‘Wet wrap’ therapy may effectively treat children with eczema

An alternative treatment known as “wet wrap therapy” may effectively heal children suffering from the skin condition eczema.

First described in 1987 by researcher Noreen Nicol, wet wrap therapy involves dressing and wrapping children in wet clothing, in order to better heal their irritated skin.  Now, in a new study published in the Journal of Allergy and Clinical Immunology, researchers at National Jewish Health in Denver have put the therapy to the test, finding that wet wraps can have profound effects.

The research comes at a time when more therapeutic options are needed, as the number of children with eczema is on the rise.  Also known as atopic dermatitis, the itchy skin condition has increased twofold to threefold since the 1970s, according to the Cleveland Clinic.

“Eczema is not only a big problem in this country, but a huge global health problem,” lead researcher Dr. Mark Boguniewciz, a pediatric allergist and immunologist at National Jewish Health, told FoxNews.com.  “When you look up the numbers, a national health survey of children found the prevalence was up to 18 percent, and in some places it’s over 30 percent.  Those are big numbers.”

Eczema is an inflammatory condition of the skin, often accompanied by asthma or hay fever.  The exact cause of the disorder is unknown, but researchers believe it’s most likely due to a combination of an abnormal skin barrier and a dysregulated immune system.

Although eczema may affect any area of the skin, it most often causes skin rashes on the arms and the knees – and these rashes can be extremely itchy and painful.

“These poor patients at the more severe end are scratching themselves bloody, and for a parent to see his or her child’s sheets covered with blood is really troubling and upsetting,” Boguniewciz said. “And for the patients who don’t outgrow this disease, it’s hard to have a social life.  These patients are often socially isolated.”

In order to combat the inflammatory skin condition, children at the mild end of the spectrum may be prescribed certain moisturizers or topical steroids.  But for those with more severe forms of the disease who don’t respond to treatments, powerful immunosuppressants or oral corticosteroids may be prescribed.  While mostly safe and effective, these treatments can be concerning for parents, as they can have side effects on a child’s blood pressure, bones and kidneys when used long term.

Wet wrap therapy was developed by Nicol, with the National Jewish Medical and Research Center, so that parents could have a safer, simpler treatment option for their children.  The therapy calls for an afflicted child to soak in a warm bathtub for 10 to 20 minutes.  He or she is then patted dry and a moisturizer or topical medication is applied to inflamed areas of the skin. Once that is finished, the child must immediately be dressed in wet clothing or wraps to trap the medication, followed by a layer of dry clothing.

After around two hours, the clothing is removed and the inflammation has theoretically decreased.

“Wet wraps help heal the skin barrier and help it recover,” Boguniewcz said. “From this data and other work, this can be a lasting effect, even when you discontinue treatment…The wraps make the medication you put on more effective without reaching for stronger medicines.  We wanted to know could we get more out of a lower potency medicine, and this suggests that we can.”

To test the effectiveness of the wet wrap therapy, Boguniewcz, Nicole and colleague Mary Kinnert tried the treatment on 72 children – the largest group to undergo wet wrapping.  For around two weeks, researchers applied the wet wraps two to three times a day, depending on the severity of the patient’s condition, and then tapered down the therapy to treat only the affected areas. They quantified the severity of the children’s conditions using SCORAD (Scoring Atopic Dermatitis) and ADQ (AD Quickscore) measurements.

Overall, the children who underwent this in-patient therapy saw an average reduction in symptoms of 71 percent, and they maintained healthy skin a month after returning home.  Most notably, the healthy skin was maintained without solely relying on medications typically prescribed to these patients, allowing patients to back off a lot of the more intense oral medications after treatment was over.

The researchers hope to follow up their study to better understand this approach, and they caution parents not to try this on their own just yet, as it’s a complicated process and overdoing it can do more harm than good.  However, they say their results are promising for patients suffering from this skin condition, especially since therapeutic effects were seen long after treatment ceased.

“Once you heal that skin, it’s a lot easier to maintain control,” Boguniewcz said.