Wet wrap therapy uses two layers of clothing or bandages, one damp and one dry, to lock moisture and medication into eczema-affected skin. It’s one of the most effective at-home treatments for moderate to severe flares, and you can do it with supplies you likely already have. The basic cycle is: soak, treat, wrap, wait. Here’s exactly how to do it.
What You’ll Need
Before you start, gather everything so the process moves quickly once skin is out of the bath. You need:
- A lukewarm bath with bath oil or a gentle emollient cleanser (no hot water, which worsens eczema)
- Prescribed topical medication if your doctor has provided one, plus a milder option for the face
- An unscented moisturizer, applied generously as a barrier layer
- A wet inner layer: either cotton pajamas soaked in warm water, or tubular bandages dampened with warm water
- A dry outer layer: dry pajamas, clothing, or dry bandages over the wet ones
- Blankets to keep warm during the wrap period
For children, specialty garments designed for wet wrapping (brands like Tubifast or Comfifast) can make the process easier, especially for squirmy toddlers. Standard cotton pajamas work well for full-body coverage. Medical-grade silk garments are not suitable for wet wrapping.
Step-by-Step Process
Start with a lukewarm bath lasting about 15 minutes. This hydrates the skin and softens it so it absorbs medication and moisturizer more effectively. Don’t use soap on affected areas unless directed to. In severe cases where skin infections are a concern, a small amount of bleach may be added to the bathwater, but only if your doctor has recommended it.
When the soak is done, pat the skin dry gently, leaving it slightly damp. You want the surface moist, not dripping. Then apply any prescribed topical medication to affected areas on the body. If the face is involved, use the milder medication your doctor recommended for that area. Follow the medication with a generous layer of unscented moisturizer over all treated skin. Don’t be stingy here. The moisturizer acts as a seal.
Now apply the wet layer. If you’re covering most of the body, dress in pajamas that have been soaked in warm water and wrung out so they’re damp but not dripping. For smaller or harder-to-reach areas like arms, legs, hands, or feet, use tubular bandages dampened with warm water and wrap them directly over the treated skin. The purpose of this wet layer is to keep the creams pressed against the skin rather than rubbing off.
Over the wet layer, add a dry layer: dry clothing, a second set of pajamas, or dry bandages. This insulates the wet layer, slows evaporation, and protects bedding or furniture. Wrap up in blankets to stay comfortable, since the damp fabric can feel cool at first.
How Long to Leave Wraps On
Keep the wraps on for a minimum of two hours. Most guidelines suggest removing them after two to four hours, or whenever the wet layer has dried out. If you or your child falls asleep with wraps on, they can safely stay on overnight for more severe flares.
For an intensive treatment period, the full cycle of bath, treat, and wrap can be repeated up to three times a day. This level of frequency is typically reserved for severe flares and should be done under medical guidance. As the skin improves, you gradually reduce how often you’re wrapping, stepping down from multiple daily sessions to once a day, then to occasional use as needed.
What to Do After Removing the Wraps
When you take the wraps off, the skin underneath will be well-hydrated but vulnerable to rapid moisture loss. Reapply a thick layer of unscented moisturizer immediately. Don’t wait. If another wrap session is coming soon (within a few hours), this moisturizer application bridges the gap and prevents the skin from drying out and cracking between sessions.
Between wrap sessions, keep up regular moisturizing at least twice a day. The wraps bring a flare under control, but consistent daily moisturizing is what keeps the skin stable once you stop wrapping.
Important Safety Considerations
Wet wrapping increases how much medication the skin absorbs. This is part of why it works so well, but it also means you should only use prescription steroids under wraps if your doctor has specifically told you to. Using a strong steroid under occlusion without guidance can thin the skin or cause other side effects. Moisturizer-only wet wraps, without any steroid, are a safe option for hydration and itch relief during mild to moderate flares.
Intensive wet wrap therapy (multiple times per day with medicated creams) is meant to be a short-term intervention, typically lasting days to two weeks. It’s not designed as a permanent routine. Once the flare calms down, you taper the frequency based on how the skin responds.
Avoid wet wrapping over skin that’s actively infected. Signs of infection include oozing, crusting, increased redness spreading beyond the eczema patches, or skin that feels hot to the touch. Trapping bacteria under a moist wrap can worsen the infection. If infection is suspected, that needs to be treated first.
Tips for Wrapping Children
Kids often resist the initial sensation of cool, damp clothing. Warming the wet layer in a bowl of warm (not hot) water right before putting it on helps. Having a favorite show, book, or game ready for the two-hour wrap period makes a big difference, especially for the first few sessions when the routine feels unfamiliar.
For babies and toddlers, pre-made tubular bandage garments are easier to manage than trying to wrap standard gauze around small, moving limbs. Cotton onesies soaked in warm water work well as a full-body wet layer for infants. Keep the room warm, and have dry blankets ready to bundle up in right away.
NIAID researchers who studied wet wrap therapy found that training caregivers to continue treatment correctly at home was a critical factor in its success. If your child’s doctor recommends wet wraps, ask for a demonstration or detailed written instructions specific to your child’s skin. The technique is simple, but getting the details right, especially the amount of medication, which areas to treat, and how long to continue, makes a real difference in outcomes.