How to Sleep Better with Eczema?

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Did you know? Up to 83% of people with eczema report trouble sleeping at least 3 nights a week. Poor sleep is one of the most frequently reported quality-of-life challenges in eczema patients.

Many people with eczema struggle to fall asleep and stay asleep due to persistent itching, discomfort, and even anxiety about scratching in their sleep.

But restful sleep is possible with the right habits, routines, and skincare strategies.

In this guide, we’ll explore why eczema can make nights miserable and, more importantly, what you can do to sleep better and wake up feeling more refreshed.

How to Sleep Better with Eczema?

1. Follow a Soothing Bedtime Skincare Routine

A proper skincare routine before bed can make a world of difference in managing eczema and promoting better sleep.

Start with a lukewarm bath lasting about 10 to 15 minutes. Avoid hot water as it can strip your skin’s natural oils and worsen dryness.

Add calming agents like colloidal oatmeal, baking soda (recommended in small quantities once or twice a week), or even a few drops of sunflower seed oil to the bath to reduce inflammation and hydrate the skin.

After bathing, gently pat your skin dry with a soft towel—never rub. Immediately apply a thick layer of fragrance-free moisturizer or emollient, preferably one containing ceramides, glycerin, or colloidal oatmeal.

This helps lock in the moisture absorbed during the bath.

For stubborn areas, consider wet wrap therapy—a technique where you cover the skin with a damp cotton cloth and then a dry one to seal in moisture and calm the skin overnight.

2. Choose the Right Bedding and Sleepwear

What you sleep on and wear can significantly impact how your skin feels throughout the night.

Soft, breathable fabrics like 100% cotton or bamboo are ideal because they are gentle on sensitive skin and allow air to circulate, reducing sweat buildup.

Avoid scratchy materials like wool or synthetic fabrics, which can cause friction and exacerbate itching.

Keep your bedding clean and allergen-free by washing sheets, pillowcases, and blankets at least once a week. Use a fragrance-free, hypoallergenic detergent to avoid chemical irritation.

It’s also helpful to change pillowcases every couple of days, especially if you apply topical treatments to your face or scalp.

Wear loose-fitting cotton pajamas that don’t cling to your skin or trap heat, as tight clothes can cause sweating and irritation in eczema-prone areas.

In addition, the right mattress for eczema can play an important role in limiting the irritation caused by your skin condition, especially if you have sensitive skin.

3. Control the Bedroom Environment

Your sleeping environment plays a crucial role in eczema management. Start by keeping the bedroom temperature cool, ideally between 60–67°F (15–19°C).

Overheating can increase itchiness, so make sure your bedding and sleepwear don’t trap too much heat.

Consider using a fan or air conditioner, but balance it with a humidifier to prevent the air from becoming too dry, especially in colder months.

Dust mites, pet dander, mold, and pollen are common indoor allergens that can trigger eczema flares. To minimize exposure, vacuum frequently, dust surfaces, and use allergen-proof covers on mattresses and pillows.

If you have pets, try to keep them out of the bedroom, as their dander can irritate sensitive skin. An air purifier with a HEPA filter can also help remove airborne allergens.

4. Stop the Itch Before Bed

Itching is the most frustrating part of eczema, and scratching only makes it worse by damaging the skin barrier and inviting infections. That’s why it’s essential to address itchiness before bedtime.

Apply your prescribed topical corticosteroids or non-steroidal anti-inflammatory creams as directed by your dermatologist.

For over-the-counter options, creams containing pramoxine or menthol can provide temporary relief.

In some cases, taking a non-drowsy antihistamine during the day and a sedating antihistamine like diphenhydramine or hydroxyzine at night can help reduce the itch and promote sleep. Always check with your doctor before starting any medication.

Cooling techniques such as cool compresses, ice packs wrapped in cloth, anti-itch cooling gels, or opting for cooling mattresses may also reduce flare intensity.

5. Practice Sleep Hygiene and Relaxation

Just like people with insomnia, those with eczema benefit from strong sleep hygiene practices. Go to bed and wake up at the same time every day to regulate your body’s internal clock.

Avoid caffeine in the evening and limit heavy meals right before bed. Replace screen time with relaxing activities like reading, gentle yoga, or meditation to calm the nervous system.

Stress is a well-known eczema trigger, and anxiety about flare-ups or scratching at night can make sleep even harder.

Consider incorporating relaxation exercises into your evening routine, such as deep breathing, progressive muscle relaxation, or guided sleep meditations.

Apps like Calm or Headspace offer routines specifically designed for people struggling with sleep.

6. Trim Nails and Use Hand Protection

Even if you don’t realize it, you may be scratching while you sleep. This can lead to bleeding, open wounds, and even skin infections. To reduce the risk, keep your fingernails trimmed short and file them smooth. This helps minimize skin damage if you scratch in your sleep.

You can also try wearing soft cotton gloves or socks on your hands while you sleep.

They act as a physical barrier and remind you not to scratch. If your child has eczema, mittens or specialty sleepwear with built-in hand covers can offer a similar level of protection.

7. Track and Manage Triggers

Everyone’s eczema triggers are different, and figuring out what causes your flares is essential for managing symptoms and getting better sleep.

Common triggers include certain foods (such as dairy, nuts, or eggs), seasonal allergens, harsh skincare products, stress, and even hormonal changes.

Start an eczema journal to record what you eat, your skincare routine, your emotional state, and your sleep patterns.

This log can help you identify patterns—maybe flare-ups occur after eating a specific food or after high-stress days. Once you have a clearer picture, you can take steps to avoid those triggers or prepare your skin better when you know exposure is unavoidable.

8. Know When to Seek Professional Help

If your eczema symptoms are so severe that you’re routinely losing sleep, it’s time to talk to a dermatologist. Lack of rest can lead to emotional distress, weakened immunity, and even worsening skin.

A doctor can assess whether you need prescription-strength medications, such as stronger topical steroids, oral antihistamines, or new biologic treatments like Dupilumab (Dupixent) for moderate-to-severe cases.

Additionally, therapies like phototherapy (light therapy) or oral immunosuppressants may be recommended if topical treatments fail. Your dermatologist can also help you create a more targeted, long-term skincare strategy to manage symptoms and improve your quality of life.

9. Consider Mind-Body Therapies

Mind-body therapies like acupuncture, biofeedback, or cognitive behavioral therapy (CBT) can help reduce stress, improve sleep, and potentially calm the immune response that triggers eczema.

CBT for insomnia (CBT-I) in particular is an evidence-based approach that helps retrain the brain for better sleep and may indirectly reduce eczema-related sleep loss. Some people also find relief with gentle acupressure, aromatherapy (lavender or chamomile), or regular mindfulness practice.

Why Does Eczema Get Worse at Night?

Eczema symptoms often intensify during the night, and there are several reasons for this. First, our body’s natural circadian rhythm causes changes in temperature and hormone levels during sleep, both of which can affect the skin.

For instance, body temperature tends to drop in the evening, which can make dry skin feel itchier. Additionally, the body produces more histamines at night, a chemical that increases inflammation and itching.

Another factor is the lack of distractions.

During the day, we are busy with work, conversations, and other tasks, which can take our mind off the itch. At night, when everything is quiet and you’re trying to relax, the discomfort becomes more noticeable.

Lastly, bedrooms often have dry air, especially in heated or air-conditioned rooms, which further dehydrates the skin and increases irritation.

What NOT to Do Before Bed? 

Even if you’re following a gentle skincare and sleep routine, certain bedtime habits can unknowingly make your eczema worse. Avoid these common pitfalls to give your skin the best chance at healing overnight:

1. Don’t apply steroid creams right after a hot shower

Hot water may feel soothing in the moment, but it strips the skin of essential oils, leaving it drier and more prone to irritation.

Applying topical steroids immediately after a hot shower can increase absorption into the bloodstream and possibly cause irritation. Instead, use lukewarm water, pat the skin gently dry, and apply your moisturizer first.

Once the skin is hydrated and calm, you can then apply steroid creams as prescribed.

2. Don’t use harsh exfoliants or retinoids at night.

Nighttime is when the skin does most of its healing, and harsh active ingredients like scrubs, acids, or retinoids can interfere with that process.

These products can thin the skin barrier and increase sensitivity, which is the last thing eczema-prone skin needs.

Save these for non-flare periods (if your dermatologist recommends them at all), and stick to nourishing, barrier-supportive products instead.

3. Skip fabric softeners and scented laundry detergents.

Your sheets and pajamas come in direct contact with your skin for hours, so it’s essential to wash them with care. Many commercial fabric softeners and fragranced detergents leave behind residues that can irritate eczema-prone skin.

Choose fragrance-free, hypoallergenic laundry products and skip softeners altogether.

Dryer balls made of wool or silicone are safer alternatives for softening clothes without chemicals.

Final Thoughts

Sleeping with eczema is hard, but not impossible.

By caring for your skin, managing your environment, and practicing relaxation techniques, you can improve both your skin health and your quality of sleep.

Everyone’s eczema journey is different, so it may take time to find the right combination of habits that work for you.

Be patient with yourself, and don’t hesitate to seek help from a healthcare provider when needed.