STUDENT NAME:

REGISTRATION NUMBER:

INSTITUITION:

SUBMISSION DATE:
 RESEARCH ON WET WRAPPING THERAPY AND ECZEMA

Introduction

Topical treatments, such as wet wrapping therapy (WWT), are useful for treating skin

diseases including eczema. It's frequently used as a gentler alternative to steroids and other harsh

medications. It's a tried-and-true method for soothing irritated skin and alleviating eczema

symptoms without the risk of unwanted effects. In wet wrapping therapy (WWT), a moisturizing

cream or topical steroid is applied to the skin, and then a wet layer of clothes is applied on top.

Following this, the garment is wrapped around the injured region many times. This serves to

both insulate the region and maintain a constant moisture level. Because it is mild and effective,

it is commonly used on newborns and young children who suffer from severe eczema.

Scientific evidence suggests that WWT can help alleviate eczema's uncomfortable

symptoms. In mild to severe eczema patients, it is frequently the first line of therapy. Those who

have had success treating their eczema with WWT can also use it as a maintenance therapy.

Using WWT as a therapy for eczema has several advantages, including being safe, simple,

effective, and inexpensive. Using WWT to treat eczema comes with a number of possible risks.

To begin, WWT-appropriate apparel might be hard to come by. Second, clothes worn during

WWT may be uncomfortable or unattractive. Third, there is evidence to suggest that not all

instances of eczema respond well to WWT. Finally, WWT has the potential to cause side effects

(such as skin irritation) in certain users.

15-20% of British youngsters suffer with eczema at any given time. About a third of all

cases in the community involve adults. Atopic eczema, particularly when it is moderate to

severe, can have a significant impact on a person's and their family's standard of living. Constant
itching, skin damage, pain, inability to sleep, and the social stigma associated with a visible skin

disease are just some of the negative effects of living with a chronic skin condition. Other

factors, such as the need for regular doctor visits, special clothing, and the application of messy

topical applications, also contribute to the burden of disease. A genetic predisposition as well as

a mix of acute and non-allergic variables appear to be crucial in defining disease manifestation in

atopic eczema, although the exact origin of the condition remains unclear. In the United

Kingdom, there is a plethora of options for managing atopic eczema. This type of treatment

frequently has a shaky empirical foundation. When it comes to treating atopic eczema, primary

care is where we know the least. ( Hoare et al.,2001).

Primary care providers in the United Kingdom are responsible for treating eczema

patients. In fact, nearly all children who have eczema visit their primary care provider at least

once per year. A 1998 cross-sectional study in a UK general practice context showed that

16percent of eczema in children aged 1-5 was moderate or severe, although current population-

based assessments of eczema symptom severity in the UK are missing. 7 Studies using children

with eczema who were recruited from primary care in the United Kingdom show that this

number might be considerably higher. Population studies in the United States have found that 7

percent of kids and 11 percent of adults having eczema experience severe symptoms. While

more severe instances may be sent to a specialist, the vast majority of these situations may be

handled without the involvement of tertiary facilities. Primary care visits and prescriptions

account up a sizable portion of the total expense of treating eczema.( de Lusignan et al., 2021).

It is estimated that 12 million people in the United Kingdom suffer from the skin ailment

known as eczema, with the illness being seen most frequently in children who are less than 14
years old. It is estimated that 350 million people throughout the world are affected with eczema,

making it the most common form of inflammatory skin disease.

THE IMPACT OF ATOPIC ECZEMA

The impacts of eczema eczema extend far beyond the surface of the skin, having a

negative impact not only on the patient's life quality but also on their partnerships, feelings of

self-worth, self belief, and job performance or school, in addition to their capacity to undertake

specific academic and professional goals.

itch

Skin irritation is among the most obvious and bothersome physical symptoms that can

accompany allergic skin conditions. Itching may make it difficult for a person to obtain a decent

night's sleep, which can have a severe effect on a person's overall health and well-being. This can

result in weariness, which in turn can interfere with a person's academic achievement, their

performance at work, and their personal relationships. (lewis,2006).

visibility

The skin of the hands, face, and neck are more susceptible to eczema, and as a result,

these areas are most likely to be impacted by the condition. But being self-conscious about one's

looks could lead one to shun social occasions and isolate themselves, this can have a catastrophic

effect on one's feeling of self-worth and confidence.

stigma
 Due to the obvious stigma that is linked to having a skin condition, individuals,

particularly children, may be at risk of being bullied and teased. This is especially true in social

settings. This form of social isolation has been related to a number of negative consequences on

mental wellbeing, along with low self-esteem, loss of faith, mood changes, anxiety, and

melancholy.

lifestyle

If a person has atopic eczema, it can restrict their capability to participate in many

elements of day-to-day life, such as their choice of clothing, pets, sports, hobbies, and even

occupations, particularly if those activities reveal them to allergens or irritants that make their

condition worse. This includes the person's ability to choose between wearing certain types of

clothing, participating in certain types of sports, and even choosing certain hobbies.

financial burden

A person's efforts to manage their atopic eczema are not only hard on their emotional

wellbeing, but also on time and money they have available to devote to the illness. Patients and

their relatives might be put under a large amount of financial and emotional pressure as a result

of the costs of treatment, missing time at school or work, appointment fees, and the concomitant

increase in laundry and clothing bills.

 how to cope with atopic eczema to improve your mental health

It is essential that you maintain a proper skin care routine in order to protect your eczema

from becoming worse, despite the fact that doing so may be difficult for you to accomplish while
you are going through a time that is difficult, busy, and stressful. This treatment plan should

include not just emollient therapy and topical treatments, but also any extra medications that may

be required to bring your eczema under control.

It's possible that you'll find the following recommendations beneficial in terms of reducing

feelings of stress and anxiety, particularly via the practices of meditation, mindfulness,

distraction strategies, and breathing exercises.

These stress-relieving and mood-boosting methods can help you take back control of

your life.

 Make sure you give yourself time to unwind and de-stress every day

 going for a walk

 taking a warm (not hot) bath

 reading a book

 meeting up with friends

 trying a new activity or sport

Treatment for eczema

The four primary objectives of eczema therapy are:

 Take care of the itch.

 Repair skin damage.

 Avoiding flare-ups .

 Avoid infections .
 Your age, your medical history, the intensity of your symptoms, and a number of other

aspects are all taken into consideration when formulating a treatment plan that's tailored specifically

to your needs. Combining several kinds of treatment is the way to go if you desire the finest possible

outcomes from your efforts. There are more methods of self-care that you may incorporate into your

regimen in order to preserve a glowing complexion.

Medications

It is possible for eczema medicine to reduce inflammation of the skin and hasten the

process of healing when it is administered exactly as directed. On the other hand, not everyone

will react in the same way to the treatment. As a result, you and your clinician might need to try

out a number of different strategies before arriving on the most effective plan of action. If the

prescribed medications are no longer producing the expected results, it may be essential to

switch to a different mode of therapy.

Ointments, creams, gels, foams, and solutions containing corticosteroids. Steroids like

hydrocortisone are used in these treatments to fast alleviate irritation and decrease inflammation.

Different intensities are available, from light OTC remedies to stronger prescription drugs. Mild

eczema is often treated with over-the-counter hydrocortisone. Depending on the severity of your rash

and its location, you may require a different dosage of these steroids. A stronger one could be

recommended by a doctor for particularly thick or scaly skin. Stretch marks and skin thinning are

among the rare side effects of these medications if used properly.

PDE4 antagonist. Crisaborole, sold under the brand name Eucrisa, is a nonsteroidal anti-

inflammatory medication that is helpful against mild to moderate eczema. This medication is only

accessible with a prescription from a medical professional. Patients aged 2 and above have reported a
reduction in inflammation as well as an improvement in their skin's look after receiving twice-daily

treatments.

Creams that can help repair the protective barrier of the skin are called moisturizing agents.

This may be obtained without a prescription from a medical professional as well as via retail shops.

They achieve their effects by preventing the loss of water from the skin, healing damage, and

lowering levels of roughness, redness, and irritation. Consult your physician or local pharmacy if you

are unsure about which products can irritate your skin and which ones you should steer clear of. This

might be due to the fragrances or other ingredients in the goods.

Medications that block the effects of calcineurin. People with moderate to severe eczema

may get relief with topical medications such pipecuroniums and tacrolimus. Although they reduce

inflammation, they are not steroids. When over-the-counter steroid treatments fail or create side

effects, doctors frequently prescribe these. The Food and Drug Administration (FDA) issued a

particular warning for them because of research suggesting they may increase the risk of developing

cancer and non-lymphoma. Hodgkin's Modern research, however, disagrees. Please discuss these

potential side effects with your doctor before beginning any new medication.

Medicines containing corticosteroids, whether orally or intravenously. Extremely severe or

difficult-to-treat eczema can benefit greatly from these potent medications. You should limit your

usage of these drugs to a minimum to reduce your exposure to potentially harmful consequences

including skin deterioration and bone loss.

Substances that alter the immune system on a systemic level. Some people find that

immunosuppressants such cyclosporine, methotrexate, and mycophenolate mofetil are helpful in

preventing an inappropriate immunological response by the body. It comes in tablet form, liquid
form, and injectable form. They are useful for persons with mild to severe eczema when the other

therapies have failed. They alleviate irritation, allowing the skin to recover without constant

scratching. Serious adverse effects include hypertension and damage to the kidneys. Taking these

drugs for too long increases your chance of developing these side effects.

Biologics. These synthetic drugs contain proteins extracted from cells and tissues. By

reducing the body's immunological response, they help reduce inflammation and the itching and

flaking of eczema. They are injected subcutaneously or intravenously. When existing therapies for

mild to severe eczema have failed, dupilumab (Dupixent) is the initial biologic to get FDA approval

for patients aged 6 and up.

Antibiotics. Scratching rips at the skin, letting germs penetrate and produce an illness.

Contagious bacterial infections can be treated with these pills.

Phototherapy

Those with moderate to severe eczema may get relief from exposure to ultraviolet (UV)

light. Sunlight's ultraviolet (UV) rays assist prevent an overreaction by the immune system.

However, prolonged exposure can hasten skin's aging process and even increase the likelihood of

developing skin cancer. Doctors will provide the lowest effective amount and keep a close eye

on your skin during this procedure.Your doctor may prescribe phototherapy in conjunction with

a topical medication.

In phototherapy, there are two main varieties:

Light treatment using ultraviolet rays. Your skin may be subjected to UVA rays, UVB rays, or

both at a dermatologist's office. Coal tar is sometimes used in tandem, and it is rubbed into the
skin. Based on the treatment plan you've chosen, you'll have appointments anywhere from twice

to 5 times a week.

Puva treatment. In this method, the skin is made extra sensitive to UVA rays by the use

of the prescription drug psoralen. Those who have tried UV treatment without success can

consider this alternative.

At-home skin care

If your skin is in good condition, you'll be less likely to experience dryness, irritation, or

redness, and you may even spend less time and effort medicating your condition. In addition, self-

care is a wonderful experience.

Don't use cold water for a shower or bath. A skin-drying effect of hot water. Remove dirt and

oil using a mild cleaner rather than soap. Avoid using rough washcloths and body scrubbers. Make

sure to leave some moisture on your skin after drying off with a soft towel.

Moisturize your skin regularly. It should be done soon after you finish washing up. Try to

find fragrance-free moisturizers if you're prone to skin irritation. Try slathering on a heavier, oilier

skin lotion or ointment before bed, then topping it off with cotton gloves and socks to keep in the

moisture. Wearing gloves to bed can also prevent nighttime itching.

Not washing your hands and body excessively is to be avoided. It will cause skin dryness.

Also, avoid using any hand sanitizers that include alcohol.

Keep your distance from things that might aggravate your skin. Many common products

have been linked to exacerbating eczema, including those used around the house and in the laundry,
as well as fragrant soaps, bubble baths, and cosmetics. Find out what causes skin irritation and steer

clear of it.

Go for loose-fitting cotton garments. The itchy feeling you get from wearing wool or

synthetics is real. Never wear brand-new threads the very first time you wear them without first

washing them. Launder using a fragrance-free detergent and a thorough rinse.

Keeping cool is essential. It's not uncommon to get an itch or scratch when you're hot and

sweaty. A lukewarm shower is a great way to clean up after an exercise.

Realize what sets you off. Common allergens that trigger eczema symptoms include pollen,

dust mites, animal dander, and mold.

Calm your nerves. Though it may be challenging, attempting to find time to unwind is

important for preventing a worsening of your symptoms.

Conclusion

Although eczema can be challenging to treat, it can be controlled and improved with the

assistance of a trained medical expert. It is unclear what triggers eczema, however environmental

and genetic factors are both suspected contributors. Eczema treatments range from topical

creams to antibiotics, depending on the severity of the problem. While wet wrapping therapy and

systemic steroids may help some patients, others may need stronger interventions. In the event

that your eczema symptoms are severe, it is recommended that you seek medical attention. They

will be able to advise you on what course of therapy would be most beneficial.
 REFERENCES

Hoare, C., Li Wan Po, A., & Williams, H. (2001). Systematic review of treatments for atopic

eczema. Health technology assessment, 4(37), 1-191.

https://www.journalslibrary.nihr.ac.uk/hta/hta4370/#/abstract

de Lusignan, S., Alexander, H., Broderick, C., Dennis, J., McGovern, A., Feeney, C., & Flohr, C.

(2021). Patterns and trends in eczema management in UK primary care (2009–2018): A

population‐based cohort study. Clinical & Experimental Allergy, 51(3), 483-494.

https://onlinelibrary.wiley.com/doi/full/10.1111/cea.13783

LEWIS‐JONES, S. (2006). Quality of life and childhood atopic dermatitis: the misery of living

with childhood eczema. International journal of clinical practice, 60(8), 984-992.

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1742-1241.2006.01047.x

WebMD. (n.d.). Eczema: What's The best treatment for you? WebMD. Retrieved January 9,

2023, from https://www.webmd.com/skin-problems-and-treatments/eczema/treatments-for-you