How to Help Your Child with Eczema Itching at Night

If you’ve experienced eczema, you’ll know that eczema itching at night can be even more intense than during the day. Seeing a child lose sleep through nocturnal pruritus (itchy skin at night time) can be heart-breaking and frustrating in equal measure!

Why is eczema so itchy at night?

And what can you do to support your child through the sleep disturbance?

Fortunately, we have some tips to help you understand and prevent those night time itching flares. And when that itch does strike and your little one’s sleep is broken, we have some strategies for that, too.

Why is Eczema Itching at Night a Problem?

If you’ve hit Google looking for advice on your child’s night time itchiness, you probably know all too well why it’s a problem.

Studies show that kids with mild eczema are 40% more likely to have disturbed sleep than those without the condition. Kids with severe eczema are 85% more likely to experience poor sleep. Even those without active symptoms are nearly twice as likely to experience broken sleep than children without eczema¹.

 

“kids with severe eczema are 85% more likely to experience poor sleep”

The Effects of Poor Sleep

That broken sleep is tough on the whole family, and can have worrying knock-on impacts for the child. Even minimal sleep disturbance can affect²:

• Mood
• Hyperactivity
• Attention
• Performance at school
• Immune system

Not to mention their relationships and your wellbeing as a family unit. Witnessing your exhausted child waking up itchy again and again is hard!

Scratching at Night

Another problem with itching at night is the scratching it leads to.

Whether it’s because when we’re sleepy our anti-scratch defences are down, or because we’re simply scratching in our sleep, people with eczema often wake with sore, inflamed skin from night time scratching.

Not only can scratching eczema actually cause more itching, it can lead to infections and all the complications that come with them.

  

Is my Child’s Night Time Itching Caused by Eczema?

Eczema is the foremost cause of itchiness at night³, so there’s a good chance your child’s nocturnal pruritus is eczema-related.

What is Eczema?

Eczema, also known as dermatitis, is a group of conditions that cause dry, irritated skin with an itchy rash. There are lots of types of eczema. Here are two that commonly cases night time itching:

1. Atopic dermatitis. This is a chronic (long-lasting) type, more likely to develop in children with a family history of eczema, asthma and allergies.
2. Contact dermatitis. This type of eczema occurs when the skin is exposed to an irritant. Substances that irritate the skin vary from person to person and can include anything from laundry detergent to pollen. Children with this condition might find their contact dermatitis gets worse at night if their bedding is washed with a new powder, for example.

Night time itching can be related to a child’s eczema, even if they don’t have visible symptoms (night time itching with no rash is common).

If your child doesn’t have an eczema diagnosis but you suspect their itching is due to eczema, it’s worth discussing with a health professional (especially if it’s affecting your child’s sleep).

What are Other Causes of Itching at Night?

While eczema – specifically atopic dermatitis – is the primary cause of itching at night, there are some other conditions that could be causing your child’s itching.

• Psoriasis, a chronic skin condition, which causes red, flaky, crusty patches of skin.
• Lichen simplex chronicus is thickened areas of rough skin caused by repeatedly scratching or rubbing.
• Prurigo nodularis is a chronic skin disease that occurs more rarely than eczema.
• Head lice are tiny insects common among children that live on the human head and bite the scalp.
• Threadworms are small, thread-like worms that live in the intestine and can cause intense itching around the bum, particularly at night.

Your doctor can help you determine whether one of these conditions is causing your child’s nocturnal pruritus.

Why is Eczema Itchy at Night?

Those that have experienced waking up at night itching can attest to this phenomenon. That urgent, irrepressible itch just seems to go into OVERDRIVE when the sun goes down.

There are a few possible reasons for this. Let’s take a look (or skip forward for tips on how to manage those itchy nights!):

1. Cortisol – The Hormone that Helps Control Inflammation and Itch

Cortisol is an important anti-inflammatory hormone. It also has a role in waking us up! Cortisol levels naturally drop overnight to help ensure we get a good night’s sleep, then peak early in the morning to ready us for waking.

The problem with this is that cortisol’s anti-inflammatory, itch-controlling effects are minimised at night time when the levels are low⁴.

Low cortisol usually = better sleep

BUT for people with itchy skin conditions, low cortisol = reduced protection against inflammation = more itching (which ironically leads to worse sleep!). 

 

2. Body Temperature Fluctuations at Night

Core body temperature drops when we are trying to get to sleep. This causes an increase in skin temperature as the surface blood vessels dilate and the warm blood rushes to the surface of the body. Heat is a known eczema trigger and could have a role in your little one’s itching.

3. No Distractions

During the day, our little stars are occupied with friends, learning, and generally living busy little lives! There’s plenty of distraction that might help them not to notice itching, or to experience it as less irresistible.

When lying in the dark, unable to sleep with itchy skin, there’s little else to focus on.

 4. The Itch Scratch Cycle

Unintentional night time scratching might happen when your child is fully asleep or very sleepy (scratching in sleep is unavoidable), or perhaps your child is awake and just can’t repress the urge to scratch. We’ve all been there!

Unfortunately, while scratching brings momentary relief, it signals the immune system to create more inflammation, which leads to more itching. Kids with eczema can easily get stuck in this miserable cycle at night time, with itching only growing in intensity and sleep being more and more impacted.

5. Skin Moisture Levels

Some children seem to sweat a lot at night. As well as making the skin damp (a known eczema trigger), this sweating actually leads to low skin moisture levels over the course of the night, which in turn also causes eczema to flare.

 6. Dust Mites and Other Allergens

Allergens are substances that cause an allergic reaction. In skin, this means inflammation, which – you’ve guessed it – exacerbates eczema.

Dermatitis and dust mite allergy are strongly linked⁵, meaning many people with eczema are sensitive to the dust mites that are all around us. Since dust mites can build up in bedding, carpets and other furnishings near your child’s bed, they could be producing an allergic skin response and contributing to your child itching at night.

Avoiding eczema triggers to prevent flare-ups at night

How can you prevent eczema? The truth is, you can’t. But you can avoid substances and environmental factors that cause eczema to flare up, and manage your symptoms well for quick healing when it does.

While there are common triggers, each person with eczema will have their own unique profile of things that irritate their skin. The following list has general tips, but it’s always a good idea to identify and avoid your child’s own specific triggers, too.

Go for allergy-friendly fabrics

Steering clear of triggering fabrics for bedding and pyjamas can help keep your child’s skin cool and calm.

Best avoided:

• man-made fibres (like polyester),
• scratchy fabrics - brushed wool might look soft but sensitive skin doesn’t always agree!
• feather pillows and duvets.

Try:

• light linen,
• pure cotton,
• comfortable, loose fitting pj’s.

Top tip: Remember to wash bedding and nightwear in a tried and trusted sensitive detergent.

Moisturise

If eczema is nothing new to you, you’ll know the importance of moisturiser!

Best avoided:

• any moisturiser your child hasn’t tried and tolerated well before. Speak to your doctor about recommended emollients if you’re unsure.

Try:

• applying plenty of your child’s moisturiser a little while before bed, to allow it time to soak in,
• keeping some moisturiser in the fridge so it’s chilled and ready if they wake up itchy.

Top tip: If you’re using a steroid cream, pop it on at least half an hour before bed to make sure stinging has subsided before your child snuggles down for the night.

Regulate temperature

Heat and extremes of temperature are common eczema triggers and could cause night time itching.

Best avoided:

• high central heating in the evening and at night,
• hot baths or showers before bed,
• thick blankets.

Try:

• bathing your child with lukewarm water,
• opening windows during the day to keep bedrooms cool (close them at night to shut out allergens).

Top tip: use a humidifier in cooler months when the central heating is on, to avoid dryness.

Keep dust in check

As a common allergen for people with eczema, keeping dust to a minimum in sleeping areas might help prevent nocturnal pruritus.

Best avoided:

• lots of soft toys and cushions on and around the bed (these gather dust),

Try:

• hoovering and wiping around the room as regularly as possible,
• washing bedding and favourite soft toys weekly at 60 degrees,
• airing bedding over a chair or banister every day.

Top tip: freezing soft toys for 24 hours banishes dust mites, so little ones can still have that favourite teddy.

Healthy sleep habits

As well as avoiding eczema triggers to prevent night time flare-ups, supporting your little star to develop a great bedtime routine could help them sleep through some of that itching.

Here are some habits that could help us all get more zzz’s.

• Keep to a pattern. A regular bedtime and wake-up time trains the brain to sleep soundly in the hours in-between.
• Wind down. Keeping things chilled before lights-out helps prepare the body for sleep. Keep screens switched off before bed and try relaxing music, massage or reading stories.
• Have a lighter evening meal. Heavy dinners are associated with wakeful nights.
• Discuss melatonin with your GP.Studies suggest melatonin can help improve sleep quality for children with atopic dermatitis⁶.

Top tips for soothing eczema itching at night

It’s the middle of the night, and your sleepy child won’t stop scratching and is too distressed to sleep. If you’re anything like us, you’re desperate to know how to stop eczema itching, now.

First, take a deep breath! We know it’s tough to witness, but keeping the atmosphere as calm as possible will give you all a better chance of getting back to sleep.

What you can do now:

• Reassure your little one in soothing tones.
• Apply moisturiser (even better if it’s chilled).
• Massage an unaffected area of their skin to distract their brain.
• If your little one is very young, consider swaddling.
• Try audiobooks, white noise or other calming soundscapes to distract your child from their skin (while not keeping them awake!).
• Make sure nails are clipped closely and hands are clean in case of sleep- scratching.
• Support your child to use a Cosi Care Safe Scratching Device, if you have one.

 

What is a Safe Scratching Device?

At Cosi Care we understand the need for instant relief. We invented Safe Scratching to immediately soothe itch with cold and texture that protect the skin.

Grabbing your Scratch Star or Scratch Attack Roller from the fridge or freezer when your child wakes in the night is a way you can offer them instant eczema itch relief so they can get back to catching those all-important zzz’s.

Here’s how to outmatch the night time scratch: Simply put a blob of moisturiser on the star’s metal plate or inside the roller and gently massage over your child’s itchy area in slow, circular motions.

If you haven’t yet got a Scratch Star or Scratch Attack Roller on standby, you can pick up your safe scratchers right here.

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Sources

1 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2725861

2 https://www.sleepfoundation.org/children-and-sleep

3 https://pubmed.ncbi.nlm.nih.gov/29943835/

4 https://pubmed.ncbi.nlm.nih.gov/23245983/

5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465295/

6 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2470860