The child itches and the eczema starts again as soon as wet wrapping is stopped
This generally indicates that the wet wrapping has been adequate to control the inflammation and dryness of the skin, but the itching habit has not been broken. My advice is to continue wet wrapping for another month and then to try to gradually reduce the number of applications:
24 hours on, 24 hours off for a week
Then one night only on, one night off for a week
Then two nights a week
Then once a week until dryness reappears
The child gets red and itchy during and/or after bathing
This could be due to :
The hardness of the water this may be helped by using a water softener device or an agent to soften the water.
Becoming sensitive to the bath oil try another one.
Another problem is the bath oil makes no difference to the child’s body. I find that alternating types of oil often helps. Sometimes children get used to one bath oil and its usefulness diminishes – introducing a new one can improve things dramatically.
If the child itches during bathing, you can also allow the child to bath in Wet Wraps and remove them to wash the skin just before finishing the bath. This prevents damage to the skin and allows bathing to be an enjoyable experience for everyone.
The child feels cold and shivery after the bandages are applied
This is very uncommon in children of six years and under. In older children, the problem can be helped by:
Using hotter water for the bandages.
Carrying out the process earlier, so that the child is not so wet when going to bed.
Dressing the child in warm, thick clothing after wet wrapping.
Making sure that the room where wet wrapping takes place is warm enough.
Ensuring that the bandages are not too wet.
Making bandages fit snugly.
The bandages dry out and the child gets very itchy
This is more common in summer. It can be overcome by applying Wet Wraps twice daily or using a plant water spray filled with warm water and spraying the bandages when they dry out. A wet flannel can also be used.
The child gets bored while the bandages are applied
Involving the child in the process will help. Children can help to:
Open the bandages.
Select bandages to put in the water.
Apply the creams.
Alternatively, wrapping can be done in front of the television or Ipad
The parents find it very time consuming
This is a comment some parents make, but as their technique improves the process does become quicker.
I have often suggested introducing it over a holiday period when there are more people around to help and there is less household stress.
If the evening is too hectic to do the wrapping, pick a more convenient time.
This might mean that the bandages need damping down before bedtime to prevent them drying out and the child itching overnight.
When the parents succeed, they will say that it was worth the extra effort indeed, many will state that it takes no longer than the old routine of bathing and applying moisturizers many times a day. I also emphasis the extra sleep that both parents and child will get when the Wet Wraps are used.
The skin is openly infected can it be wet wrapped
No. If there are open infected wounds, the wetness of the bandages may make the infection worse.
Firstly, clear up the infection with an oral or topical antibiotic until the skin is infection-free, then you may wet wrap.
The child has initial itching and there is blood on the bandages.
When the bandages are pulled off, they may bring scabs off too.
This can be helped by cutting the ties and soaking the bandages off in the bath, then bathing as usual.
The face is badly affected and I can’t wet wrap it.
The face often improves with moisturizers only, once wet wrapping begins to improve the eczema on the rest of the body.
11. The child’s eczema patches come back as soon as the steroid is stopped.
There are several possible reasons for this:
it may be the steroids were not reduced in potency slowly enough if Betnovate RD is used initially, Euinovate should be used to follow and then hydrocortisone 1% (HC45 or similar) followed by 0.5%.
Low-potency steroids may be needed for several days even if the skin is superficially clear, as the underlying skin may be inflamed.
I have occasionally found that an antibiotic/steroid cream or ointment may be needed, even if the skin shows no signs of open infection. I have used Fucidin H for a week in unsuccessful wet wrappers and then reduced the steroid potency, generally with good effect.
Occasionally, an antibiotic cream such as Fucidin needs to be used for longer to prevent recurring outbursts of infection.
The skin is red and itchy after the first Wet Wrap application.
This is very rare but may be due to an allergy to the bandage.
If this is the case, a tight-fitting 100% cotton polo shirt or long-sleeved vest may be used with cotton tights in the same two-layer way, with good effect.
Alternatively, parents have found that by applying bandages for a short initial period and then slowly increasing the time over a fortnight, results in the child tolerating the bandages.
Does the sunshine help eczema?
Exposure to the sun in moderation can be effective in helping the symptoms of eczema. However, avoid over exposure to the sun and ensure a sunscreen is used to avoid burning
Can children with eczema go swimming?
Children with eczema should always be encouraged to join in sports and activities with their peers. Seawater is good for eczema, though chlorine can aggravate the condition. Use emollients before swimming and after a shower to help reduce this.