If you’re suffering from itchy, inflamed, or irritated skin, you might have noticed that it seems to get more intense at night. But is this really the case? We ask why dermatitis feels worse at night and what you can do about it!
It’s a sad fact that sleepless nights and stress aggravate eczema, leading in turn to more stress and less rest. Atopic dermatitis is both triggered by and causes stress (see our blog Can Dermatitis Be Caused By Stress?), which can create a vicious circle of stress and itch, with distress causing further inflammation, and scratching leading to more distress. So anything you can do to get more rest and better sleep is going to help you manage your eczema.
So why is that flares feel so much worse at night, when that’s precisely the time you want to be able to ignore it?!
That’s the big question, and while it doesn’t have one simple answer, there are things about the way dermatitis manifests at night that can help us figure out what to do about it! Here are some possible explanations for dermatitis flares at night:
- Your body temperature rises in the evening before sleep and heat can trigger itching
- Production of inflammatory cytokines increases at night, which makes you more itchy
- Your body loses more water at night time, making your skin drier and more itchy
- If you’ve had a bath before bed, you may have used shampoo, body wash or bubble bath which has caused a reaction - or just got dehydrated and itchy from the hot water!
- Both caffeine and alcohol before sleep can cause a reaction
- You can overheat under covers - which leads to feeling itchy
- Your bed linen might’ve been washed with strong detergents, and constant contact with irritants can exacerbate flares
- It’s hard to use distraction techniques at night: when you cycle through lighter sleep cycles, you become more aware of the itch and start scratching, and in deeper sleep cycles you can’t stop yourself from scratching
- It’s hard to reapply emollients if you’ve been asleep, so you wake up feeling dry and itchy in the middle of the night
- If you’ve had a drink before bed, you might be reacting to the alcohol or caffeine, even if your bedtime tipple was only a cup of tea!
- You can end up more anxious if you’re awake when you need to be asleep; worrying about insomnia unfortunately just makes the problem worse, and the more anxious you feel, the worse the flare
So there are several reasons why your dermatitis can flare at night; a combination of several could make a significant difference to your ability to sleep!
Some suggestions for managing dermatitis at night:
- Apply emollients before bed: ointments keep the skin more hydrated than creams or lotions
- If you have a bath before bed, follow the 'soak and seal' routine: pat skin just barely dry, then seal in the moisture with an emollient (balm, cream or oil) within three minutes
- Keep your room cool with fans or open windows
- Use a humidifier if your room is too dry
- Sleep in natural fabrics
- Wet or dry wrap if necessary
- Keep pets out of the bedroom
- Pollen-proof your room in high season, by getting changed out of outdoor clothes in the bathroom and keeping windows closed
- Avoid caffeine or alcohol before bed
For more tips and tricks on getting a good night’s sleep, read Ruth Holroyd's Sleep Tips For The Eczema-Prone on our Info Hub!
Recommended products for skin prone to dermatitis:
Balmonds Skin Salvation
with hemp and beeswax
Balmonds Daily Moisturising Cream
with shea butter and calendula
Bath & Body Oil
with lavender, hemp and olive
If you require medical advice we recommend you always contact your healthcare professional.
If you or someone you are caring for seems very unwell, is getting worse or you think there's something seriously wrong, call for emergency services straight away. For general medical advice, please contact your healthcare professional, this article does not contain or replace medical advice.
Do not delay getting help if you're worried. Trust your instincts.