Eczema is an allergic skin disorder and dry skin contributes to problems in the skin barrier. During winter months, when there’s less moisture in the air, our skin tends to lose moisture more quickly than it does in the spring, summer and fall. As discussed on the video, this is a method used for stubborn eczema when the skin is just diffusely affected or when there are patches of thickened skin that are not responding to topical therapies. The steps are as follows:
1) Bathe as usual, keeping bath or shower to 10 min or less, gently pat the skin dry rather than vigorously rubbing the skin which can worsen eczema.
2) Apply moisturizer like Coconut oil, Aquaphor or plain Vaseline petrolatum to the skin within 3 minutes of getting out of the water (“soak & seal” method).
3) Take a smaller/tighter pair of long-sleeved cotton pajamas wet and wring out the excess water then put them on your child.
4) Put a slightly larger dry pair of long-sleeved footed and zippered pajamas over the damp pair.
5) Leave this on for a minimum of 2 hours but ideally overnight. This can be repeated nightly for a few nights but not for weeks in general.
6) Always ask your doctor if whatever topical medications they have prescribed for you or your child are ok to use with wet wraps as this method increases the absorption of topical medications.
If there is just one “hot spot” to treat like an elbow, ankle or the back of the knees, you can use this same method but only get the corresponding part of the pajamas wet on the base layer. Alternatively, you can use ACE wraps or cotton gauze on a localized area with a dry over damp layer in the winter.
Another tip is that ointments work better than creams and creams work better than lotions in terms of their ability to seal in moisture. Ointments have a greasy petrolatum base that does not absorb well but coconut oil tends to feel less oily to the patient. Creams tend to come in a tub as they are too thick to use with a pump. Lotions come in a pump. You can adjust the moisturizer you are using based on the season with creams or lotions in the warmer months and ointments or coconut oil in the winter months.