Q: I’ve had an adverse reaction to bleach. Is vinegar or chlorine a substitute?
A: There are a lot of things that people have added, ranging from vinegar to baking soda to salt. Anecdotally I do sometimes tell people to put salt in the tub because I’ve had several people tell me that that seems to be soothing and they can sometimes tolerate that when there are open sores. When we’re advising people we do note that if they have really open sores, then they are probably not going to be able to tolerate the bleach baths—especially if they’re really infected. In that case you need to get the aggressive therapy going, the antibiotic going, and then maybe three or four days later you can try getting into the bath (whether it’s a bleach bath or otherwise). I’ve had some people mix some salt with the bleach bath and that seems to be soothing. That’s just been our experience. Vinegar is an interesting question because it actually is an acid and we’ve been talking about trying to lower the pH. We use it a lot for patients who have issues with a different kind of infection called Pseudomonas, and it seems to be helpful for that, but we don’t use it in a tub. The thing about vinegar is that when it’s used it’s not diluted as much as the bleach is. You would probably have to put a pretty good-size amount of vinegar in per tub for it to do anything.
Excerpted from the Ask-the-Experts Session, 2010 NEA Conference