Eczema, or dermatitis, is a skin condition that causes patches of itchiness, inflammation, swelling, and cracked skin. When eczema flares up at night, the discomfort can make it difficult to get to sleep.
This sleep disruption is common, affecting 33.0 to 87.1 percent of adults with eczema. The condition causes difficulty sleeping in 83 percent of children with eczema, and this can significantly affect the quality of life.
In this article, we look at why eczema symptoms flare up at night and how to prevent them.
Why does eczema flare up at night?
Eczema symptoms may worsen at night.
Researchers are not sure what causes eczema, but various genetic and environmental factors may be involved.
Eczema symptoms may feel worse at night for a few reasons:
- Due to the body's sleep and wake cycles, a person's temperature decreases at night, which can make the skin feel itchy.
- If a person has moisturized during the day, the effects may have worn off by night.
- People are more likely to scratch in their sleep, which can make itchiness worse.
People tend to wake up a few times during the night without realizing it. They may be scratching because they are too sleepy to remember to hold back. This can make the itchiness worse, which can interrupt sleep further.
How to prevent eczema itching at night
One of the best ways to prevent nighttime eczema flare-ups is to avoid triggers before bed. Some triggers can include activities and materials.
The following tips may help prevent eczema itching at night:
- Moisturize well before bed. Use an oil-based moisturizer or a medicated cream, such as a steroid cream, before bed. A doctor can provide stronger versions.
- Bathe at night. 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 colloidal oatmeal, bleach, or vinegar.
- Use wet wrap therapy. If the skin tends to dry out during the night, try wrapping a damp cloth around the affected area after moisturizing. Leaving the wrap on overnight can help keep the skin hydrated.
- Avoid harsh fabrics. Do not use sheets or pajamas made from fabrics that can irritate the skin, such as wool or polyester. Clothing and linens made from 100 percent cotton are gentler on the skin.
- Avoid allergens before bed. Many people with eczema also have allergies, and reactions can make eczema symptoms worse. It can help to stay away from common allergens, such as pet dander and pollen, at night.
- Take an antihistamine. While antihistamines may not reduce itching, they may make a person drowsy, helping them to sleep in spite of the itching.
- Try melatonin. Research from 2016 suggests that the supplement melatonin can help children with eczema get to sleep more quickly.
- Wear gloves to bed. Making it more difficult to scratch can help control eczema itching at night. Some people find relief by keeping their fingernails short or wearing gloves to bed.
- Keep the bedroom cool. Sweating or just feeling hot can make the skin itchier.
- Get into a good sleep pattern. Go to sleep at the same time each night and make time for a relaxing activity, such as reading or meditation, before bed.
People with eczema and others who have sensitive skin should avoid the following, especially before bed:
- soaps, lotions, and cosmetics that contain fragrances or dyes
- household cleaners
- dust mites
- nickel and other metals
- cigarette smoke
- high-stress situations
If eczema is stopping a person from sleeping, or if the condition is severe, a doctor may recommend immunosuppressant medications. These prevent the immune system from overreacting and triggering flare-ups.
Light therapy, or phototherapy, can also help with severe eczema.
Bedtime itching in infants and babies
Using baby wipes on an infant may trigger a skin reaction.
Eczema can first appear during infancy, usually as a rash on the face and scalp. This can cause nighttime itchiness and discomfort.
Often, treatments for children and babies are the same as those for adults, but caregivers can take certain extra precautions to keep babies more comfortable, particularly at night.
To reduce the symptoms of eczema in babies:
- know and avoid the triggers
- follow a daily bathing and moisturizing routine
- avoid or exercise caution when using antibacterial ointments, such as those that contain neomycin or bacitracin, as they can irritate the skin
- avoid using baby wipes that contain isothiazolinones, which can trigger skin reactions
- avoiding shampoos and other products that contain cocomidopropyl betaine
Eczema is a common, noncontagious skin condition that can cause itching, rashes, rough patches, and pain.
These symptoms frequently disappear with age. About 95 percent of children with eczema have no symptoms after 20 years.
When eczema causes itchiness, it can prevent or disrupt sleep, but bathing, moisturizing, and taking medication regularly can significantly reduce symptoms.
While eczema may never clear up completely, symptoms are usually manageable.