Sleep Tips for Severe Eczema

Medically Reviewed by Melinda Ratini, MS, DO on March 03, 2022
5 min read

Any type of eczema can disrupt your sleep. And of course, the more severe your eczema, the more likely it is to cause sleep problems. That can be serious because a lack of sleep can make it harder to manage work, school, and home life. It also raises your risk for physical illness, weight gain, depression, and even accidents at home and on the road.

To make things worse, a restless night can worsen eczema symptoms, leading to an unfortunate cycle of bad sleep and eczema flare-ups. But there are a number of things you can do, some on your own and some together with your doctor, that may help improve your sleep, even during an eczema flare. If you’re a parent of an infant or child with eczema, you may have to do some of these things for them. Talk to your child’s doctor about what’s best.

It’s a good idea to start by zeroing in on what might “trigger” an eczema flare-up. A diary of diet, sleep, and activity can help with this. You and your doctor can come up with a treatment plan to manage those triggers.

Then you can start to home in on how to manage the condition for the best possible sleep. You can begin with some of these sleep tips for severe eczema.

Try to plan your bathing and moisturizing for right before bed, especially if your eczema tends to get worse at night. Some doctors call this the “soak and seal” method. You bathe briefly with lukewarm water and then seal in the moisture with moisturizing cream. The trick here is in the details:

  • Cleanser: Use a gentle cleanser (not soap) without dyes or perfumes to clean skin. Don’t scrub. Ask your doctor or pharmacist if you’re not sure the cleanser is OK for your eczema.
  • Time: Extended contact with water can dry out your skin, so limit bath time to 5-10 minutes.
  • Temperature: Hot water can dry out your skin; try to keep the temperature lukewarm or cooler.
  • Drying: Try to pat rather than rub yourself with a towel. Leave your skin slightly damp.
  • Medication: Apply any prescribed topical meds to your skin areas right after drying.
  • Moisturizer: It’s important to get it on quickly. Slather it all over your body within 3 minutes of drying. Look for a high-oil content moisturizer. Your doctor or pharmacist can suggest some. When possible, moisturize wherever and whenever your skin touches water, like after you wash your hands.

Start with this general rule: Hard surfaces like wood floors are better than soft surfaces. That’s because softer things like carpet and curtains are more likely to hang on to allergens that could trigger a flare-up of your eczema. For window treatments, this could mean wooden or metal blinds instead of curtains.

Keep it simple if possible. The less stuff -- knickknacks, piles of books, cupboards, couches, desks -- the less opportunity for dust and other allergens to settle. For closets and other storage, look for furniture like cupboards and armoires you can close.

Beyond that, it helps to keep your bedroom quiet, dark, and cool. Around 65 F seems to be best for sleep.

As your mattress ages, it takes on wear and tear and absorbs loads of fluid from your body along with millions of dead skin cells. As the years pass, this makes it a cozy place for dust mites to hang out. That’s why it’s a good idea to plan for a new mattress every 7 years or so.

Avoid foam mattresses that mold to your shape. They can lessen air circulation, warm you up, and lead to a flare-up. If a child with eczema has a bunk bed, try to give them the top bunk so dust doesn’t fall on them from the upper mattress.

Natural feather filling in pillows or comforters can trigger flare-ups, too. Look for synthetic fillings that are nonallergenic (some manufacturers give information about this on packaging and websites).

In general, the safest path is bedding that is 100% cotton. It absorbs moisture and you can wash it in hot water to get rid of dust, mite droppings, dirt, sweat, dead skin, pollen, and other possible allergens.

This means regular cleaning. Start with a deep clean of your bedroom. Look for “soft” surfaces like curtains, cushions, comforters, and sheets. These should be washed or dry cleaned.

Where you see dust, especially on hard surfaces like windows and door frames, it may be better to remove it with a damp cloth rather than dry-dusting it into the air where it may cause more irritation.

Don’t forget to give some attention to the light fixtures, blinds, desks, molding, baseboard, and floors. Even ceilings and walls can benefit from a wiping down. Make sure to keep any carpet in the room clean and consider a hard surface like wood for floors where possible.

Good habits before bed can do a lot to help you get to sleep and stay that way. Each person is different, but there are some things that doctors may tell you about to help you sleep better. These include:

  • Try not to eat too much heavy food close to bedtime.
  • Avoid alcohol and caffeine later in the day.
  • Unplug from electronics like your phone and computer at least an hour before bed.
  • Start a calm pre-bedtime routine: bathe, stretch, read, meditate, relax, wind down.
  • Go to bed and wake up at the same time every day.
  • Get outside in the sunlight early in the day (sunlight helps set your sleep patterns). But be sure to protect your skin from the sun year round.
  • Exercise -- but not too close to bedtime because that can disrupt your sleep.

It’s important to stick to the treatment plan you make with your doctor. That might include:

  • A schedule for bathing and moisturizing: It might help to bathe and moisturize closer to bedtime. (See above for details.)
  • Topical meds to control eczema outbreaks: These might include corticosteroid creams, calcineurin inhibitors, and others.
  • Oral drugs: Meds in pill form, like abrocitinib (Cibinqo), azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), methotrexate (Rheumatrex, Trexall) or upadacitinib (Rinvoq) can help control serious inflammation. Doctors may also suggest corticosteroids like prednisone, but usually only for short periods because of the possibility of serious side effects.
  • Drugs for infection: Because dry, splitting, and scratched skin often gets infected, your doctor may prescribe antibiotic cream or drugs to treat infection.
  • Monoclonal antibodies: Doctors sometimes use a relatively new injectable “biologic” medication called dupilumab (Dupixent) or tralokinumab (Adbry) for the most serious cases of eczema.
  • Mild sedation, like antihistamines, to help with sleep: This could be especially helpful for children.