Wet wraps

‘Wet wraps’ are wet bandages wrapped over emollients and/or topical steroid creams to areas of red, hot, weeping eczema (most often due to atopic dermatitis). It may also be valuable in erythroderma, whatever its cause.

How does wet wrapping work?

Wet wraps work via three different ways:

• Cooling – as water gradually evaporates from the bandages this cools the skin and helps relieve topical steroid emollient solution
• An emollient and/or steroid

Generally, wet wraps are used for a few days until the redness, swelling and weeping has settled down. To maintain results, emollients should be applied frequently throughout the day to the affected areas.

What are the benefits of wet wrapping?

• Reduced itching and scratching
• Reduced redness and inflammation
• Skin rehydration
• Better skin healing process
• Reduced steroid usage once the condition is controlled
• Improved sleep.

Are there any side effects from wet wrapping?

Currently there is little evidence to show that a topical steroid under wet wraps produces more side effects than if applied normally to skin without wet wraps. Minor side effects of topical steroids include burning, irritation and stinging when first applied. If the coldness is unpleasant, two layers of dry wraps may be used.

One study found that a wet wrap with steroid, used for prolonged periods, was linked with bacterial infection and a drop in cortisol levels.