned. Atopic skin is much more prone to secondary infections, so try to avoid swimming pools for a while if your or your child’s skin is severely scarred due to atopic dermatitis. You can partly protect your skin against infections and irritating disinfectants by applying a slightly more oily cream (barrier cream) to it before swimming. The cream will work as a barrier between your skin and the water. While taking a break during swimming, wash your skin with fresh, cool water and apply the cream again. To minimise the chance of infection, carry your own towels, bathrobes and sandals at the pool. Pay special attention to body parts that are highly likely to develop fungal and virus infections. Wipe your feet well between the toes to stop any infection from occurring and spreading quickly to your already affected skin.

It’s very important to take the time and wash your skin with lukewarm water and apply the suitable skincare product after swimming. This will make it easier for you to remove any chemicals and impurities from your skin. Partially dry your skin and apply the appropriate skincare cream to it while it’s still damp.

Dealing with the reactions of other visitors

If as an adult patient you receive inappropriate or perhaps insulting comments or questions about your condition, calmly present your illness and your feelings to the commentators if you have the strength and need for it. Otherwise, raise your head and instruct the author of the inappropriate comment about the comments’ insulting nature and the basics of polite behaviour, without compunction. If the target of the insults is your child, be subtle about your response and pay attention to your child’s feelings and the way he or she experiences the situation. If the child feels extremely uncomfortable, offer him or her clothes to cover up the body and have a thorough discussion with him or her about the unpleasant experience.

Atopic dermatitis patients have very limited options when it comes to participating in sports and social activities. I wish you a carefree plunge into the swimming pool if it’s the thing for you!