Eczema symptoms often get worse once a person has gone to bed, and they can interrupt or delay sleep. Medications, wet wraps, medicated baths, and other methods can help people with eczema get plenty of rest.

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Different types of eczema, including atopic dermatitis and contact dermatitis, can cause patches of:

Scratching leads to further irritation, cracking, “weeping” of clear fluid, and scaling.

This article looks at how common eczema is, when it occurs, why it flares up during sleep, the effects of scratching, and whether it can spread. It also looks at preventing eczema and bedtime itching in infants.

According to the National Eczema Association, approximately 10% of people living in the United States have some form of eczema. Atopic dermatitis is the most common type of eczema.

People with eczema experience flares, which are periods during which the symptoms worsen. When eczema flares up after going to bed, the discomfort may make it difficult to get to sleep.

This sleep disruption is common, affecting between 33% and 87.1% of adults with eczema. Among children with eczema, up to 83% have difficulty sleeping at times, which may significantly affect their quality of life.

Researchers are not sure what causes eczema, but various genetic and environmental factors may play a role.

There are a few reasons why eczema symptoms may feel worse once a person has gone to bed:

  • As a result of the body’s sleep and wake cycles, a person’s temperature decreases at night, which may make their skin feel itchy.
  • If a person moisturizes their skin during waking hours, the effects may wear off by the time they go to bed.
  • People are more likely to scratch their skin while they sleep, which can make itchiness worse.

People may also scratch the skin on waking because they are too sleepy to remember to avoid it. This can make the itchiness worse, further interrupting sleep.

When a person itches eczema, it brings short-term relief. This is because they are temporarily damaging receptors on the skin, which causes the brain to send pain-relieving chemicals, such as serotonin, to the body.

This chemical plays an important part in modulating pain perception. It can cause a feeling of happiness, as well as providing relief from an itch.

The “itch-scratch cycle” triggers eczema flares. This cycle occurs when itching leads to scratching, resulting in the body releasing inflammatory mediators, aggravating eczema, and causing additional symptoms. The rash may grow and spread on the affected body area as the skin inflames in the area surrounding the itch.

If a person scratches their eczema so much that it leaves minor wounds, this could result in an infection. Further scratching could cause the infection to spread to broken or dry skin nearby.

However, eczema cannot spread from one person to another, and doctors consider it a noncontagious condition.

Learn more about whether eczema can spread.

One of the best ways to reduce or prevent nighttime eczema flare-ups is to avoid triggers before bed. Triggers will vary among individuals, but they may include both activities, such as stressful events, and materials.

The following tips may help prevent people from scratching the skin at night:

  • Moisturizing well before bed: Using oil-based ointments, moisturizers, or a medicated cream, such as a steroid cream, before bed may be beneficial. A doctor may prescribe stronger versions.
  • Bathing before bed: Bathing regularly is important for keeping the skin hydrated and preventing infections. Always moisturize within 3 minutes of bathing to lock in hydration. Try medicated baths, which may include:
  • Using wet wrap therapy: If the skin tends to become dry at night, try wrapping a damp cloth around the affected area after moisturizing. Leaving the wrap on overnight can help keep the skin hydrated.
  • Avoiding harsh fabrics: Avoid sheets or pajamas made from fabrics that can irritate the skin, such as wool or polyester. Clothing and linens made from 100% cotton are gentler on the skin.
  • Avoiding allergens before bed: Many people with eczema also have allergies, and reactions can make eczema symptoms worse. It may help to avoid common allergens, such as pet dander and pollen, at night.
  • Taking an antihistamine: Even if antihistamines do not reduce itching, they may make a person tired, helping them get to sleep.
  • Trying melatonin: 2016 research suggests that the supplement melatonin may help children with eczema get to sleep more quickly. The study concluded that melatonin supplementation is a safe and effective way to improve sleep-onset latency and reduce disease severity in children with atopic dermatitis.
  • Wearing gloves to bed: Making it more difficult to scratch can help control eczema itching at night. Some people get relief from keeping their fingernails short or wearing gloves to bed.
  • Keeping the bedroom cool: Sweating or feeling hot may make the skin feel itchier. Learn more about reducing body heat.
  • Getting into a good sleep pattern: It may be helpful to go to bed at the same time each night and make time for a relaxing activity, such as reading or meditation, before doing so. Learn about sleep cycles and improving sleep.

Learn more about home remedies for itching.

Allergens or chemicals to avoid

People with eczema and sensitive skin should avoid some common causes of contact dermatitis, especially before bed. These may include:

  • soaps, lotions, and cosmetics that contain fragrances or dyes
  • household cleaners
  • mold
  • dust mites
  • gasoline
  • nickel and other metals
  • cigarette smoke

If eczema is severe or stops a person from sleeping, a doctor may recommend immunosuppressant medications. These prevent the immune system from overreacting and triggering flare-ups.

Light therapy, known as phototherapy, can also help with severe eczema.

Eczema can first appear during infancy, usually as a rash on the face and scalp. This can cause nighttime itchiness and discomfort.

The treatment options for children and babies are the same as those for adults, but parents and caregivers can take extra precautions to keep babies more comfortable, particularly at night.

The following practices may reduce the symptoms of eczema in babies:

  • knowing and avoiding the triggers
  • following a daily bathing and moisturizing routine
  • avoiding or exercising caution when using antibacterial ointments, such as those that contain neomycin or bacitracin, as they can irritate the skin
  • avoiding using baby wipes that contain isothiazolinones, which can trigger skin reactions
  • avoiding shampoos and other products that contain cocamidopropyl betaine, which can cause allergic contact dermatitis

Below are the answers to common questions about eczema:

Who typically gets eczema?

Atopic dermatitis is most prevalent in children. However, 80% of those affected will outgrow the condition by adolescence or adulthood. It is more likely to affect people who experience hay fever or asthma.

Current research also suggests that eczema is more common and severe among non-Hispanic Black children and less common among white children. This may be due to genetic and environmental factors, as well as disparities in healthcare utilization.

What triggers eczema to itch?

The development of eczema is mostly hereditary, but many things may trigger eczema symptoms and cause a flare. Common triggers include:

  • irritants, such as fragrances or chemicals in:
    • soaps
    • detergents
    • shampoos
    • bubble baths
  • environmental factors or allergens, such as:
    • cold or dry weather
    • pet fur
    • pollen
    • mold
  • food allergies
  • certain materials, including wool and synthetic fabrics
  • stress
  • sweat or moisture
  • hormonal changes

How do I stop eczema itching immediately?

Eczema is a chronic condition, but there are ways to reduce or limit the itching. The two main treatments for eczema are moisturizing products called emollients and steroid creams.

A person should use emollients daily to prevent the skin from drying out, which can help reduce itchiness. A doctor can also prescribe steroid creams to reduce swelling, itching, and discoloration.

How do I cure eczema permanently?

There is no cure for eczema, but identifying and avoiding triggers may help a person prevent flares. For example, if certain soaps or fabrics irritate a person’s skin, they should avoid them.

Certain lifestyle approaches, such as reducing stress and working with a dietitian to evaluate potential food allergies or nutritional deficiencies, may also help reduce flares.

Eczema is a common, noncontagious skin condition that can cause itching, rashes, rough patches, and pain.

When eczema causes itchiness, it can prevent or disrupt sleep. However, people can take steps to minimize the symptoms and get sufficient sleep. These include avoiding known triggers, keeping the bedroom cool, and moisturizing well.