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Dilute the Dilemma - A basic guide to skin rashes, irritations and ailments

Updated: Jun 20, 2022

The most important message I can give you is the following “dilute the dilemma”®. Another expression is, “dilution is the solution”. This means when you see a rash or almost any acute skin injury you must soak it.

Use the following formula: 1. Dissolve 1 teaspoon of baking soda in 2 cups of water 2. Soak a washcloth in the solution 3. Apply to the affected areas for 30 minutes three times a day

Baking soda compresses are especially effective in solving eyelid rashes (for example) because baking soda doesn’t irritate the eyes. For more widespread severe rashes, dissolve 2 cups of baking soda in a tub of warm water and soak as much as needed (1 hour, 2-3 times a day). Most eruptions will improve within 7-10 days using this simple buffering solution. Never use topical antibiotics like neomycin or triple antibiotic salves because of their significant allergic properties. They have NO proven efficacy and often cause exacerbation of skin systems. I have NEVER used them in my nearly 50 years of clinical practice. Often when I am called to consult on a patient’s rash that is worsening I always ask about the use of topical antibiotics and stop them immediately. Even if you use topical antibiotics on rashes and wounds and it heals, it's not because of the antibiotic effect. Petrolatum would work just as well. Although soaking with the baking soda formula almost always works and buys time until the skin heals itself.

A common event I see is when a patient is hospitalized for presumed cellulitis (skin infection) especially in the lower extremities that is not responding to systemic antibiotics. Once I stop the topical antibiotics (which are usually being used) and institute soaks the skin eruption usually resolves. My usual protocol with hospitalized patients who have rashes or wounds that will not heal and perplex their physicians is to start normal saline soaks (4 teaspoons of salt in 4 cups of water) for one hour 3-4 times daily using a washcloth applied to skin eruptions. This allows for observation of the rash and its response. The old adage that salt water heals everything seems to be true.

Salt and baking soda contain sodium which creates a hypertonic solution. As we all know such solutions cause osmosis of water out of cells to dilute the extracellular salts. Therefore bacteria, viruses and inflammatory cells all collapse as they become dehydrated. Its simple chemistry you learned in high school. Using these concepts makes it easy for the healthcare professional and patients to deal with most skin dilemmas.

My favorite statement to physicians or patients is to go to the grocery store to get your baking soda or salt and not the “harmacy”. Please feel free to share this with your physician, who probably hasn’t been exposed to this simple approach. It’ll save a lot of time, aggravation and money! Don R. Scott MD

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