When and how you should use wet wrapping

We often get asked about wet wrapping and so thought it was about time that we talked about this subject here.  Our lovely friends in Canada The Eczema Company have written a really informative blog about when and how to use wet wrapping and have kindly allowed us to share it with you.

Wet wrapping therapy is a miracle short-term fix for moderate to severe eczema. While in no means a cure, wet wraps can offer a much needed break from the everyday stress of dry, itchy eczema. Results can be dramatic after one time, but it will usually take 1-2 days with wrapping 2-3 x per day before major changes in the skin can be seen.

Wet wrapping is a commitment (both in time and energy) and can be a challenge getting little ones to cooperate. Good distraction techniques are crucial – read my tips below for wet wrapping and children.

Disclaimer: If you are currently using topical steroids, pro-topic, or any other medication to treat the eczema, you must speak with your physician on how to properly use the medication with wet wrapping. Also, before beginning wet wraps you should speak with your practitioner about the process, make sure they’re on board, and determine how long you can safely carry on with wet wrapping. Our physician believed eczema wet wraps could begin to dry out the skin if used for more than one week, so we were always careful to abide by his one-week policy.  Wet wrapping must never be started if there is any sign of the skin being infected.

What is wet wrapping therapy?

Wet wrapping therapy consists of soaking and sealing the skin in the following way:

• First, a bath to soak the skin.
• Afterwards the skin is lightly dried, then sealed with a heavy layer of cream or balm/salve.
• Next dress the skin with damp clothing or a layer of damp bandages.
• Then top with a layer of dry clothing or bandages.
• Leave the wraps on for at least two hours.
• Add another layer of cream or balm salve, then dress as usual.

Why does it work?

The layer of wet clothing locks the moisture in, giving the creams or balms/salves time to completely saturate and penetrate the skin. In addition, as the water evaporates from the wet layer, it provides a cooling sensation for the skin, which can relieve the eczema itch.

What are wet wraps?

Eczema wet wraps are the garments or materials used to wrap eczema skin in a damp protective layer. They come in many styles. Some are made specifically for wet wrapping and for eczema children, while some items can be found in your closet (cotton form fitting pyjamas, white cotton tube socks for hands and feet, etc).

What do you need to get started?

• Bathtub filled with lukewarm water
• Bath oils (only if desired)
• Towel
• Cream or balm/salve (National Jewish does not recommend Aquaphor)
• Topical prescription – only if directed by your physician
• Spray bottle filled with plain water
• (2) Sets of clothing or bandages/dressings. Exact garments will depend on areas you want to treat, but can include:
  • (1) one-piece pyjamas or top & bottom, form fitting
  • (1) one-piece pyjamas or top & bottom, slightly larger
  • (2) turtleneck for wrapping the neck, or scarf
  • (4) pairs of long white cotton tube socks to cover hands and feet
  • (2) sets of gauze bandages for wrapping the face and head

How to wet wrap (step-by-step)

My son had head-to-toe eczema, but the eczema on his face was mild in comparison to the severe eczema on the rest of his body, so we concentrated on the neck down. However, wet wrapping can be done over the entire body, including face and head, or just localized to one part of the body like behind the knees or feet. Basically, only use wet wrapping where you need it most.

1. Soak in a bathtub filled with lukewarm water (90-96 F or 32-36 C) for 15-20 minutes.  You can add a few drops of a moisturizing or soothing oil to the bath water if you wish. Nothing else should be added. Make sure the areas of the body to treat stay fully submerged in the water.
2. Pat (never rub) dry with a cotton towel.
3. Immediately (within 2-3 minutes) moisturize the skin with the cream or balm/salve, making sure to liberally apply on the areas of the body that need treating. The skin should be very moist when finished. You may need to go back and apply another layer in some areas before moving to the next step.
4. Wet one layer of clothing or bandages in warm, not hot, water. Wring them out until damp, not too wet or dripping. Dress in this layer of warm, damp clothing or bandages fully covering the areas of eczema to treat.
5. Cover the damp layer with the dry layer of clothing (slightly larger) or bandages.
6. Leave the wet and dry layer on for a minimum of two hours.
7. Check the wet layer every once in a while to make sure it’s still damp. If it starts to dry out use the spray bottle of pure water to dampen the clothing again.
8. Check the temperature of the room to ensure comfort. It shouldn’t be too hot, too cold, or too breezy (if there is a fan).
9. After at least two hours, remove the clothing or bandages and completely moisturize the skin again with the creams or balm/salve.
10. Dress as usual.
11. Repeat two to three times per day or as advised by your physician.

Note: Some people like to leave the wraps on an entire night, sleeping with them on. However, we had a hard time keeping the wet layer damp, so we only used wet wraps during the day when we could keep an eye on the wet layer.

Tips for wet wrapping and your eczema child

Attempting a smile for the camera while keeping one eye on the television.

• Wet wrapping is long and boring for children, so make sure to have plenty of entertainment and distraction techniques lined up. We relied on TV a lot, which was a treat for our son. Read my post for ideas Itchy Irritated Skin, Scratching Little Fingers – Part Two: Distraction Techniques.
• Use caution with long wet bandages that could become unwrapped, potentially creating a suffocation hazard. This would be of particular concern if the child wears the wet wraps to sleep.
• Cotton clothing made for children with eczema, such as those found here can be much easier for fast wet wrapping. AD Rescue Wear makes excellent full bodysuits for children 6 months to 3 years and tops and bottoms for older children for wet wrapping. While they are more expensive, they make wet wrapping far easier and much less time consuming.

Wet wrapping worked wonders for us. How did it work for you? Please share your experiences with us.