Keeping Eczema Under Wraps: Recommendations for Applying Wet Wraps

Keeping Eczema Under Wraps: Recommendations fro Applying Wet Wraps

• Gather your supplies
  • Topical steroid ointment and/or emollient prescribed by your physician
  • Warm water in a sink or a basin
  • The wraps themselves consist of a bottom (wet) and top (dry) layer. Gauze wrap (e.g. Kerlex) or cotton sleepers pajamas, or long johns may be used. It will be necessary to have 2 of the material chosen. Alternatively, it is possible to use the “daddy sock” method for wrapping extremities. Simply cut a small hole in the toes of any adult-sized pair of 100% cotton socks to create a pair of tubular cotton bandages that fit easily over an extremity, can be moved up and down as needed, and can be washed and reused.
• Apply the steroid ointment directly to the patient’s inflamed skin using tongue depressors or popsicle sticks (similar to hw a spatula is used in cooking). Using a “spatula” helps to avoid direct contamination of the mediation supply, allows large areas to be covered quickly and evenly, and prevents the caregiver from being unnecessarily exposed to topical corticosteroids.
• Apply emollient to the rest of the patient’s skin.
• Take a layer of the wrap (e.g. gauze or one sock) and soak it in warm water.
• Wring out any excess water until this bottom wet layer is only slightly damp.
• Wrap the affected area with the wet layer material. Make sure the wet layer is not too tight.
• Immediately put the dry layer over the wet layer. Do not use plastic as they dry layer (it is too occlusive and may be a choking hazard).
• Make sure the wrapped patient remains in a warm environment, which helps to promote a higher degree of humidity and ensures that the child does not get too cold as the evaporation process occurs.
• Wet wraps are generally left in place overnight and may reapplied for 5 to 7 days in a row. As always, follow the advice of the physician for frequency of change and duration of use.
• Maintain close contact with the physician while undergoing the use of wet wraps. Report any suspected adverse effects immediately.