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Eczema affects between 10 percent and 20 percent of children worldwide, causing itch, inflammation, and irritation of the skin. Itch, also known as pruritus, can be severe enough to wake a child up and make getting back to sleep difficult.
Sleep loss in children can have more serious consequences than just sleepiness the next day. Chronic sleep loss can lead to poorer quality of life and poorer performance in school, and cause children to be mistakenly diagnosed with behavioral problems or learning disabilities.
MyEczemaTeam members described how the condition affects their children. One member wrote, “My daughter is scratching nonstop — and I mean nonstop — every night, and she, my wife, and I don't sleep because of it. Is there any miracle out there that anyone can share to end this despair?” Another shared, “Been a long night. My son screams and scratches all night long.”
Fortunately, parents whose children experience eczema-related sleep disturbance have several options for helping their kids find relief.
Getting children to sleep can be a challenge even when they don’t have eczema. Parents of children with the skin condition might feel the cards are stacked against them when it comes to getting a full night’s rest.
Many parents, especially those with very young children, may not want to give them any pharmaceutical drugs to help them overcome sleep impairment. They may not even want to provide them with over-the-counter remedies.
Luckily for these parents, there are many ways to address childhood eczema and the related itch with some simple changes in routine. Not all of them will be popular with kids, but parents who proactively make these changes are likely to see their children itch less and sleep more as a result.
Helping a child with eczema get a better night’s sleep depends in large part on the routine that’s followed before “lights out.” These methods are meant to lull them into a state that’s more receptive to deep, lasting sleep when they actually go to bed.
A short, lukewarm bath before bedtime has been demonstrated to yield good results. Body temperature falls as we get closer to our usual bedtime. Warming a child's body with a bath, followed by some time to cool down, may help them start yawning and pull them towards sleepiness. Be sure to keep the bath short, as longer, hotter baths can worsen eczema symptoms.
Teaching children with eczema the practice of progressive muscle relaxation may also yield benefits. This involves the child tensing up a muscle group for 10 seconds, then relaxing it for 20 seconds, then moving on to the next muscle group. Like the warm bath, this is meant to reduce stress.
Children with eczema might also benefit from watching something funny in the evening. A Japanese study found that laughing in the evening helped the body produce more melatonin, the hormone released by the brain when sleep begins to set in.
Making a child’s bedroom an itch-free zone is challenging, but not impossible. It takes a few approaches, some of which children can help out with if they’re old enough. One of them is frequent dusting, as dust mites have been said to trigger eczema flare-ups in children who are allergic.
One MyEczemaTeam member found special sleeping attire that worked for her daughter, age 4. “We bought bamboo gloves and a bodysuit off of Amazon. What helps her more than anything is lubing her up in Vaseline and wearing her gloves and suit to bed. It’s a nightly routine, but as long as we keep it up, her itchy spots are gone.”
Parents of young children should also watch what their kids eat, as food allergies can trigger eczema flare-ups. While some adults with eczema found that certain foods triggered their flare-ups, there has not been conclusive data about how diet affects children with eczema. Still, if parents see that their child eats a particular food and has a rough night afterward, they might consider seeing how their child does without that food.
The clothing children wear both in the daytime and at bedtime is also a consideration. They should wear loose-fitting, comfortable clothes during the day, and parents who buy their children new clothes should put them in the laundry before the first wear. Sleepwear should also be loose-fitting and made of natural fibers, such as cotton. Gloves on the hands can also help children remember not to scratch.
Sleep hygiene — defined simply as habits that promote a good night’s rest — is another tool parents can use to help their child with eczema sleep better. Some of the suggestions may be a tough sell to some kids, but they have been shown to help children sleep deeply despite severe eczema-related itch.
Parents should make sure their child’s bedroom is comfortable, dark, quiet, and relaxing. Perhaps more importantly, the Centers for Disease Control and Prevention (CDC) recommend children have no electronic devices in their rooms, such as televisions or smartphones. Using these devices before bedtime affects circadian rhythm and suppresses melatonin release, making it harder to fall asleep.
The CDC recommends avoiding large meals and caffeine before bedtime, as these can keep kids awake when they should be asleep. Finally, the CDC also recommends kids get plenty of exercise, since regular physical activity during the day can make it easier to fall asleep at bedtime.
If following bedtime tips and sleep hygiene recommendations don’t do the trick, some parents might consider giving medicine to help manage itching and overcome sleep disruption. There are several options available, all of which have been approved for use by children — even very young children.
Topical corticosteroids (also called steroids), which ease skin inflammation, have been shown to have good outcomes in reducing itch for children. Examples of these medicines include alclometasone, desonide, and hydrocortisone. Parents should be aware that children must only be prescribed low-potency steroids, identified as class 6 or class 7 agents.
For children ages 6 and older, Dupixent (dupilumab) may be considered in cases of moderate to severe atopic dermatitis not controlled by topical medications. This medication is injected every other week to supress the overactive part of the immune system that causes eczema symptoms. In a study of 251 adolescents with poorly controlled atopic dermatitis, dupilumab had improved itch, sleep, and quality of life after 16 weeks.
Antihistamines, known to most people as anti-allergy medicines, can also be given to children with eczema to help them sleep better at night. Antihistamines come in sedating and nonsedating forms. Sedating antihistamines are beneficial in cases in which the child has such comorbidities as hay fever or hives. Over-the-counter antihistamines sold in formulations for children include diphenhydramine, cetirizine, and loratadine, sold under the brand names Benadryl, Zyrtec, and Claritin. Some antihistamines, such as hydroxyzine, are available by prescription. Diphenhydramine and hydroxyzine are sedating and may help a child fall asleep more quickly.
Parents who are not comfortable giving their children medications may feel more comfortable considering melatonin supplements. These are available over the counter and have been shown to improve itch and reduce sleep disorders in children.
Always talk to your health care provider before making any changes in your child's medications or trying new supplements. Your doctor can help you check for dangerous interactions and make sure dosages are correct.
More than 10,600 MyEczemaTeam members are parents of children with eczema. Some of them have weighed in with advice for helping kids with eczema get to sleep more easily, stay asleep, and wake up refreshed.
“I’ve been using Childs Farm lotion,” one member said. “It’s very good.”
Another member recommended Aveeno Baby lotion and had some recommendations for bath time. “Consider colloidal oatmeal baths followed by application of Gold Bond cream with 2 percent colloidal oatmeal after drying off,” she said. “If this does not help, consider 'wet wrap' therapy. It's kind of a chore but can really help.”
By joining MyEczemaTeam, the social network and online community for those living with eczema, you gain a support group of thousands of parents who understand what it's like to have a child who’s losing sleep quality due to eczema.
Does itching from eczema keep your child awake at night? Has a dermatologist found the right treatment for your child’s eczema? Are you considering changes to your child’s routine because of eczema? Share your tips and experiences in a comment below or on MyEczemaTeam.