You’re not imagining it: Eczema symptoms do get worse at night.
Ugh, not again: It’s 2 a.m., you’re wide awake, and all you can think about is how very badly you want to scratch that dry skin on your arm. Is it just your imagination, or is your eczema worse now than it was this afternoon?
The good news is you’re not going crazy; the bad news is that eczema symptoms can get worse at night.
Here’s why: Your body’s levels of cortisol peak in the middle of the night. This hormone helps control inflammation and itch, so that’s why you feel naturally less itchy first thing in the morning. When cortisol levels are lower in the evening before bedtime, you can feel itching more intensely.
To compensate for the body’s lower levels of cortisol and keep eczema itch to a minimum, try the following tips from dermatologist Suzanne Friedler, MD, of the Mount Sinai Hospital and St. John’s Episcopal Hospital.
Shower at night and moisturize before bed. Bathing in the evening will give you a full night in bed to rehydrate with the proper moisturizer. (Here’s how to pick the right moisturizer for eczema.) Ideally, moisturizing should happen within three minutes after showering, and at least 20 minutes before crawling into bed for the night.
Try cotton gloves and plastic wrap. After you slather on a moisturizing ointment or cream, wrap your hands in plastic wrap and slip on some gloves. This will help lock in that hydration while you snooze. Those gloves serve another great purpose: preventing you from scratching and causing rashes or bleeding throughout the night.
Use wet dressings. Use these only with a doctor’s OK. Follow these instructions for doing a wet dressing at home.
Keep temps cool. Your bedroom shouldn’t be too hot; this can promote dryness.
Choose cotton sheets or other light, natural fibers. You want them to be breathable.
Consider sedative antihistamines. Don’t make this a habit, but for tough nights, you can use these intermittently.
These tips should bring some nighttime relief from your eczema symptoms. For more tips, check out the most common skin care mistakes that make eczema worse and how to take a bleach bath for eczema.
Dr. Friedler is a dermatologist and clinical instructor at The Mount Sinai Hospital and St. John's Episcopal Hospital.
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Ever notice how the itch of
eczema gets worse at night?
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That's because of our body's
natural circadian rhythms.
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Our bodies naturally produce cortisols,
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our peak is in the middle of the night.
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That means our levels
are highest in the morning,
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as the day goes on, our steroid levels
go down and our body's itching goes up.
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Also at night when we're not
busy doing other activities,
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we tend to notice the itching more.
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Overnight treatments are great
way to hydrate the skin for
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long periods of time, as well as
soothe the skin and avoid scratching.
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Moisturizing before bedtime and
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adding plastic wrap under cotton gloves
to your hands and feet is very helpful.
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For pediatric patients with severe eczema,
wet dressings can be a bit of work, but
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they can have a huge payoff.
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Applying a wet dressing involves following
the patient's normal moisturizer
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and/or steroid with wet gauze or
a wet cotton t-shirt.
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Follow that with a dry dressing and
then the patient's ready for bed.
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Wake up in the morning,
skin should be filling a whole lot better.
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Your home environment also plays
a important role in controlling eczema.
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Keeping your room temperatures
comfortable, having a humidifier,
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using cotton sheets, and
when needed adding an antihistamine for
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itch should help you get
a good night's sleep.
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Eczema. Schaumburg, IL: American Academy of Dermatology. (Accessed on August 24, 2017 at https://www.aad.org/media/stats/conditions/eczema.)Eczema and bathing. San Rafael, CA: National Eczema Association. (Accessed on December 30, 2020 at https://nationaleczema.org/eczema/treatment/bathing/.) Eczema in children: 7 tips to stop the itch. London, UK: National Health Service, 2016. (Accessed on December 30, 2020 at http://www.nhs.uk/Livewell/Allergies/Pages/Stopthescratching.aspx.) Why does eczema itch more at night? Denver, CO: AD Rescue Wear, 2014. (Accessed on August 25, 2017 at https://www.adrescuewear.com/blog/why-does-eczema-itch-more-at-night/.)