Atopic dermatitis, commonly known as eczema, is a chronic skin condition that causes intense itching, dryness, and inflammation. For babies, symptoms often worsen significantly at night, often disrupting sleep for the entire family. This nighttime escalation is partly due to the body’s natural circadian rhythm, which reduces the anti-inflammatory hormone cortisol. Simultaneously, the skin experiences increased transepidermal water loss (TEWL), which further dries the compromised skin barrier. The objective of managing eczema at night is to minimize friction, control temperature, and prevent the baby from scratching the irritated skin.
Selecting Optimal Fabrics
The material that touches a baby’s skin during the night is crucial for managing eczema. Fabrics should be soft, highly breathable, and chemically non-irritating to prevent friction and trapped heat.
Organic cotton remains a popular choice because it is soft and allows the skin to breathe easily. However, cotton’s main drawback is its high absorbency; if the baby sweats, the damp fabric can hold moisture against the skin, leading to irritation. Silk is recommended for its extremely smooth texture, which minimizes friction, and its natural temperature-regulating properties.
Modern fabrics like bamboo viscose or Tencel (a wood pulp-derived fiber) are highly beneficial because they combine softness with superior moisture-wicking capability. These materials help draw sweat away from the skin, preventing the wet, irritating environment that can trigger a flare. Conversely, coarse wool must be avoided due to its rough fiber texture, and synthetic fabrics like polyester and nylon trap heat and moisture, quickly becoming a major irritant.
Garment Features to Prevent Scratching
A significant goal of nighttime dressing is to break the itch-scratch cycle, which can cause skin damage, infection, and worsen inflammation. Certain sleepwear designs incorporate specialized features to physically block the baby’s nails from reaching the skin.
Integrated scratch mittens, or fold-over cuffs, are a highly effective feature that ensures the baby’s hands are covered throughout the night. Full-body suits that include enclosed feet are also valuable, as they prevent scratching damage to the lower legs and ankles, common sites for eczema. Look for garments constructed with flat seams, which lie smooth against the skin, and printed or external tags to eliminate internal sources of friction. Loose-fitting necklines and easy-access fastenings, such as poppers or zippers, simplify the process of applying nightly emollients and creams. Keeping the baby’s fingernails trimmed and smooth remains a necessary complement to any anti-scratch strategy.
Layering for Nighttime Temperature Regulation
Regulating a baby’s temperature is paramount, as overheating and subsequent sweating are significant triggers for eczema flare-ups. Sweat contains salts and other irritants that can sting and intensify the itch sensation on sensitive skin. The ideal nursery environment for an eczema-prone baby is a cool room temperature, typically ranging between 60 and 68 degrees Fahrenheit (16 to 20 degrees Celsius).
A good guideline is to dress the baby in one more layer than a comfortable adult would wear in the same room. A simple layering system might include a single, thin cotton onesie beneath a cotton or bamboo sleep sack. These layers should be easily removable to allow for quick adjustments during the night. Parents should check the baby’s chest or the back of their neck; if the skin feels hot or clammy, a layer should be removed immediately to prevent overheating and irritation from sweat.
Therapeutic Eczema Sleepwear and Wet Dressing
Beyond standard sleepwear, specialized therapeutic garments offer advanced material benefits designed to soothe eczematous skin. These items are often made from fabrics infused with anti-microbial agents, such as zinc oxide, which is known for its soothing properties and ability to reduce bacterial growth. Zinc-infused textiles are soft and help minimize the risk of secondary skin infections, which are common when the skin barrier is compromised by eczema.
For more severe flare-ups, a technique known as wet dressing or wet wrapping may be recommended, which uses specialized garments to maximize hydration and cooling. This therapy involves applying a topical treatment, covering the skin with a layer of damp clothing, and then immediately covering that with a second, dry layer of clothing. The inner layer is typically made of cotton or a medical-grade viscose/Tencel that retains moisture well. This system keeps the skin cool through evaporation and holds emollients and topical medications close to the skin, enhancing their absorption and providing substantial relief from severe itching.