Baths Under 10 Minutes in Lukewarm Water and Moisturizer Right After Are the AAP’s First Defense Against Kids’ Winter Dry Skin

Ten minutes is the limit the American Academy of Pediatrics puts on a child’s bath in winter, and the water should be lukewarm rather than hot. In its guidance on dry winter skin in babies and toddlers, written by Amy Lynn Stockhausen, MD, FAAP, the AAP pairs that short soak with a second step: moisturizer, applied right away. Pediatric dermatologists and children’s hospitals add detail on why the routine works and how to adjust it once heating season dries out the air.

Bath time

“Short baths are best,” the AAP says, and it defines short as less than 10 minutes. Hot water can dry the skin and make nerve endings more sensitive, which raises the urge to scratch, according to the same guidance. Lukewarm water avoids both problems.

Other medical sources land in the same place with slightly different numbers. A Johns Hopkins parent guide, based on an interview with pediatric dermatologist Katherine Puttgen, says to keep baths under 15 minutes in warm water. Dr. Gigi Chawla, chief of general pediatrics at Children’s Minnesota, points to the AAP’s under-10-minute limit for babies and toddlers and adds that baths are gentler on dry skin than showers. Dr. Janiene Luke, a dermatologist at Loma Linda University Health, says long, hot baths can deplete the skin’s natural oils and recommends mild, fragrance-free cleansers.

The AAP’s soap advice is specific. Bubble baths and foamy, scented soaps often contain detergents that strip natural oils, it says. Non-soap cleansers are less drying and are often recommended for sensitive or dry skin, and the AAP suggests choosing products that are fragrance-free, deodorant-free and hypoallergenic. Antibacterial soaps may irritate the skin, so the AAP advises skipping them for general bathing.

When the bath ends, the AAP recommends patting the skin dry with a soft cotton towel instead of rubbing.

Moisturizer

The step that follows the towel matters as much as the bath. The AAP says moisturizer goes on damp skin right after bathing, and that misting the skin with water first helps between baths. It recommends using a moisturizer at least twice a day, even when the skin is not irritated.

The kind of product makes a difference. According to the AAP, ointments contain the most oils, suit very dry or irritated areas, contain no preservatives and should not sting or burn when applied. Creams also work well because their oils help seal moisture into the skin. Lotions are thinner, with more water and fewer oils, and may fit warmer months or less dry skin better.

The Johns Hopkins guide makes a similar case for ointments, suggesting a fragrance-free product with petrolatum as the only or first ingredient. It says moisturizers should be applied at least two to three times a day, and that for children in diapers each diaper change is a convenient moment. More frequent moisturizing improves itch control and reduces the need for topical steroids, the guide adds.

Dr. Scott Bookner of Scarsdale Pediatrics, in a Boston Children’s Health Physicians post, adds a point about timing: gently pat the skin with a soft towel instead of rubbing, leave some moisture on it, and apply a fragrance-free lotion or cream soon afterward to lock that moisture in. Luke of Loma Linda likewise says a thick moisturizer goes on immediately after bathing, and that thicker creams and ointments seal in hydration better than thin lotions.

Humidity at home

Winter dryness is partly a weather problem and partly a heating problem. Forced-air heating lowers indoor humidity, the AAP says, and that dries the skin.

The AAP’s answer is a humidifier. A whole-house humidifier can help keep the overall environment at around 40 percent humidity, the guidance says. Where a whole-house unit is not an option, a console or cool-mist room humidifier can add moisture to the air. Luke of Loma Linda makes the same recommendation, saying a humidifier helps maintain a healthier humidity level in the home, and Bookner suggests running one in a child’s room. Chawla repeats the 40 percent target.

The Johns Hopkins guide does not give a humidity target.

Clothing and laundry

What touches the skin all day counts too. The AAP recommends cotton-based clothing, especially right after moisturizing, because it helps seal in moisture and keeps sweat from building up. Synthetic fabrics can trap heat and cause sweating and irritation. Cotton or bamboo sheets and pillowcases are soft, breathable and less irritating, the AAP says, and new clothing should be washed before it is worn to remove finishing chemicals or dyes.

Detergent is part of the same advice. The AAP recommends “free and clear” detergents without fragrances, dyes or perfumes, ideally labeled for sensitive skin, and says dryer sheets and fabric softeners can contain irritating chemicals, fragrances and oils.

Johns Hopkins also lists wool among the common irritants for children with eczema and recommends cotton or other natural fibers next to the skin. The guide also advises protecting children from very cold or very hot environments.

When to call the pediatrician

If dry, irritated skin persists after these changes, the AAP says to talk with a pediatrician about additional steps, which may include prescription medication.

Eczema is a common reason. The Johns Hopkins guide says the American Academy of Dermatology estimates that 10 to 20 percent of children have it, and that most of those children struggle most in winter. A diagnosis requires a medical history and physical exam by a pediatrician, and the guide says dermatologists generally agree that a rash that does not itch is not eczema.

The guide also gives a limit on over-the-counter treatment. For infants, a mild hydrocortisone ointment may be used for up to one week, and a family should consult the pediatrician if the rash persists or if hydrocortisone is needed more than one week per month. The pediatrician can also prescribe other topical creams or an antihistamine, according to Johns Hopkins.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.

Image: Charles Barilleaux, CC BY 2.0, via Wikimedia Commons