Fast Fixes for Nighttime Itching
Your guide to a better night’s sleep for your child with pediatric psoriasis.
If your child’s psoriasis makes them feel itchy, they’re not alone. A study in the Journal of Pediatric Dermatology showed 71% of the children interviewed with psoriasis experienced itching. There’s also a good chance bedtime is when the itching really ramps up. When you add skin help to the list of bedtime needs—another glass of water, just one more book, a 15th trip to the potty—it can be a real struggle to get your child the rest they need. To provide a little comfort for your child’s skin (and your parental sanity), we spoke to experts about how to help your child navigate nighttime itchiness.
After-Dark Itching Really Is a Thing
In one study of people with inflammatory skin conditions including psoriasis, 65% reported increased itching at night. Why? For one, adults and kids alike might feel itchy during the day, too, but our work, school, and play distract us from being bothered by it. Another reason is that heat can aggravate itch, and often at the end of the day your child’s body temperature may be slightly elevated post run-around time. Plus, some kids feel a little more anxious at night, and that increased stress can trigger their psoriasis symptoms. These steps can soothe your child’s skin and get them back to bed.
Set Up Good Sleep Habits
Unfortunately, settling down and getting a good night’s sleep is a common problem for children with and without psoriasis. One study in Sleep Medicine found 20% of all children have trouble getting to sleep or staying asleep (30% of girls, specifically). A number of factors can keep children awake, including poor nighttime habits, known as sleep hygiene. To get your child’s night off on the right foot, try these steps from the College of Family Physicians of Canada:
Limit naps during the daytime (where age-appropriate, of course). And try to stick to a consistent bedtime.
Eat dinner at least two hours before bedtime to help your child begin their digestion process before they lie down.
Avoid caffeine, often hidden in the chocolatey foods or sugary drinks our kids crave.
Shut off screens at least an hour before bed. The blue light emitted by TVs, phones, and tablets can reduce our natural levels of the sleep hormone melatonin, impacting our ability to fall and stay asleep.
Children should sleep in their own beds to avoid being disturbed by other people. And keep their room dark and slightly cooler than you’d have it during the day.
Experiment With Relaxation Techniques
Even with stellar sleep hygiene your child may need your help to relax and let go of any stress from the day. According to the National Psoriasis Foundation, stress can make itch worse. “Relaxation techniques before bed such as meditation or yoga can be extremely helpful to calm itching in children,” says Nikki Roberson, owner and master paramedical esthetician at FACEit skin studio in Jacksonville, FL. Roberson works alongside healthcare professionals on treatment strategies for people with skin conditions. It can be as simple as guiding your child through saying good-night to each of their body parts, to focus on relaxing.
Pick the Right Time to Apply Products
If your child uses acne treatments or skin exfoliation products, make sure they use them in the morning, not before bed. The reason? Acids, such as salicylic or glycolic are common ingredients often found in these products. While these commonly used acids are safe for most people, one of their immediate side effects can be itching.
Slather on a Soothing Moisturizer
Roberson also recommends applying products that are calming and restorative before bedtime. Whatever brand you choose, the American Academy of Dermatology (AAD) suggests selecting something that comes in a heavy cream, ointment, or oil, rather than a lotion, and making sure the product is fragrance-free. Look for products that contain calamine, camphor, hydrocortisone, or menthol. These ingredients tend to work best on itchy psoriasis.
Fill the Tub for an Oatmeal Soak
Colloidal oatmeal, found in your local drugstore in the bath and soap section, is not only soothing but is also a protective anti-inflammatory agent. “The best method for relief is to soak in a colloidal bath, then pat the skin gently before applying moisturizers or topical steroids,” advises Tamy Buckel, M.D., a board-certified dermatologist in Chestertown, MD. “This soak-and-smear method can be very effective.” Follow the directions on the package, remembering to keep the bath water comfortable for you child and not too warm to irritate the skin.
Try an Antihistamine
“If nighttime itching continues, an antihistamine can also be taken at night,” Dr. Buckel advises. Antihistamines can be effective at bedtime since some they are known to induce drowsiness or enhance sleep. Additionally, certain antihistamines, such as hydroxyzine, have also been shown to reduce anxiety. Because different antihistamines can affect children in a variety of ways, your dermatologist can recommend which medication your child should try and at what dose for nighttime itching.
Apply Wet-Wrap Dressings
Like the name implies, wet wraps involve applying a double layer of bandages or gauze with a moist first inner layer and a dry outer layer over top of the area that itches. Oftentimes a topical corticosteroid or moisturizer is applied on the affected skin first, followed by application of a warm moist cotton cloth with a dry cotton cloth on top. This method cools the skin, moisturizes more effectively, enhances the absorption of the steroid cream, and can protect the skin from scratching. Beware: Wet wrapping should be used for only a short period of time and when there is not an active infection on your child’s skin. This method can cause the medication applied to the skin to work better, so usually a less-potent medication is recommended. Ask your dermatologist.
Ask Your Doctor About Melatonin
Remember melatonin—the natural sleep hormone we mentioned? Our brains secrete it at high levels at night and low levels during the day, to regulate our sleep/wake cycles. Some adults use it to help trigger sleep. While there is limited research available on children and melatonin supplements, a recent study found it to be an effective drug in children and adolescents for short-term use. Dr. Buckel agrees it can be a helpful tool, but you should consult your child’s doctor first.
Prevalence of Itching: Journal of Pediatric Dermatology. (2011.) “The burden of childhood psoriasis.” https://pubmed.ncbi.nlm.nih.gov/21692835/
Why We Itch at Night: Advances of Dermatology and Venereology. (2021.) “Nocturnal itch: Why do we itch at night?” https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0280
Sleep Hygiene: Canadian Family Physician. (2016.) “Sleep-related melatonin use in healthy children.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830653/
Relaxation Techniques: National Psoriasis Foundation. (2020.) “Life with Psoriasis.” https://www.psoriasis.org/life-with-psoriasis/
Avoid Products: Mayo Clinic. (2021.) “Salicylic acid (topical route).” https://www.mayoclinic.org/drugs-supplements/salicylic-acid-topical-route/side-effects/drg-20066030
Soothing products: American Academy of Dermatology Association. (2021.) “What psoriasis products are available without a prescription?” https://www.aad.org/public/diseases/psoriasis/treatment/medications/non-prescription
Antihistamines: International Journal of Molecular Science. (2016.) “Nocturnal Pruritus: The battle for a peaceful night’s sleep.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813276/
Wet-wrap Therapy: Brazilian Annals of Dermatology. (2018.) “Wet wrap dressings as a rescue therapy option for erythrodermic psoriasis.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063126/
Melatonin: Sleep Medicine. (2020.) “Efficacy and safety of melatonin for sleep onset insomnia in children and adolescents: a meta-analysis of randomized controlled trials.” https://www.sciencedirect.com/science/article/abs/pii/S1389945718307561