Does Itching Keep Them Up at Night? Here’s How to Manage Your Child’s Nighttime Atopic Dermatitis Flares
Health ConditionsSkin ConditionsEczema

Does Itching Keep Them Up at Night? Here’s How to Manage Your Child’s Nighttime Atopic Dermatitis Flares

Does Itching Keep Them Up at Night? Here’s How to Manage Your Child’s Nighttime Atopic Dermatitis Flares
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Published on December 15, 2025
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Also called eczema, atopic dermatitis is characterized by itchy, flaky, scaly skin, and it can happen on any part of the body, including the face.

 Although symptoms like these can be disruptive whenever they happen, flares at night may be particularly problematic for children, since they can affect sleep, according to Nada Mallick, MD, pediatric critical care specialist at Children’s National Hospital in Washington, DC.

“Part of the difficulty with frequent sleep interruptions is their potential ripple effects,” she says. “This can range from challenges in academic performances due to daytime sleepiness, all the way up to emotional disturbance. Because of that, it’s helpful to know if itching is leading to sleep problems, and to try some strategies that can reduce the incidence of scratching during the night.”

With that in mind, here’s a deeper look at the impact of these nighttime flares and how they may affect a child, along with some ways to manage them.

The Impact of Nighttime Flares

Sleep disturbances in children due to eczema are common, according to research in The Journal of Allergy and Clinical Immunology: In Practice. Researchers found that about 67 percent of children and adolescents with eczema had sleep disturbances, and 61 percent suffered daytime sleep-related impairment.

 The study noted that sleep issues worsened with more intensity in itching.

This disruption over time takes an emotional and physical toll. The study found that for those children old enough to talk about their experiences, many struggled with depression, fatigue, and anxiety.

Another study, involving children ages 4 to 12 years with moderate to severe atopic dermatitis, found high levels of sleep disturbance and behavioral problems, compared with children without the condition. Those challenges tended to increase along with eczema severity.

Nighttime scratching and sleep disruption also create a vicious cycle. As the itch keeps your child from sleeping, sleep deprivation can disrupt the release of hormones and anti-inflammatory compounds, negatively affecting skin integrity and making eczema worse.

The child with eczema who’s scratching all night isn’t the only one impacted: so is the parent who has to wake often to take care of them. Poor sleep can create emotional dysregulation and significantly raise depression risk, according to Johns Hopkins Medicine. Restorative, slow-wave sleep is crucial for brain health, including the parts that handle emotion, so if you’re not getting that — as a child or as a parent — it can cause consequences over time.

Key Tips for Parents to Manage Nighttime Flares

Helping your child get better sleep can involve a range of strategies that address both skin health and sleep hygiene.

Establish a Consistent Bedtime Routine

A strong starting point for good sleep is to establish a bedtime routine that’s predictable, to prepare your child for sleep. That may shorten the time it takes them to fall asleep and help them stay sleeping. When they’re sleeping more soundly, mild itching might not disturb them.

Research suggests children with consistent bedtime habits, such as going to bed at the same time each night, showed better emotional control and behavior throughout the day.

Create a Soothing Sleep Environment

Pay attention to what’s in your child’s room and get rid of things may disrupt sleep, like noise, light, and irritants such as dry air or rough sheets, says Tanya Evans, MD, a dermatologist and medical director of the skin cancer program at the Melanoma Clinic at MemorialCare Saddleback Medical Center in Laguna Hills, California.

“Children can be particularly sensitive to environmental factors, so for sleep, you want to make sure everything in the bedroom is geared toward minimizing potential eczema triggers and promoting comfort,” she explains. That might involve using a humidifier, keeping the bedroom cool, opting for hypoallergenic bed linens, and using room-darkening shades.

“If itching persists, you may need to take further steps to modify a room, such as removing carpet that may have dust mites,” she adds.

Have a Skin-Care Routine Before Bedtime

As part of an evening wind-down routine, prioritizing skin health can reduce nighttime itching, says Dr. Evans. Your child can have a nightly bath, but limit it to 10 to 15 minutes maximum, she says, because staying in the water longer may dry out the skin and actually make itching worse. In addition a short-duration bath, other tips include:

  • Keep bath water lukewarm instead of hot or too cool
  • Use mild, fragrance-free cleansers and shampoos to reduce risk of irritation
  • Pat skin dry instead of rubbing
  • Moisturize immediately after a bath with emollients or topical ointments

“Taking the time to moisturize thoroughly as a way to lock in the moisture from the bath can go a long way toward helping with nighttime comfort,” says Evans. “Also, it will improve the skin barrier in the long term.”

Focus on Adequate Hydration and Nutrition

Aside from an evening routine, what you do during the day can have an impact on kids with eczema, particularly nutrition and hydration.

“This often means identifying any possible allergens and paying attention to whether certain foods consumed in the evening may be leading to increased itching at night,” says Evans. Some potential culprits may include:

  • Eggs
  • Dairy products
  • Soy
  • Wheat
  • Fish
  • Peanuts
  • Tree nuts

One essential note, Evans adds: Avoid too much liquid right before bed, such as a large glass of water. If your child wakes up because they have to use the bathroom, they may start scratching.

Use Medications Wisely

Treatment for atopic dermatitis in children is similar to what’s used for adults, says Dr. Mallick. That means a dermatologist will first recommend over-the-counter moisturizers that are unscented and dye-free to repair the impaired skin barrier.

If nighttime itching becomes problematic, you may try short-term use of a topical corticosteroid to control skin inflammation and calm the itch. There are some available over the counter, such as a hydrocortisone cream, and if needed, you can move up to higher-strength prescription steroid creams, nonsteroidal topical medications, or systemic oral or injected medications.

“Parents and caregivers should consult a dermatologist when treatments such as moisturizers and topical corticosteroids aren’t working, because that usually means moving on to prescription options,” says Mallick.

When to See Your Doctor

When navigating sleep issues and atopic dermatitis with your child, it’s helpful to keep a symptom diary that includes sleep duration and quality, suggests Evans. If symptoms are worsening or becoming more frequent, that’s a prompt to see a doctor, she says. Some troublesome signs include:

  • Uncontrollable itching
  • Rash that doesn’t improve
  • Signs of infection like redness, warmth, fever, and pus-filled bumps
  • Changes to skin texture
  • Issues with behavior or self-esteem that seem tied to the eczema

“As with any issue related to eczema with your child, check in with your dermatologist if the condition doesn’t seem like it’s being effectively managed,” Evans recommends.

The Takeaway

  • Sleep difficulties are common in children with atopic dermatitis, and waking up at night can lead to more nighttime scratching.
  • Sleep disruption can cause problems for your child during the day, like trouble regulating emotions and focusing on schoolwork.
  • Strategies to promote skin health as well as better sleep for children with eczema include keeping a consistent bedtime routine, creating a soothing sleep environment, and gently bathing and moisturizing every night.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Eczema. Boston Children’s Hospital.
  2. Fishbein AB et al. Sleep Disturbance in School-Aged Children With Atopic Dermatitis: Prevalence and Severity in a Cross-Sectional Sample. The Journal of Allergy and Clinical Immunology: In Practice. August 2021.
  3. Abdullah AH et al. Poor Sleep Quality in Children With Atopic Dermatitis and Its Effects on Behavior: A Multicenter Cross-Sectional Study From a Low-Middle-Income Country. Pediatrics International. January 2023.
  4. Afzal UM et al. Sleep Deprivation and the Skin. Clinical and Experimental Dermatology. October 2023.
  5. Depression and Sleep: Understanding the Connection. Johns Hopkins Medicine.
  6. Rosen D. Advice From a Pediatrician to Help Your Child With Eczema Get Good Sleep. National Eczema Association. July 15, 2021.
  7. Adwoa D et al. Associations Between Sleep Health and Child Behavior at Age 6 Years in the INSIGHT Study. Journal of Developmental & Behavioral Pediatrics. January 2025.
  8. Mehta Y et al. Relationship Between Atopic Dermatitis and Food Allergy in Children. Cureus. December 31, 2022.
  9. Treatment of Atopic Dermatitis. American Academy of Pediatrics. June 2021.
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Sanober Pezad Doctor, MD

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Dr. Sanober Pezad Doctor is a double board-certified dermatologist and internationally recognized leader in integrative and holistic dermatology. She is an anti-aging and regenerative medicine specialist and the founder of AGEnesis and Baby SkinWise.

She earned her MD in dermatology, venereology, and leprology and a diplomate of national board (DNB) in dermatology. She is board certified in anti-aging and regenerative medicine from the American Academy of Anti-Aging Medicine (A4M). She's also a trained clinical homeopath through the Center for Education and Development of Clinical Homeopathy (CEDH).

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Sanober is a medical school gold medalist and recipient of multiple national and international awards. She is also the chief dermatology medical advisor for emerging clinical research in integrative skin and hair health, with more than 50 published scientific articles.

Sanober is a proactive, compassionate medical practitioner with a thorough understanding of overall mind-body-spiritual wellness. She's also a key advocate for the healthy aging movement. She's a simple mommy to the core and strongly believes "prevention is better than cure." She's on a mission to make you and me into the healthiest version of ourselves.

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