Is washing clothes in hot water at 69 degrees Celsius sufficient for managing detergent allergy?

Managing Detergent Allergy: Hot Water Washing Alone Is Not Sufficient

Washing clothes in hot water at 69 degrees Celsius alone is not sufficient for managing detergent allergy and may actually worsen skin irritation. 1

Understanding Detergent Allergy and Hot Water Effects

• Detergent allergy can present as either irritant contact dermatitis (ICD) or allergic contact dermatitis (ACD), with symptoms including dryness, burning, roughness, erythema, scaling, or fissures 1
• Hot water is a known risk factor that can contribute to and worsen hand dermatitis by damaging the skin barrier 1
• A combination of chemical irritants (detergents) and physical irritants (hot water) results in keratinocyte release of proinflammatory cytokines that cause skin barrier disruption 1
• Using very hot water (such as 69°C) for washing is specifically listed as a risk factor for inducing or worsening hand allergic contact dermatitis and irritant contact dermatitis 1

Recommended Approach for Managing Detergent Allergy

Identify and Avoid Triggers

• The primary approach should be to identify and avoid the specific detergent allergens or irritants 2
• True allergic contact dermatitis to laundry detergents is relatively rare (0.7% in one study), but irritant reactions are more common 3
• Common allergens in detergents include fragrances, preservatives, enzymes, and surfactants 4, 5

Washing Recommendations

• Use lukewarm or cool water instead of hot water for washing clothes 1
• Choose detergents specifically formulated for sensitive skin that are free of allergenic surfactants, preservatives, fragrances, or dyes 1, 6
• Consider using detergents with added moisturizers to help mitigate skin irritation 1
• Ensure clothes are thoroughly rinsed to remove all detergent residues 5

Additional Management Strategies

• Apply moisturizer immediately after any skin contact with water or detergents 1, 2
• For severe cases, consider the "soak and smear" technique: soak hands in plain water for 20 minutes and immediately apply moisturizer to damp skin nightly for up to 2 weeks 1
• For persistent dermatitis, topical steroids may be recommended to mitigate flares 1
• Consider wearing protective gloves when handling laundry, but apply moisturizer before wearing gloves 1

Common Pitfalls to Avoid

• Washing clothes in very hot water (like 69°C) can worsen skin irritation and should be avoided 1
• Using dish detergent or other harsh cleaners for laundry significantly increases irritation risk 1
• Failing to use supplementary hand lotion or cream after exposure to water or detergents 1
• Assuming that hot water alone will remove all detergent residues from clothing 5
• Dismissing skin complaints as simply "detergent allergy" without proper evaluation, as the diagnosis may lie elsewhere 7

When to Seek Medical Attention

• For recalcitrant hand dermatitis that doesn't respond to the above measures 1
• When there is a change in baseline hand dermatitis or suspected allergic contact dermatitis 1
• For patch testing to identify specific allergens when allergic contact dermatitis is suspected 2