Son with eczema wakes up in the middle of the night itching
October 19, 2021 8:28 AM   Subscribe

My son has severe eczema but it’s manageable during day time.but he wakes up around 2am (almost every day), itches like crazy for almost an hour and then sleeps .Somedays I give him homeopathy medicine when he itches in the night.That helps but not all the time.somedays the itchiness stops after some time by itself.Somedays he is so sweaty when he’s up,he changes his top ,itches and then sleeps again.There is no one thing or a pattern that we could find out that triggers.

He use to sleep through the night few years back ,but I don’t remember what we did right then.

His food includes low sugar and free of all major allergens.he takes vitamins.He runs in the treadmill everyday for a hour or so.He is okay during the day (maybe little itchy here and there ) but overall fine all day.He takes warm shower after exercising .Apply lotion after shower.A/c was on till yesterday.We had to switch on the heat today as the temperature dipped below 50 here in east coast.

Air purifier,humidifiers run all night in his room. He has a fan at high speed running next to him.I apply lotion before bed.I wash his sheets every week in allergy free detergent.But still,looks like we are missing something from getting a good night sleep.

Do you have any advice or suggestions that has helped people with eczema sleep good without waking up itching in the middle of the night?
posted by SunPower to Health & Fitness (32 answers total) 2 users marked this as a favorite
How old is your son?
posted by DarlingBri at 8:34 AM on October 19, 2021

I'm sure someone who understands this well will chime in, but there's a circadian rhythm to histamine levels.
posted by 10ch at 8:42 AM on October 19, 2021 [3 favorites]

Can you see a dermatologist? Eczema is often genetic, so if changing environmental factors isn't helping, I would stop bothering with that. Our seem prescribed Elidel after a brief course of hydrocortisone to reduce the inflammation. Two weeks and it all cleared up.
posted by stray at 8:45 AM on October 19, 2021 [8 favorites]

Somedays I give him homeopathy medicine when he itches in the night.That helps but not all the time.

This would only help because of the placebo effect. Homeopathic remedies have no actual medical benefit.

What lotions is he using? Are they specific for eczema? I find Aveeno Eczema Therapy lotion to be an absolute miracle for my eczema.
posted by tiny frying pan at 8:53 AM on October 19, 2021 [17 favorites]

Response by poster: My son is in his early 20’s and we have an appointment with the dermatologist in December.I’m going to bring this up with her.Meanwhile trying to help as much I can because he use to sleep well and I don’t know what changed.I’ve used many lotion like eucerin ,cereve,Aquaphore,vanicream,aveeno(he never liked aveeno and it didn’t work for him).Aloe Vera gel is soothing for him .But nothing helps during night time itching.
posted by SunPower at 9:05 AM on October 19, 2021

This might seem counterintuitive, but there's some evidence that kids playing in the dirt boosts their immune system and can reduce allergies. Definitely see a dermatologist and find out if there's any actual medication you can get to help with the late-night itching, but one thing that might start to help is making sure he gets enough time playing in the dirt.

Also, avoid the homeopathic remedies, because they have no medical benefit and also often have poor quality control, so there may indeed be an active ingredient that's poisonous when not diluted to be virtually undetectable, which is what homeopathy is. They can be really dangerous because of this, and they're not going to help his condition beyond the placebo effect, as mentioned above.
posted by limeonaire at 9:07 AM on October 19, 2021 [3 favorites]

Ahh, I see, adult son. I misread this as being about a child. Nonetheless, the same principles might apply!

That said, as an adult, he has other diagnostic tools available. I wouldn't suggest an extensive patch test for a small child unless the situation were severe, but an adult could stand to do a full patch test for contact dermatitis and prick tests for food allergies. That's what I'd suggest. Until you do that, just wildly switching lotions and environmental factors might just exacerbate the situation; it did for me until I found out what I was actually allergic to, and it turned out to be everywhere in my environment (benzalkonium chloride wipes and formaldehyde-releasing products, among other things).
posted by limeonaire at 9:10 AM on October 19, 2021 [2 favorites]

Could he just be running hot at a particular stage of sleep, and that's setting off the itching? A night sweats sort of scenario, which can happen even in a cool room. Potential causes apparently include anxiety, low blood sugar, alcohol and a variety of medicines. (Also, less applicably, the menopause.)
posted by ManyLeggedCreature at 9:12 AM on October 19, 2021 [1 favorite]

If it's severe and he's not seeing a dermatologist regularly, please start there. Poor sleep due to constant itching is awful and can contribute to other health issues (I know from personal experience).

I see that you use hypoallergenic detergent, but what are the other conditions in his room? Is there regular vacuuming? Dust and dust mites are very common eczema triggers. At my worst, I was vacuuming daily, using a HEPA filtered vacuum, and changing my sheets every three nights

If his mattress is very old, consider replacing it or at least using a very well sealed allergy zip cover.

There are also adult eczema garments made from super soft cotton and can optionally have gloves/mitts sewn on the ends to curtail scratching. You can also encourage him to cut and file his nails really short to reduce any damage from scratching.

All shampoos and body washes should be very gentle and unscented, at least while you're figuring out a routine. Baby products are a good place to start - I love the Mustela line of products.

You should consult with the dermatologist, but 24 hour OTC allergy meds like Xyzal might help, or Benadryl taken before bed.
posted by rachaelfaith at 9:39 AM on October 19, 2021 [2 favorites]

He's 20 years old, he can take an antihistimine.
posted by DarlingBri at 9:46 AM on October 19, 2021 [8 favorites]

I'm also an adult son with eczema. What works for me is: Warm showers only, not hot. No showers at night. Take an antihistamine before bed. Apply plain petroleum jelly or aquaphor before bed (and a couple times during the day, especially after showers) to keep natural moisture in.

Anytime I have to use any other type of moisturizer or lotion it will be either not as effective as petroleum jelly, or it will actually make things worse.
posted by Diddly at 9:55 AM on October 19, 2021 [4 favorites]

Maybe a wool mattress topper? That would help with temperature regulation and it’s hypoallergenic.
posted by pairofshades at 9:55 AM on October 19, 2021

Things that help get my eczema under control are:
* Being diligent in taking my seasonal allergy pill every day
* Not taking hot showers. Just warm enough (not so that I'm actually cold, but am wishing it were a touch warmer)
* Avoiding heaters / AC since they dry out the air. I might not even do the fan next to the bed since that constant air movement against my skin tends to make my skin feel more dry and irritate more easily. I love a radiator instead of a heater.
* This last one is obviously the hardest, but trying my best not to scratch. When I have a flareup, if I feel an urge to scratch, I reach for lotion instead and massage it in. The best remedy is to not scratch a sensitive spot into a flare up from the get-go, but I know you're not asking about that, and controlling scratching during sleep is impossible.

On preview, yep everything Diddly said down to Aquaphor (I also use Vitamin E cream)
posted by blueberrypuffin at 9:56 AM on October 19, 2021

If he's not taking an anti-histamine that's what I would suggest. I think if the homeopathic remedies aren't helping and you've tried the most obvious environmental changes then you need to take a step up, at least so he can get some unbroken sleep before speaking to the dermatologist.
posted by plonkee at 10:04 AM on October 19, 2021

Response by poster: Thank you all for your suggestion.will be checking the allergy free clothing and bed cover.

We have given him Benadryl before and has helped him sleep with out itching. But he takes Benadryl only on days when he is very itchy before going to bed.normally he sleeps within few minutes in bed.So going to sleep was never the problem.It’s the waking up in the middle of the night.
posted by SunPower at 10:18 AM on October 19, 2021

If Benadryl helps, a daily antihistamine would likely help through the night. I'm sure the dermatologist can recommend what to use, but maybe try a 24 hour Claritin or Zyrtec?
posted by tiny frying pan at 10:21 AM on October 19, 2021 [1 favorite]

Yes, definitely try some second generation antihistamines. I find Zyrtec to be most effective, followed closely by Allegra, but everyone is different.

I'll also nth Aquaphor. I often will put on aquaphor, then cover the area with a light gauze (though I usually use the kind that's more breathable as opposed to water proof. Mainly I do that because my hands are the worst spots for me and I just don't want to be getting greasy aquaphor on everything around me. But also maybe it would help remind him not to scratch those areas and minimize the damage of scratching in his sleep.

Maybe he should try sleeping in mittens?

Also, since he's 20, he just needs to do everything possible not to scratch when he's awake. Obviously he can't help when he's sleeping. But if he wakes up at 2 am and the itching is driving him crazy, maybe he needs to get up and read a book or something for a little bit to distract himself before going back to sleep.
posted by litera scripta manet at 10:37 AM on October 19, 2021

I was going to suggest a daily antihistamine as well, one of the non-drowsy ones. I started taking mine for issues unrelated to my eczema and as a bonus it cleared my skin right up.
posted by kbuxton at 10:38 AM on October 19, 2021

Response by poster: Kbuston…what is the non-drowsy antihistamine that helped clear up your skin?
posted by SunPower at 11:29 AM on October 19, 2021

I am no expert. But, looking at what you're saying, some possible avenues of research:

(A) He takes a shower post-exercise. Is it possibly related to the soap or shampoo being used, whether the water's hard/soft, or whatever cleaner's used on the shower?

Trying to think of what's unique to sleeping, but not to the rest of the day you describe:

(B) How about the sheets, pillowcase, fitted sheet? Try washing a new set of each in something entirely different.

(C) Does the itching persist if the air purifier is removed from the equation? (Thinking impurities in its manufacture, etc.)

(D) Does the itching persist if the humidifier is removed from the equation? (Thinking impurities in the water or the water reservoir.)


(E) Also, as a terrible but possible one-off, any chance there are bedbugs? Where he itches, do they look like welts from a bite? Look for brown lines/marks along the side of the mattress, especially closer to the frame and in areas out of the light.

I would basically try removing things/changing things one by one from the equation for a night or two to see if things get better. Process of elimination.
posted by WCityMike2 at 12:15 PM on October 19, 2021

He also might want to try a low-histamine eating plan.
posted by Ideefixe at 12:47 PM on October 19, 2021

If benadryl helps him sleep through the night without itching, just have him take a benadryl - it's okay if he doesn't need it to fall asleep.
posted by bile and syntax at 1:29 PM on October 19, 2021 [1 favorite]

Or it should be OK for him to take a Benadryl at 2AM when he wakes up.
posted by mskyle at 1:39 PM on October 19, 2021

We have given him Benadryl before and has helped him sleep with out itching. But he takes Benadryl only on days when he is very itchy before going to bed.

I'm sorry, I'm really struggling to understand. You know the Benadryl is effective when he is itchy before bed, is there a reason you are reluctant to give him one if he wakes up at 2 am? He can take one every day, why save them for "only" days when he's itchy before bed?
posted by DarlingBri at 1:50 PM on October 19, 2021 [3 favorites]

If he takes a daily allergy pill like Zyrtec or claritin, he could try taking it at night instead of in the morning.

My son had eczema when he was younger. The only lotion that helped was Aveeno eczema therapy with colloidal oatmeal. Regular Aveeno lotion did nothing! It had to be this specific type of aveeno lotion that I’ve never seen in stores, only online. It didn’t work immediately, we had to use it for several days in a row for it to work.

Desitin also worked, but it’s a thick white diaper cream and smells terrible.
posted by bq at 2:05 PM on October 19, 2021

Sounds miserable. When I'm really itchy, corn starch is mildly helpful. Good luck
posted by theora55 at 2:48 PM on October 19, 2021

I've had eczema as a young child, then it mostly went away until early college years (early 90's, my old friend busithoth used to call it my ear leprosy) then it mostly went away until the late 90's/early aughts when I was living in NYC. I saw dermatologists, they would give me steroids or a shot if it was bad (and by bad I mean face, ears, back, arms, and nipples. The white t-shirts I wore under my work shirts got permanently stained with a bloody, yellow oozy stain, I lost waiter jobs because you cant ooze and flake skin when waiting tables, it was a nightmare) and I tried oatmeal baths, salt baths, olive oil baths, every manner of lotion...ugh it got into my scalp, I even used that
T-Gel shampoo. Nothing brought anything but temporary relief.

Then I got on a mild anti-depressant/anti anxiety drug, I think it was called Wellbutrin at the time, and my skin started clearing up after the first pill- a placebo effect of a sort of course, I chalk it up to the fact that I was doing something I had not yet tried, and everything else had failed.

Since then it flares up in the fall and is mostly allergy related, as it turns out I am allergic to a bunch of stuff that happens in the fall where I live now. Attacks mostly my inner forearms and my upper back. Nowhere near as severe as the bad times in NYC.

The point of my gruesome tale? Allergies and stress/anxiety can make eczema much worse and less manageable, so consider those factors. I'm not your son's doctor and this is not medical advice, just anecdotal information from a guy who has had a lot of eczema over the years and over and under and around the ears.
posted by vrakatar at 9:21 PM on October 19, 2021 [1 favorite]

Seems like a dermatologist and then a daily antihistamine (ceterezine=Zyrtec, fexofenadine=Allegra, loratidine= Claritin) is a good next thing to try. All three are OTC in the US.

Benadryl personally I reserve for times when nothing else is working; it’s got the downside that if your son has to be functional in the morning, 2am might be too late— many people are still a tad groggy after 6 hrs. For most people that effect wears off by 8 hrs though, and a little grogginess is going to happen due to sleep loss anyhow.
But the three other antihistamines I listed above have much less drowsiness for most people.

Two more environmental things to try: I have to wash my sheets in very hot water, as one of my major allergens is dust mites and high temps are necessary to remove their protein. Also helps reduce pollen reactions for me. I don’t usually get skin reactions though, for me it is lungs and eyes; but make sure whatever allergens could be the problem really are getting removed by your process. I also keep a whole stack of clean pillow cases in case I wake up with a reaction. They can go on the pillow but also underneath to prevent contact with the sheets.

Last thing: check to makes sure the soap and shampoo he uses are gentle. Sodium lauryl sulfate is a really common foaming agent in soaps and shampoos— and can cause skin reactions in sensitive people (hello, itchy scalp that *finally* went away when I switched to sulfate free shampoo). Even “for sensitive skin” formulations occasionally have it. Fragrance free and sulfate free is what I look for.
posted by nat at 1:23 AM on October 20, 2021 [1 favorite]

I've had eczema since I was about seven. The only treatment that makes any discernible difference is a topical corticosteroid (mometasone furoate 1mg/g).
posted by aussie_powerlifter at 2:00 AM on October 20, 2021

Crazy-making Itching at night is also characteristic of scabies, which evidently can be difficult to diagnose. Maybe made more difficult if there are eczema patches on the skin?
posted by Sublimity at 6:56 AM on October 20, 2021

I just want to second aussie_powerlifter. I spent years in my 20s doing all sorts of environmental things that were total pains in the ass and none of them worked well and many were miserable (like no hot showers are you kidding me). Now I have a prescription corticosteroid and I put it on the second a tiny patch appears and my life is full of joy and low-itch.
posted by dame at 7:26 AM on October 20, 2021

When considering which type of lotion to use, try skipping them all and going for creams. If he needs to up it from there, petroleum jelly. I agree that allergy pills could be helpful, just make sure he asks the doctor's office when to stop use before his visit. (If they do any allergy testing, it needs to be out of his system by then, I think it's usually something like five days.)

I also think it's a good idea to introduce potential allergen foods back into his diet. If he has an actual allergy, it should either be apparent then or at least this will help it show up on the allergy test if it's a milder reaction.

Which detergent are you using? All is the one I've seen recommended by allergists. Other brands make ones that claim to be scent-free or good for allergies, but some are terrible (Tide's scent-free one smells bad and makes me sneeze).
posted by blueberry monster at 5:38 PM on October 23, 2021

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