Bottom Line: This old-school-meets-modern treatment might just clear your atopic eczema
Looking for a way to get atopic dermatitis, also known as atopic eczema, under control without oral or systemic drugs? Wet wrap therapy is a little time-consuming, but it could bring the skin soothing relief you’ve been looking for.
Wet dressings have been used since ancient times to treat inflammation, cool the skin and reduce itching. Underused in the US for atopic dermatitis, this treatment also helps keep skin hydrated.
Wet wrap therapy is also a good interim step when prescription topical medications alone aren’t helping or helping enough, but you don’t want to start a systemic medication, such as an oral immunosuppressive drug that suppresses the immune system, or any of the new approved biologic drugs. Such drugs can have serious side effects and can lead to a rebound effect once you stop treatment.
Research shows that wet wrap therapy is effective for moderate-to-severe atopic dermatitis. A recent study involved 72 children who had the wet dressings applied two to three times a day for two to 16 days. Skin-clearing results lasted one month after wet wrap therapy was stopped.
Although much of the research on wet wrap therapy has been done on children (the condition often starts early in life), adults can also successfully use it, said Noreen Heer Nicol, PhD, FNP, lead author of the study and associate professor at University of Colorado College of Nursing in Auror.
Wet wrap therapy is recommended for moderate-to-severe atopic dermatitis and not as maintenance therapy or for mild disease. The “wraps” are typically applied for two to four hours up to two times a day and can be left on overnight. Patients generally see results in three to four days.
But before you get started, talk to your health-care provider about the best prescription topical medication to use under the wraps, such as a topical corticosteroid. An appropriate potency topical steroid ointment or cream is most often recommended. Over-the-counter moisturizers alone are noteffective under the wraps. Also ask how many times a day you should wrap, for how long each time and for how many days in a row. This will vary from patient to patient based on the severity of the eczema. A nurse or another health-care provider on your care team may be able to show you how best to apply the wraps, particularly if you have eczema on your face.
Once you’ve gotten the go-ahead from your health-care provider and any training necessary, gather your supplies. You’ll need your prescription topical medication, a thick moisturizing cream (dye-free and fragrance-free) and two sets of “dressings” (see below) for each area you need to treat, plus warm running water.
Dressings can be any variety of soft, clean clothing—many patients use regular cotton-blend clothing for this—that is designed to cover the parts of the body you want to treat such as…
Note: If treating your face, you need gauze and surgical netting to hold it in place. Both are available at most pharmacies and at medical-supply stores.
Start by setting up an area where you can be comfortable after you’ve applied the wraps, such as a couch or chair. Protect the furniture with one or two thick towels or blankets and have another blanket available to cover yourself with. The room should be warm so that you won’t feel chilled.
To begin treatment, soak your whole body or just the affected areas in a warm bath for 15 to 20 minutes and then pat your skin dry. Then immediately—within three minutes—apply your prescription topical medication to the affected areas and apply moisturizer to your clear skin. If you’re using a jarred moisturizer, don’t scoop it out with your hands—use a spoon or other implement to prevent contamination.
Saturate one dressing at a time with very warm water, then squeeze out some of the water—the dressing should be wet but not dripping. Put the wet dressing over the area you want to treat and then put a dry dressing over it. If you’re using pajamas, for example, top one pair that’s wet with one pair that’s dry. Do this quickly to get the most warmth from the water before it cools off. If you’re applying gauze to your face, use two layers of wet gauze followed by two layers of dry.
Once you have the wet and dry dressings on, get under the blanket. This is a good time to read a book, watch a movie or take a nap. Remove the wraps, and repeat the process according to your health-care provider’s recommendations. You can rewet the dressings if they seem to dry out before the two to four hours are up. Once you remove the dressings, apply your recommended moisturizer to your entire body to avoid dry skin.
Cautions: It’s important to get the OK from your health-care provider before using wet wrap therapy because it can lead to skin infections such as impetigo and inflamed hair follicles if used on inflamed skin or it can increase the risk for a herpes outbreak in people who are already susceptible to herpes. Excessive use of inappropriately strong topical corticosteroids can lead to stretch marks called striae and can suppress certain hormones. Some people experience an allergic reaction to a substance in their prescription topical medications as well as moisturizers.
A review of 49 studies by Danish and American researchers found that wet wrap therapy can be effective for other skin conditions including psoriasis, nonspecific dermatitis and pruritus (itchy skin due to a variety of conditions). If you’re looking for relief from red, itchy and/or scaly skin, talk to your doctor about whether wet wrap therapy could be right for you.
