By Dr. Frank Lichtenberger MD, PhD
An Explanation on Why Tencel® Fabric is Superior for Eczema Sufferers and Wet Wrap Therapy.
By Dr. Frank Lichtenberger MD, PhD
Before we talk about the Tencel® fabric itself, we should review why wet wrap therapy is effective for atopic dermatitis/eczema and some of the problems we encounter with wet wrap use.
Wet wrap therapy traps much needed moisture near the eczema skin, reduces itching, and enhances the effects of medication used on the skin. This “three-pronged” approach is the ideal antidote for the dryness, itching, and inflammation associated with atopic dermatitis/eczema. When using wet wraps for moderate to severe atopic dermatitis/eczema (the kind you should see a doctor for), the most common side effect is “folliculitis”.
Folliculitis, or irritation of the hair follicles from wet wraps, develops as a consequence of how the fabric handles the water component. If the hydration is not trapped at the level of the skin by the wrap, water and bacteria can be pushed into the pores causing folliculitis. Folliculitis is very irritating and usually requires antibiotics to treat – which is why some wet wraps are done under close clinical supervision. I personally see patients back in clinic less than 7 days after starting wet wraps to make sure they haven’t developed folliculitis. Tencel® fabric absorbs moisture without developing bacterial biofilms which tend to develop with other fabrics such as cotton, but especially synthetic fibers (polyester, etc.).
Scientists and physicians have known for hundreds of years that bacteria causes disease, however, it is only very recently that we have discovered that some bacteria are important for our bodies to function properly – giving rise to the term “microbiome”. Most people have heard that good bacteria are important for healthy gut function, and the same is true for skin. Over 90% of eczematous skin is associated with a more aggressive form of bacteria, which contributes to the inflammation of skin lesions. Wet wraps made from cotton or polyester can develop films of moisture, which can be breeding grounds for bad bacteria. Tencel® fabric does not allow water (which is necessary for wet wraps) to form these films – thus not allowing the BAD bacteria to multiply wildly, and conserving the microbiome of the skin.
Atopic dermatitis/eczema is a complicated condition, with components of allergy, infection/inflammation, and loss of barrier function. Tencel® fabric is an eco-friendly, sustainable fabric that is the most effective fabric on the planet for itch reduction.
The “Eczema Itch” is awful and itching from eczema is actually worse than normal itching. It is almost impossible to resist the intense itching which some describe as being similar to poison ivy. Itching damages the skin barrier so more of the allergen can enter making the situation worse. Thus begins the Itch/Scratch Cycle that is very hard to break and the situation becomes quite miserable for the patient. The inflammation in the eczematous skin amplifies how the nervous system sends the “itch message” to the brain. Because of the itch amplification, some fabrics that are normally not itchy (i.e.: cotton, rayon) can irritate or cause itch on skin that is affected by eczema. Tencel® fabric was compared to cotton and synthetic fiber fabric in a University study, and was found more comfortable to eczematous skin than any other fabric. Tencel® has a feel that is softer than silk, which itch-amplified skin desperately needs!
In summary, Tencel’s® main features: naturally anti-itch, inhibiting bacteria on the fabric, holding 50% more moisture than cotton, and being one of the softest fabrics available, makes it ideal for wet wrap therapy for eczema. This fabric is also the least disruptive to the natural environment of the skin, which is very important when dealing with skin that has an impaired barrier function.
The above image shows the moisture absorbency of TENCEL® versus cotton.