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Wet Wraps

Atopic eczema is a common, chronic, itchy skin rash that tends to affect people with other allergies like hay fever and asthma (see atopic eczema).

Wet wraps or wet dressing is used to treat severe atopic eczema or severe flares. They can also be used to prevent itching, especially at night and to avoid using steroids if applied early enough in a flare-up. Wet wraps can be easily applied at home after you have been taught how to use them.
 

  • Use aqueous cream, paraffin oil or an emollient as a soap substitute.
  • Use an emollient every day … as often as is possible, to keep the skin moist.
  • Steroid ointments must be used when there is a flare. During a flare the skin is being damaged by the eczema and the steroid ointment will prevent that damage.
  • Once a flare is under control a lower strength ointment should be used and then slowly reduced until it can be stopped and just the emollient continued.
  • Wet wraps can be done with steroid ointments and emollients during a flare and with the emollient alone when the skin is not flaring.
  • Wet wraps can be done with commercially available cotton clothes, or with home-made wraps made from stockinette bandage.
CALMWEAR CLOTHING

AFSA’s proudly SA made range of therapeutic eczema clothing has the following items:

  • Onesie
  • Elbow/knee Patch
  • Pants with feet
  • Top with mittens
  • Mask
  • Anti-scratch jacket
  • All our items are made with 95% Cotton Lycra for all the benefits of natural cotton with a four way stretch. Materials contain no dyes or latex.
  • No inside seams, soft silk labels on the outside and protected lined zips prevent irritation.
  • Mittens, where present, can be opened at the wrist to allow hand use and prevent scratching.
  • Elbow/knee patches allow targeted use of medications under wraps.
  • Calmwear clothing can be used as wet wraps with either another layer of calmwear clothes or normal pyjamas on top, or can be used as clothing to wear over stockinette wet wraps.

 

STOCKINETTE

Where necessary, wet wraps can be made from stockinette. To make the right size cut strips for the arms, legs, body and head.

  • Arms: Measure from the ear to the longest finger on the hand. Add 10 centimetres and double. Then cut. Cut two of these and tie a knot in the middle.
  • Legs: Measure from the hip till the toes. Add 10 centimetres and double. Allow a bit extra if the thighs are fat. Then cut. Cut two of these, fold in half and mark the half with a pen.
  • Body: Measure from the ears till below the knee. Cut two of these. Put the two pieces on top of one another and fold in 3. Cut holes in the top thirds corners for the arms.
  • Head: Estimate the size you need for your child head. Double it. And cut
HOW DO WET WRAPS HELP?
  1. They improve skin inflammation and hydration by the cooling effect of water.
  2. The emollient under the wrap penetrates the skin better.
  3. Helps the steroid ointment absorb and work better.
  4. Stops the child from scratching.
  5. Improves sleep.
  6. Reduces the long-term use of steroids.
WRAPS ARE OFTEN RECOMMENDED TO BE DONE EVERY NIGHT FOR 7 NIGHTS IN A ROW.

Children going to school can remove the wraps when going to school and re apply them at night before going to bed. Do NOT forget to use your ointments and moisturise all the time, even when the wet wraps are not on. It is very important to apply an emollient directly after removing the wet wraps.

A medical specialist with a special interest and skill in allergy might be able to help. See the list of health professionals with skills in allergy on the AFSA website.

WET WRAPS PROCEDURE:
  1. Choose your wet under layer (stockinette or Calmwear clothing) and immerse in a bowl of warm water, not in the bath. For stockinette immerse only 1 vest, and only 1 half of the arm/legs and head units, as these are both the wet and dry layers.
  2. Fill a bath with lukewarm water and wash your hands.
  3. Undress your child, then rub aqueous cream or paraffin oil gently on the child’s body.
  4. Put the child in the bath and wash the child’s body with your hands.
  5. Once all the aqueous cream or oil is removed, take the child out of the bath and pat the child
    dry with a soft towel. Do not rub.
  6. The child’s skin should still be a bit clammy.
  7. Apply the steroid ointment on all the rash areas on the body using the fingertip method. (See eczema)
  8. Now apply the emulsifying ointment on the whole body.
  9. Gently squeeze out the wet layer. If you are using stockinette you must first put on the arms
    then make tiny holes at the top and tie with the string made from the bandage behind the child’s back. Its best to put on the wet vest then the dry vest and tie them together at the back. Then cover the legs by rolling the wet part of the leg bandages up the leg, twisting the loose dry section so that the foot is now enclosed, then rolling the dry part back upto the vest again. Tie the wet part of the stocking to the wet vest and the dry part to the dry vest. Do this with both legs.
  10. Now dress the child completely.
  11. After the body and limbs are done you can use the steroid ointment on the face and scalp.If
    you are going to cover the face either use your Calmwear mask or put on the wet part of the stockinette on first, twist it at the top and pull on the dry part. Connect the mask to the vest. If necessary, cut holes for the eyes and mouth. If the face is not to be covered just apply the ointment and no mask.

The Procedure is now done.

Download Wet Wraps Introduction Leaflet