Eczema symptoms often worsen at night and can interrupt or delay sleep. Medications, wet wraps, and other methods can help stop itching and other eczema symptoms at night.
Different types of eczema, including atopic and contact dermatitis, can cause patches of itchiness, inflammation, swelling, and cracked skin.
Scratching leads to further irritation, cracking, weeping of clear fluid, and scaling.
According to the National Eczema Association, approximately 10% of people living in the United States have some form of eczema, with atopic dermatitis being the most common type.
People with eczema experience flares, which are periods during which the symptoms worsen. When eczema flares up after bed, the discomfort may make sleeping difficult.
This sleep disruption is common, affecting between 33% and 90% 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 unsure what causes eczema, but various genetic and environmental factors
There are a few reasons why eczema symptoms may feel worse once a person has gone to bed:
- Due to the body’s sleep and wake cycles, a person’s temperature decreases at night, which may make their skin feel itchy.
- If people moisturize their skin during waking hours, the effects may wear off when they go to bed.
- People are more likely to scratch their skin while sleeping, making itchiness worse.
People may also scratch their skin when they wake because they are too sleepy to remember to avoid it. This can worsen the itchiness, further interrupting sleep.
The development of eczema is primarily hereditary, but many factors 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
When a person scratches eczema-affected areas, it may bring short-term relief. This is because the itching temporarily damages receptors on the skin, causing the brain to send pain-relieving chemicals, such as serotonin, to the body.
This chemical plays an important part in controlling pain perception. It can also cause a feeling of happiness and provide 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 substances, aggravating eczema, and causing additional symptoms. The rash may grow and spread on the affected body area as the skin inflames 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 disease to spread to broken or dry skin nearby.
However, eczema cannot spread from one person to another, and doctors consider it a noncontagious condition.
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 may include stressful events, exposure to pollen or pet dander, and wearing certain materials such as synthetic fabrics.
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: Regular bathing is essential for keeping the skin hydrated and preventing infections. Always moisturize after bathing to lock in hydration. Try medicated baths, which may include:
- colloidal oatmeal
- diluted bleach, but use this with caution
- apple cider vinegar
- 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 wool or polyester, which can irritate the skin. 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 worsen symptoms. Avoiding common allergens, such as pet dander and pollen, at night may help.
- Taking an antihistamine: Even if antihistamines do not reduce itching, they may make a person tired, helping them get to sleep.
- 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.
- Getting into a sound sleep pattern: It may be helpful to go to bed at consistent times each night and make time for a relaxing activity, such as reading or meditation, before doing so.
Allergens or chemicals to avoid
People with eczema and sensitive skin need to 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
- pet dander
If eczema is severe or prevents a person from sleeping, a doctor
Eczema can first appear during infancy, usually as a rash on the face and scalp. This can cause nighttime itchiness and discomfort.
Treatment options for children and babies are the same as those for adults. However, 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
Who typically gets eczema?
Atopic dermatitis is most common in children. However, around 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.
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 needs to use emollients every day to prevent the skin from drying out and 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 prevent flares. For example, if certain soaps or fabrics irritate a person’s skin, they should avoid them.
Specific lifestyle approaches, such as reducing stress and working with a dietitian to evaluate potential food allergies or nutritional deficiencies, may also help reduce flares.
How do you break the itch cycle of eczema?
Finding the best treatment for eczema can help break the itch cycle, including using creams and wet wrapping at night.
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.
