‘Wet wraps’ are wet bandages wrapped around emollients or topical steroid creams to areas of red, hot, crying eczema (most frequently due to atopic dermatitis) (most often due to atopic dermatitis). It may also be useful in erythroderma, whatever the source.
How does wet wrapping work?
Wet wraps function in three separate ways:
- Cooling – as the water eventually evaporates from the bandages, this cools the skin and helps reduce inflammation, scratching, itchiness with bumps and soreness.
- Moisturising – emollients wrapped over with wet bandages are thoroughly absorbed into the skin to have a longer-lasting moisturizing effect.
- Steroid absorption – increased absorption of topical steroid molecules into both the superficial and deeper skin layers where inflammation is present.
Besides, the bandages offer protection against the itching and rubbing period, so the skin has a chance to heal properly.
How do you use wet wraps?
Wet wraps with severe eczema are more commonly applied in a hospital. However, wet wraps can also be applied in the neighbourhood or at home at the first symptoms of a deteriorating condition to minimize the need for hospital admission.
There are various techniques and bandages used for wet wrapping, but the general procedure is as follows.
- The patient should first soak in a bath of bath oil or emollient fluid, depending on the region being treated.
- The area is freely applied with an emollient or steroid cream (as prescribed by the doctor)
- Bandages are wrapped or spread over the top of the creams, immersed in hot water (often a tubular bandage is used),
- Dry bandages to cover clothes are put over the top of the wet bandages.
- Later on, before reapplying the dry outer bandage, the dry bandage can be removed and water sprayed on the underneath layer to keep it moist.
Convenient eczema garments have been created for children with eczema for wet wrapping. For wet covering, medical-grade silk garments are not necessary.
Generally, when the redness, swelling and tears have died down, moist wraps are used for a few days. Emollients can be added consistently during the day to the infected areas to maintain results.
What are the advantages of having wet wrapping?
- The wet wrapping advantages include:
- Decreased coughing and itching
- Reduced inflammation and redness
- Rehydration of skin
- A better method of skin regeneration
- Reduced use of steroids until the condition has been managed
- Sleep improvement
Are there any wet wrapping side effects?
There is currently no evidence to suggest that a topical steroid causes more side effects under wet wraps than if it is usually added to the skin without wet wraps. Minor side effects of topical steroids include when first applied, itching, itching and stinging. Two layers of dry wraps may be used if the coldness is uncomfortable.
One research showed that wet steroid wrap, used for extended periods, was associated with bacterial infection and reduced cortisol levels.