Keep the clothes on!

December 19, 2007 7:41 AM

Help me find a way to keep my son's clothes on.

My son has horrendous eczema. He scratches himself bloody on a daily basis. Let's skip the reason behind that for right now, he's been seen by at least 3 dermatology groups and has a surgeon who follows him on an ongoing basis. To minimize the damage he sleeps in footed pajamas (some places call them blanket sleepers). He also spends a good part of any day wearing them. The trouble is that at night, he'll take them off and go to town on his skin. For some time I've run a safety pin through the zipper and the neck of the pajama to keep it shut. But the last three nights he's been able to get that off. This is not good. What I'm looking for is some way of keeping his clothes on at night, something that won't require a lot of sewing or alteration of the pajamas (though that certainly could be done). Any clever ideas? Oh, and he's 6.

posted by ericales to clothing, beauty, & fashion (24 comments total)

Use one of those little travel padlocks on the zip instead?

Tell him Santa won't come if he doesn't keep them on.
posted by zeoslap at 7:47 AM on December 19, 2007 [1 favorite has favorites]

Would it be possible to get him to wear cotton gloves, possible with the wrists secured to make them hard to get off? That would reduce the damage from fingernails at least.

Is he doing this in his sleep or is he waking up to do it? At six he should be able to understand not to do it if he's awake. If he's asleep that's another matter.
posted by GuyZero at 7:47 AM on December 19, 2007

You could also have him wear mittens or something and keep them on with some velcro so he couldn't scratch.
posted by zeoslap at 7:48 AM on December 19, 2007

It's when he's asleep that is the main problem. We used to tape to layers of socks on his hands. After a few close calls with restricting circulation we gave up on it. We might be able to rig up some kind of harness to keep mittens on, but he's apparently resourceful, even in his sleep.
posted by ericales at 7:54 AM on December 19, 2007

Yeah, my kids do crazy stuff while asleep. And that's the age for it too - they don't quite wake up but they're pretty functional. Maybe tying a knot with a string instead of a safety pin at the back of the neck. Or, for the worst case, sew his sleeves onto the body of the sleeper so he can't move his arms. Uncomfortable but effective.
posted by GuyZero at 7:58 AM on December 19, 2007

What you'd need to do is sew a little loop of fabric at the top of the pajamas. Then you'd have something to lock the zipper pull to with zeoslap's travel lock. Zip ties would also work. I think a travel lock would be better though. Easier to use the restroom in the middle of the night that way.
posted by natabat at 8:00 AM on December 19, 2007

I think you should sew mittens onto the sleeves of his pajamas just like the feet are attached. Why not try putting his pajamas on inside out so they zip up the back from inside? That might make it a lot harder for him to unzip. You could also try adding a few buttons over the zipper. All this would be a giant pain if he has to 'go' in the middle of the night, though. Poor fellow. Good luck!
posted by infinityjinx at 8:01 AM on December 19, 2007

What is being done to control the itching? I had this as a child and found that for some unknown reason it became intolerable at bedtime. This itch can be so intense that you cannot simply tell a person to stop. The itching would stop by applying heat (check with your doctor first.) I used very hot tap water. The itch would increase, then vanish and I was able to then sleep through the night.
posted by Raybun at 8:09 AM on December 19, 2007

I've thought about the string around his neck, but my wife is pretty freaked out about him being strangled by it. The loop and padlock seems like a decent plan. Except now I've got this image in my head of his pajamas being like a chastity belt.

And I only wish this would interfere with toilet use. As part of all his medical issue we're only now really trying to get him potty trained.
posted by ericales at 8:11 AM on December 19, 2007

How structured are the sleeper PJs? Could he wear them in reverse with the zipper in back?

Also, is it possible the zipper itself is irritating him? Is it uncovered in any way? Is he using the teeth of the zipper to scratch and inadvertently opening it (and then going to town scratching)?

Poor little guy. He can't be sleeping well; he must be exhausted.
posted by 26.2 at 8:13 AM on December 19, 2007

When he gets them off he mostly scratches his legs. Even when they're on he'll do a lot of rubbing of his legs together. Doing them inside out might work, at least for a while before he catches on.
posted by ericales at 8:19 AM on December 19, 2007

You might want to try lighter cotton jammies underneath. These Hanna long johns are really soft and might be less irritating. Then, like 26.2 suggested, put the footie jammies on backwards over top so he can't get to the zipper.
posted by jrossi4r at 8:36 AM on December 19, 2007

My parents used to wrap my brother's limbs in plastic wrap under his pajamas to keep him from itching. He also would itch to bleeding. I don't think anything worked perfectly, but after years of treatments and techniques, this is what they ended up doing. (I'm sure they also had nightmares of him suffocating, but at a certain point with eczema you choose your demons.) They also gave him a lukewarm oatmeal bath right before bedtime (and his many lotions and salves). Aveeno has a colloidal powder that seems good. I'm sorry your son is in such discomfort and that you're having such a struggle to manage it.
posted by cocoagirl at 8:53 AM on December 19, 2007

Part of the issue may be the increased warmth caused by the pj's. When my eczema-ridden hands are under the covers where it's warm there is a marked increase in itchiness and will "night scratch" and cause damage. You might want to make sure the pj's are very very light.

The suggestion to use hot tap water for the itching is a not very good one in my experience. The sensation is orgasmic and the itching stops temporarily but it severely increases the spread and severity for me.
posted by hecho de la basura at 9:08 AM on December 19, 2007 [1 favorite has favorites]

sew his sleeves onto the body of the sleeper so he can't move his arms

Wow, maybe we should get him a prepaid medical gift card for all the therapy he'd need after being 6 years old, essentially strait-jacketed and super itchy!

Being a lifelong super-itchy night scratcher myself, I'm going to second that the PJ's are a source and not solution to his problems. I scratch more when I'm hot. Now that I'm grown I sleep nearly naked and use lots of blankets that can be easily thrown off for warmth. Socks, pants, anything aside from a pair of loose boxers on my lower half results in bloody shins.

I'm also accepting medical gift cards for lotion and therapy. Thanks.
posted by Pollomacho at 9:33 AM on December 19, 2007 [1 favorite has favorites]

Instead of the blanket pjs which have a fair amount of room in them, what about lighter, tighter cotton or silk long john style pjs? They won't have feet on them, but you could sew on some socks. Also, while the top and bottom are separate, you could also sew on some hook and eye fasteners or something to help attach them so he can not just lift his shirt and scratch. A long zipper around the belly, maybe? The other advantage to these is that he'd not be able to easily pull his arms into the sleeves to access his skin without taking off the shirt. I find that my eczema seems way less itchy when I have clothing that rests snugly right up against the skin instead of brushing along it.
posted by onhazier at 9:35 AM on December 19, 2007

My daughter developed eczema when she was two. Left to her own devices she would do the exact same thing you’re describing in your son. We had an elaborate night time routine. Too many hot baths made the eczema worse, so once a week we would bathe her in warm (not hot) oatmeal baths and BEFORE her skin dried out lotion her up. We’d use Eucerin lotion. We did not use oil because it seems to make it worse. Then we would put her in all cotton tights. The cotton was like a second skin for her and there was no “tickling” of the surface of her skin from any roughness from the inside of footed pajamas. Also, if she decided to scratch through the tights, it the damage was mitigated by the cotton. We would apply lotion like a bedtime massage every night. I’d put her foot on my shoulder and rub in the lotion concentrating behind the knees.

During the day, she would wear the tights that she wore the night before. They would have a residue of the lotion so it helped. I know he’s a boy, but there are dark colored tights and you could cut the feet off for daytime use (this will not work at night because they will just yank up the tights). I would buy tights any time I saw them in thrift stores.

This kept he eczema under control BUT sometimes due to changes in the weather, exposures to her allergy trigger or laziness on the part of her parents, she would have a fairly significant outbreak and I would use cortisone lotion to get her back on track. I know you probably already know about hydrocortisone, and that if you use too much it can “thin the skin”, or so they say. But there certainly is a time and place for it.

Good luck, and I have to say… it usually does get better with age. (although daughter is now 13 and still has it, but not as bad)
posted by vermontlife at 9:41 AM on December 19, 2007 [2 favorites has favorites]

If anyone in the family sews it might be a good idea to make some PJs with the closures on the back and of course made of non-scratchy material or hire a seamstress or tailor to make some.
posted by estronaut at 9:59 AM on December 19, 2007

Benadryl.
posted by Ambrosia Voyeur at 10:00 AM on December 19, 2007

vermont life offers some excellent advice. I second everything mentioned in their comment - with one caveat.

Make sure your son has Eczema. I know, I know - you have. But get it validated some more. I have psoriasis. Psoriasis doesn't have to look like the pictures that you commonly see. In fact, I was misdiagnosed for years (by several doctors and dermatologists) before people considered that it might psoriasis. Many of the symptom-relieving methods are common with eczema, but the actual treatments aren't necessarily the same. You'd be surprised at how many otherwise competent pediatricians, general practitioners and dermatologists can get this diagnosis wrong.

Like I said before, vermontlife's advice is top notch.

My suggestions:
Triamcinilone helped me sleep at night when i was younger and often kept up with itching. It's an topical steroid in a petroleum jelly base. It works best (for me) if applied just before bed, when wearing pajamas. Good stuff for getting over a painful hump. It's prescription, of course.

Oatmeal baths (Aveeno)

No more soap! I haven't used soap in the shower (except occasionally) for at least 15 years. My skin is much better for the change.

Biodegradable, fragrance free laundry detergent - or just plain water. Water is surprisingly good at washing things. Who knew? (of course, it isn't much good for stains and such, which is a bit of a problem with a child.

Consider asking a doctor about using the occasional sleep-aid. Eczema, like psoriasis, can be aggravated by stress. Lack of sleep is stressful. It's an brutal circle. I'm not sure what's safe for six-year-olds, so leave that to the doctors. Sleepytime tea or Valerian tea might help facilitate a deeper sleep with less itching.

Finger-taping.
Exactly what it sounds like. Tear off a few inches of medical cloth tape and wind it around each finger, covering the fingernail and tip. You can to a slightly better job by placing a bit of tape over the fingernail tip first, before wrapping the other bit of tape around the end of the finger.

Be careful of over-clothing the child. Kids don't fully grasp what makes them sleep better or worse, and it's really easy to bundle the hell out of a kid, not realizing that they can get too warm at night, causing them to sleep poorly. A waterbed can help with this though, since keeping the bed heater on the lower end of the scale will allow for your child to be swaddled up while still conducting some of the excess heat away form them. Plus, kids freaking love waterbeds.

Climate
Consider radiant heating, if you have the option. Electric baseboards and forced-air HVAC systems do a lot of messing about with the humidity of the air. Radiant heating via floor or old fashioned radiator seems more friendly to those with skin conditions - it's an expensive thing to change though - and I haven't even made the change for myself. But I always sleep with the window open, regardless of the season, just to get the right level of humidity and fresh air in the room.
posted by terpia at 12:18 PM on December 19, 2007

While it sounds like medically your son's in good hands, I would like to share what worked for me. After seeing a plethora of doctors that continually pushed the regular round of semi-treatments (baths, lotions, creams, etc.), I eventually found a doctor that took a different approach. He had a whole cabinet of different topical medication samples. He would give me one to try for a few weeks, evaluate it, and see if it worked for me. If not, he'd send me home with another sample. After a few months with mediocre success we found one that worked pretty decent. Some of them I tried would help clear up my skin, but goddamn would they make me itch.

So I guess in a roundabout way what I am trying to say is try a different brand/type/base of medication that doesn’t add to the itch (if that’s the case here).

For what it’s worth, I wholeheartedly recommend Dermatovate ointment. It works wonders for me, as well as numerous others I've suggested it to.

I get it in Mexico. It's cheaper than filling my US prescription co-pay, and works better. It was recommended to me by the Mexican Pharmacist as a substitute for Ultravate.
posted by enobeet at 2:26 PM on December 19, 2007

I leave it to the more experienced here about whether or not keeping the kid in the PJ's is a good idea or not.

But as to HOW to do that, try putting them on the kid backwards. IE Zipper down the back not the front.

My toddler likes to strip naked and take off her diaper. This is the only thing that keeps her cloted at night, she can't reach the zipper to get them off.
posted by mazienh at 2:55 PM on December 19, 2007

Thank you for the continued responses.

So far as clothing is concerned, I suppose we don't have much to lose by trying less clothing. One of the dermatologists also recommended dermasilk type clothing. The only concern I have with any type of clothes is his propensity for removing them, even if they're less irritating, I don't know how much good they'll do if they are already off.

So far as drugs and stuff we've tried. We currently cover him with bag balm on a regular basis. He gets doxepin before going to bed (it appears to be a low enough dose to not affect his mood), we went right past triamcinolone and use clobetasol ointment, benadryl only sort of takes the edge off and puts him to sleep for a few hours. Oddly, he hates warm water, he demands his baths be cold. I kind of like the finger taping idea and I'll have to check with the docs regarding psoriasis. That might help explain things as he is on a dose of immunosuppressants high enough that the docs and surgeon all feel he should never even itch, much less have the problems he does.

Again thank you. I've got some stuff to try and ask about now.
posted by ericales at 6:21 PM on December 19, 2007

I once suffered from a horrible itch problem. Docs couldn't fix it! I was staying with friends, and they had some stuff called Ambesol, for tooth ache. This specific formula combined pain killer with antiseptic (Iodine, IIRC). In serious desperation, I applied Ambesol to my itchy bits. WOW! The pain killer killed the itch. I strongly suspect the antiseptic aided healing where I'd scratched myself to bleeding nearly every night, for years.

IANAD! But this might be worth a try, maybe on a specific area. Also, I agree with those suggesting the boy may be too hot.

On, surprised no one suggested, there are mitts sold for controlling exactly this sort of problem. See Posey, here. Also, you might find some boxing gloves around somewhere. Maybe a boy would be tickled by that, especially if you let him punch something now and then :-)
posted by Goofyy at 5:44 AM on December 20, 2007