Wrapping Up Severe Eczema
Severe eczema is a pain, literally. In the midst of a flare, it can be unbearably itchy and your dry, crusty skin can be extremely irritable. Fortunately, there are new treatment options, ranging from injectable biologic drugs to oral therapies, to help you get a handle on these uncomfy symptoms, but when these meds are not an option (like, say, in young children) or you need extra relief, wet dressings—topical creams and ointments—are a research-backed way to soothe, hydrate, and calm your cranky skin. You have to keep ’em covered for best (and less messy) results. Here, top eczema experts tell us the best ways to wrap up your wet dressings.
What’s a Wet Wrap?
When you or your child’s eczema is severe, your dermatologist may suggest a wet wrap, which is exactly what is sounds like. “A wet wrap is essentially covering your skin with damp gauze or clothing to help improve hydration,” says Joshua Zeichner, M.D., an associate professor of dermatology at Mount Sinai Hospital in New York City. The wet layer goes over your topical ointment, helping it penetrate better into the skin, and is then covered with a dry layer. It’s then left on for a few hours, or, ideally, overnight to help your treatment penetrate and give skin some intense hydration.
How to Wrap It Right
Nailing your technique will up the chances of the wrap being effective. Wet wraps work best on your extremities, but you could also wrap one around your torso or back if that’s where eczema tends to strike. On clean skin, apply your topical prescription medication which is usually a topical steroid (just enough to get a thin, even layer on the affected area). Then wet a piece of fabric—that can be a gauze bandage or even an article of clothing (more on that to come)—until it’s damp. Wrap it over the affected area. Make it snug, but not too tight that it affects your circulation. Check with your dermatologist or allergist to make sure the topical steroid prescribed is appropriate for the wet wrap. Sometimes a good moisturizer works as well.
Now you’re ready for the dry layer with the same material. Why the double layer? The wet layer is helpful for providing moisture, and then dry layer keeps it occluded (or locked in), allowing for better delivery of your topical treatments into the skin, says Brittany Craiglow, M.D., a pediatric dermatologist and associate adjunct professor of dermatology at Yale School of Medicine in New Haven, CT.
Click through for some easy dry layer options.
If your eczema is limited to one area, you can do a wet wrap with gauze. Dr. Zeichner likes 100% Kerlix Gauze (Amazon, $7). “It’s a long gauze roll that can easily be soaked in water and then unrolled to wrap around the affected areas of skin,” he says. Top with dry gauze. Then get dressed in light breathable fabrics (cotton is always a smart idea) to keep the bandages comfortably covered.
When little ones have severe eczema, sleeping can be a challenge for everyone. A full-body wet wrap while your child sleeps can bring relief. After a bath, lube up your child with their topical treatment. Then wet and ring out a pair of cotton pajamas and put them on your child. Top with a pair of dry PJs (or comfy sweats). “If you can’t get your child to sleep in that, let them watch a TV show or have some screen time to let the topical and moisture soak in,” Dr. Craiglow says. Check out these eczema-friendly PJs for kids (ADRescueWear, $65).
Get Hands on With Gloves
Hand eczema, or what’s known as dyshidrotic eczema (which causes itchy blisters), can be distressing, because it’s really hard to hide your digits. Sleeping with a wet wrap over your wet dressings can bring relief to your redness, itchiness, and scaly skin. Before you hit the pillow, slather on your rich treatment, apply a pair of damp cotton gloves, and top with a dry pair (CVS, $6.50). Don’t have gloves? You can slide cotton socks on your hands, too, says Dr. Craiglow.
Add Plastic Wrap
To up the intensity of your treatment, you can wrap your wet dressing with saran wrap (instead of gauze or a fabric wrap) before your dry layer, says Dr. Craiglow. Of course, make sure you only do this in a safe spot (i.e. not on your face) like your arms, legs, hands, or feet. The added layer helps better occlude the area, maximizing penetration, she says. “But know that plastic wrap can be rather cumbersome for very young kids,” she says.
Sleeve It Alone
When severe eczema is on arms or legs, a pre-made, sleeve-like bandage can keep wet dressings covered and help provide long-lasting, soothing relief to your skin, says Dr. Craiglow. These sleeves (Remedywear, $29.99) are made with extremely soft fibers and soothing zinc oxide and can be worn with or without the wet layer. Wear it while you sleep, or underneath your regular clothes, for hours of skin relief.
The Wrap Up
Wet dressings—and wet wraps—are safe and effective when done right. Research has shown that wrapping wet dressing makes the topicals more effective than applying them alone. But wet wraps can increase the risk of skin infection, especially when the topicals applied underneath are corticosteroids and not just regular moisturizers. For that reason, don’t do them for longer than one- to two-weeks at a time, and keep an eye out for signs of skin infection: pus, sores, swelling, or worsening rash that doesn’t look like your usual eczema rashes.
Wet Wrap Facts: National Eczema Association. (n.d.) “Wet Wrap Therapy.” https://nationaleczema.org/eczema/treatment/wet-wrap-therapy/
Wet Wrap Clinical Improvement: Journal of Allergy and Clinical Immunology. (2014.) “Wet Wrap Therapy in Children with Moderate to Severe Atopic Dermatitis in Multidisciplinary Treatment Program.” https://pubmed.ncbi.nlm.nih.gov/25017527/
Hand Eczema: National Eczema Association. (n.d.) “Hand Eczema.” https://nationaleczema.org/eczema/types-of-eczema/hand-eczema/
Wet Wrap Risks: American Academy of Dermatology. (n.d.) “3 Techniques That Can Strengthen Eczema Treatment.” https://www.aad.org/public/diseases/eczema/childhood/treating/three-techniques-stregthen