By the time Mary Elizabeth Bretz was 15, her mother, Christina, thought shed exhausted treatment options for her eczema. We tried everything thats on the counter and more, Christina says. We would go to the doctor constantly with her flare-ups, and they would prescribe a steroidal cream and say it may work, it may not. She says if it did work, it would only work for a short time, leaving them back at square one.
Mary Elizabeth, now 16, had her first flare-up with atopic dermatitis (a term used interchangeably with eczema) at 6 months old, and the symptoms exacerbated when she was in seventh grade. She felt the effects both physically, in the form of cuts and blisters on her skin, and emotionally. It caused me to be very self-conscious, and people would make fun of me, Mary Elizabeth says.
Christina adds that Mary Elizabeth had anxiety and depression because of her physical features. Christina noticed her daughters grades slipping, and she says Mary Elizabeth had trouble concentrating in school and on the soccer field because she was scratching her skin constantly. Soccer was taken away from me because I was in constant pain, Mary Elizabeth says. Sweating hurt so bad.
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Thats when Mary Elizabeths dermatologist suggested traveling from their home in Lexington, Kentucky, to Denver, for an intensive two-week wet wrap therapy program.
Photo Courtesy of National Jewish Health and Mary Elizabeth Bretz
Wet wrap therapy is a treatment option for intense eczema flares that are accompanied by itching or pain. Wet wraps work for moderate to severe atopic dermatitis, says Kanwaljit Brar, MD, a pediatric allergist and immunologist at National Jewish Health in Denver, where Mary Elizabeth received her treatment. (Dr. Brar didnt treat her, however.) The therapy isnt designed for mild cases. Its considered a rescue therapy, so its something we do to rescue the skin, Brar says. I like to think of it as a skin reset.
The therapy involves wrapping the affected areas of skin with damp fabric, either for a couple of hours during the day or overnight, which Brar says is the most effective and the most convenient for busy families. The therapy is generally used for a couple of days, according to Seattle Childrens, though Brar says it could be used for up to two weeks for severe cases.
During the first week of Mary Elizabeths visit to National Jewish Health, the wet wraps were applied for two hours in the morning, two hours in the afternoon, and overnight.
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The goal of the treatment, according to the National Eczema Association, is to rehydrate the skin and make medications soak in more effectively. Brar says it helps restore the skin barrier, reduces water loss, helps heal the abrasions and crusty areas on the skin, and can treat inflammation if the skin is infected. It also serves as a physical barrier, so by covering the area, it can prevent scratching as well, she says.
Wet wrap therapy is often used on children, which parents can administer at home, but it can work for adults, too. Its just a little more cumbersome given the larger bodies and bigger surface area to treat, Brar says.
Essentially, youll apply medication or moisturizer to the affected areas and then wrap the body (or part of the body) with a damp layer followed by a dry layer.
Heres how a full body wet wrap is done, per Seattle Childrens, the National Eczema Association, and Brar:
Wearing the wet clothes can be uncomfortable Mary Elizabeth recalls feeling freezing cold and wet so Brar recommends putting blankets straight out of the dryer on top of the patient for extra warmth.
You can also apply the wet wrap to just the affected areas, say the knees. Brar says in that case, cut the foot off of long socks and use those tubes as the wet layer. Or, if the eczema is on the face, a nurse can help apply a wrap made of gauze and surgical netting, according to National Jewish Health. Brar says to be careful when applying a face wrap to children especially overnight and during naptime because it could shift and end up blocking their nose or mouth.
Mary Elizabeths skin improved dramatically the first night of the therapy. It helped so much within 24 hours, she says. I woke up and it felt tremendously better.
The results will vary from patient to patient, but astudy published in the JulyAugust 2014 issue of The Journal of Allergy and Clinical Immunologyfound the benefits of wet wrap therapy continued one month after treatment ended.
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The same study noted that in practice, wet wrap therapy is a safe intervention treatment. If youre unsure of how to go about it or want more guidance, speak with a doctor first.
As Mary Elizabeth knows, wearing wet clothes can induce chilling. That was the only side effect noted in aprevious study, though Mary Elizabeth says it was still worth it.
A more serious side effect is the potential increased risk of infection. Areview published in November 2016 in The British Journal of Dermatologyfound a higher incidence of mild skin infections following wet wrap therapy. And astudy published in May 2015 in Acta Dermato-Venereologica found infections were more frequent when corticosteroids were used on the skin rather than moisturizers. Thats a catch, though, because the researchers found using wet wrap therapy with corticosteroids is more effective, so its important to keep a lookout for signs of infection. The researchers found the most common infection was folliculitis, which will look like white-head pimples or red bumps around hair follicles, accordingto the Mayo Clinic.
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Since Mary Elizabeth returned home after that two-week visit to National Jewish Health last November, she hasnt experienced any flare-ups and hasnt needed wet wrap therapy since. Christina now helps administer Dupixent (dupilumab), a biologic medication approved by the U.S. Food and Drug Administration (FDA), twice a month, which has helped keep her daughters symptoms under control.
Mary Elizabeth is no longer scratching her skin continuously throughout the day. I really feel the wet wrap therapy brought her to a level where she could concentrate and she could function like a normal person, Christina says, adding that Mary Elizabeths overall well-being improved and her grades have, too. Teachers noticed, myself and my husband noticed, and she noticed that she was able to concentrate more and the improvement was definitely there in all areas of her life.
Mary Elizabeth has regained self-confidence, too. [My boyfriend] told me when I came back from Denver that he knew I was a changed person because I was just happy in my skin.
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'I Tried Wet Wrap Therapy for Eczema, and It Helped Reset My Skin' - Everyday Health
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