Wet Dressings for Eczema

Eczema is a skin condition in which children get an itchy red rash on their arms and legs and sometimes all over their bodies.

For most kids with eczema, their rash clears up with treatment and then gets worse or flares up from time to time. Unfortunately, some kids have more hard to control eczema and they rarely have clear skin.

In addition to avoiding triggers, regularly using moisturizers and a topical steroid cream or ointment, wet dressing are a great treatment for eczema flares that are underused and often misunderstood.

Wet Dressings

Although often used for other itchy rashes, such as poison ivy and insect bites, wet dressings can also be helpful to get eczema flares under control. In addition to cooling the skin, they can help decrease itching and burning and can especially help skin that has become moist or oozing.

To prepare a wet dressing, also known as wet wraps or wet compresses, place a clean cloth in a wet dressing solution, such as:

• Cool tap water
• Burrow's solution (Domeboro Astringent Solution Powder Packets)
• Acetic acid (mix 1/2 cup of white vinegar with 1 pint of water)

Next, remove the cloth and wring out some of the solution so that it is not dripping wet.

Now, cover the affected skin area with a moisturizer and place the wet dressing over it. Keep in mind that using the moisturizer under the wet dressing is a specific treatment for eczema, and you wouldn't necessarily do that for other skin conditions. For many skin rashes, like poison ivy, sunburn, or insect bites, you would likely just place the wet dressing on the rash.

Keep the dressing on for about 30 to 60 minutes, reapplying it another two or three times throughout the day, but not too often, since that could dry out your child's skin.

Since wet dressings can be drying, only use them for a three or four days, until the worst of the eczema flare is getting under control.

More on Wet Dressings

Although wet dressings can be an effective treatment for eczema flares, they are not for everyone.

For one thing, kids don't always like them. Although it can control itching, having a cool dressing on your skin may be uncomfortable for some children. Also, overuse of wet dressings, especially if you first don't put a moisturizer or steroid cream on your child's skin can be drying, which is the last thing you want to do when a child has eczema.

So wet dressings typically are a last resort. Since they are effective, ask your pediatrician about them if your child has hard-to-control eczema.

Some other ways to try wet dressings include:

• applying a moisturizer to your child's skin after removing the wet dressing.
• sticking to plain water if diluted vinegar is too irritating.
• using a wet-to-dry dressing, in which you cover the wet dressing with a dry dressing. The classic example of this is a child with hand eczema for which you can cover his hands with a moisturizer, have him wear wet cotton gloves, and then put dry cotton gloves over them. On other parts of your child's body, you might wrap the area with wet gauze and then wrap it again with dry gauze. An extreme example might be to put wet pajamas on your child right after a bath and after you have applied a moisturizer to his skin, and then put dry pajamas over them. Do this at bedtime for three or four days during a bad eczema flare to help him sleep. Don't use wraps on your child's face, head, or neck though: To be safe, stick to wet compresses instead.
• applying a low- or medium-dose steroid to the child's skin under the wet dressing instead of a moisturizer. Because this may increase the absorption of steroids though your child's skin, applying a steroid under a wet dressing should just be done once a day and for no longer than a week at a time. Also, don't ever use a high-dose steroid under a dressing on your child's skin.
• using Tubifast Garments and Tubifast Bandages, which come in a range of sizes and forms -- as a vest with sleeves, tights, leggings, and socks -- that make wet dressings easy to use.
  
  

_Sources:

Habif: Clinical Dermatology, 4th ed.

Kliegman: Nelson Textbook of Pediatrics, 18th ed.

Treatment of patients with atopic dermatitis using wet-wrap dressings with diluted steroids and/or emollients. An expert panel's opinion and review of the literature. Oranje AP - J Eur Acad Dermatol Venereol - 01-NOV-2006; 20(10): 1277-86.