Eczema can significantly disrupt a child’s sleep, leading to discomfort for the child and concern for parents. The persistent itch, often worse at night, can interfere with rest and impact daily well-being.
Why Nighttime Scratching Occurs
Nighttime scratching in children with eczema often intensifies due to physiological and environmental factors. The body’s natural circadian rhythms play a role, as skin barrier function can worsen in the evening, increasing water loss from the skin. This leads to increased dryness and itchiness.
During the day, children are typically engaged in activities that distract them from itching. At night, with fewer distractions, the itch becomes more noticeable. Dry air, especially in heated rooms, can also exacerbate irritation. The removal of clothing or layers at night can expose sensitive skin, making it more vulnerable.
Physical Barriers to Prevent Scratching
Physical barriers can help prevent a child from scratching their eczema during sleep. Keeping fingernails trimmed short and smooth reduces potential skin damage, minimizing cuts and secondary infections.
Specialized eczema sleepwear, such as anti-scratch mittens or full sleepsuits with enclosed hands and feet, provides a physical barrier. These garments are made from soft, breathable fabrics like cotton or bamboo, designed to be gentle on sensitive skin while preventing direct contact. Wet wrap therapy can also serve as a physical barrier by covering affected areas with damp and then dry layers of fabric, protecting the skin from scratching.
Evening Skincare Strategies
A consistent evening skincare routine can soothe eczema and reduce the urge to scratch overnight. Lukewarm baths for 5 to 10 minutes are recommended, as hot water can dry the skin. Adding colloidal oatmeal to the bath can help reduce inflammation and itching, contributing to skin hydration. For children prone to skin infections, diluted bleach baths, used as directed by a healthcare professional, can reduce bacteria on the skin and inflammation; the concentration is similar to chlorinated swimming pools.
Immediately after bathing, within three minutes, apply a thick emollient or moisturizer to the still-damp skin, a method called “soak and seal.” This traps moisture in the skin, enhancing hydration and forming a protective barrier. Topical medications, if prescribed, should be applied before the moisturizer. Wet wrap therapy can also be used as a treatment after bathing and medication to cool the skin, provide moisture, and help topical medications penetrate effectively. This involves applying a damp layer of fabric over the medicated skin, followed by a dry layer, which can be left on for a few hours or overnight.
Creating a Sleep-Friendly Environment
Optimizing the sleep environment can reduce triggers for nighttime scratching. Maintain a cool room temperature, ideally between 18-22°C (64-72°F), to prevent overheating and sweating, which can worsen itching. Studies suggest children with eczema sleep soundest when their body temperature is cooler.
A humidifier can combat dry air by maintaining optimal humidity levels around 40-50%, which helps hydrate the child’s skin and reduces dryness. Select bedding materials like 100% cotton or bamboo, as these fabrics are breathable and gentle on sensitive skin. Avoid synthetic materials like polyester and wool, which can trap heat or irritate the skin. Regularly wash bedding at higher temperatures to help eliminate dust mites, a common allergen that can trigger eczema flare-ups.
When to Seek Professional Guidance
Consult a pediatrician or dermatologist if a child’s eczema symptoms persist or worsen despite home management. Seek professional medical advice for persistent, severe scratching that disrupts sleep. A healthcare professional should also be seen for signs of skin infection, such as increased redness, warmth, swelling, pus, or fever. If the eczema rash is spreading, not improving with over-the-counter treatments, or if the child experiences significant discomfort that interferes with daily activities, a medical evaluation is warranted. A doctor can provide an accurate diagnosis, prescribe stronger topical medications, or recommend other advanced treatments.