Eczema is a chronic inflammatory skin condition characterized by dry, intensely itchy, and often inflamed patches of skin. For individuals experiencing a moderate to severe flare-up, standard moisturizing and topical medication routines may not provide adequate relief. Wet wrap therapy is an intensive, supportive treatment designed to manage these acute symptoms by significantly increasing skin hydration and reducing the persistent urge to scratch. This two-layered dressing technique helps to calm inflammation and enhance the effectiveness of topical treatments.
Understanding the Therapeutic Mechanism
Wet wraps function primarily through creating an occlusive barrier that supports the compromised skin barrier. Intense hydration is the first benefit, as the damp inner layer prevents transepidermal water loss from the skin’s surface. This occlusion ensures that the emollient or topical steroid applied underneath is locked in, allowing the medication to penetrate the thickened, inflamed skin more effectively.
The second major mechanism is the powerful cooling effect achieved through water evaporation from the damp fabric. This evaporative cooling provides a soothing sensation that directly targets and significantly reduces the intense itching, or pruritus, which is a hallmark of eczema. By interrupting the itch-scratch cycle, the wraps give the damaged skin a chance to heal without the constant trauma of scratching.
Finally, the two-layer dressing serves as a physical barrier, which is especially helpful for children or during nighttime when scratching is often subconscious. This protection allows the skin barrier to begin its repair process, preventing further mechanical injury.
Gathering Supplies and Preparing the Skin
Beginning wet wrap therapy requires gathering specific materials and performing a preparatory skin routine known as “soak and seal.” You will need a clean, soft cotton fabric for the wet layer, such as gauze, strips of cotton cloth, or specialized tubular bandages. For the dry outer layer, you will need loose-fitting pajamas, sweatsuits, or a second layer of specialized wrap clothing.
The preparation begins by soaking the affected skin in lukewarm water for five to ten minutes, using a gentle, non-fragranced cleanser. After the soak, gently pat the skin with a soft towel, leaving it slightly damp to retain moisture. Within three minutes of exiting the bath, immediately apply any prescribed topical medication to active eczema areas. Follow this with a thick layer of emollient or moisturizer over the rest of the skin. This “seal” step traps moisture and medication before wrapping begins.
Step-by-Step Wet Wrap Application Guide
The first step involves preparing the cotton material for the wet layer. Soak the fabric—whether a specialized garment, tubular bandage, or cotton strips—in clean, warm water until saturated. The material must then be wrung out so it is only damp, not dripping wet, ensuring it cools the skin.
Carefully apply this damp layer directly over the skin treated with medication and moisturizer. The wrap should be snug enough to maintain contact with the skin but never so tight that it restricts circulation or movement. For hands and feet, cotton gloves or socks can be used, while tubular bandages are often easier for limbs.
Once the wet layer is in place, immediately apply the dry layer over it, which acts as an insulating seal. This outer layer, which can be a second layer of dry cotton bandage or loose pajamas, slows down the rate of evaporation from the wet layer. It also protects bedding and clothing from the moisture and topical products underneath. When wrapping limbs, the dry layer should completely cover the wet layer, and the ends can be secured gently to prevent slipping.
Duration of Treatment and Safety Precautions
Wet wraps are typically left in place for a minimum of two hours, often overnight, to maximize the therapeutic effect. During treatment, monitor the damp layer, as allowing it to completely dry out can be counterproductive. If the inner layer feels dry, temporarily remove the outer layer, re-dampen the inner wrap with a spray bottle of warm water, and then reseal it with the dry layer.
Wet wrap therapy should only be used for a short, intensive period, usually one to two weeks, or as directed by a healthcare professional, especially when topical steroids are used. The combination of dampness and occlusion significantly increases the potency of topical steroids, making consultation with a physician a necessity before starting this therapy. Signs of irritation, a new rash, or a fever should prompt immediate removal of the wraps and medical attention, as these may indicate an infection or an adverse reaction.