Wet Wrap Therapy

Aside from following a good, consistent skincare routine to maintain a healthy skin barrier, wet wrap therapy can also be applied to help with more moderate to severe cases of eczema.


What is Wet Wrap Therapy?


Wet wrap therapy is a technique used in which a layer of wet dressing is placed over the skin and wrapped with another dry layer of dressing. Wet wraps are best done after bathing and moisturizing, and the frequency at which you apply wet wraps depends on the severity of your condition. For more severe cases and during flares, it is recommended that you apply wet wraps daily and for a longer duration of time for each session. For more moderate cases, wet wraps can be applied once or twice weekly as needed and for a shorter duration of time, typically at least 1-2 hours. The following are instructions on how to proceed with wet wrap therapy.


Steps

After bathing, applying topical medications, and moisturizing (refer to Eczema Skincare 101 blog for more information on skincare directions), follow the steps below for wet wrap therapy:


  1. Wet Layer: Moisten the dressing in warm water until it is slightly damp.

  2. Wrap the moist dressing around the affected skin area.

  3. Wrap a dry dressing over the wet one.

  4. Carefully put on nighttime clothing.

  5. Leave bandages on for several hours or overnight, depending on the severity and personal tolerance.


How Wet Wrap Therapy Works


The aim of wet wrap therapy is to help rehydrate the skin, while enhancing the absorption of topical medications. The wet layer helps to create a moist, physical barrier, while the dry layer helps further trap in the moisture. The moist barrier helps to cool the skin, while increasing moisturization and softening the skin, allowing for topical medications to better penetrate into the skin. The dressings also serve as a physical barrier that protects against scratching of the skin, which can further damage a compromised skin barrier.


Effectiveness


In an observational cohort study conducted at National Jewish Health in 2014, findings showed that children who underwent wet wrap therapy saw an average of 71% reduction in eczema symptoms. Improvement in symptoms can often be seen within one week of use and other clinical studies have shown that wet wrap therapy in conjunction with topical medications is more effective than just using topical medications alone. With persistent, regular application of wet wraps, the need for use of topical medications also has been shown to decrease over time.


Being Creative with Your Wet Wraps


There are many different types of articles of clothing that can be used for the wet and dry layers. Depending on the affected skin area, your dressings can include a t-shirt, leggings, tube socks, gloves,  a body suit, pajamas, or just plain cotton bandages. The key is to make sure that the wet and dry layers are form fitting, so they wrap nicely around your skin without leaving folds or creases. Another recommendation is to use clean cotton clothing or gauze as the wet layer, as cotton has been shown to be least irritating to the skin. Aside from these considerations, you can be as creative as you want to be when deciding what you need and how you want to apply your wet wraps.


Before starting wet wrap therapy, it is important to meet with your eczema specialist to ensure that this is the right treatment approach for you. While there are no known adverse effects from wet wrap therapy use, it is still important to fully comprehend how to properly apply the wet wraps and implement it into a routine that fits your needs.


Weihong Zheng, M.D.