The role of wet wrap therapy in skin disorders – a literature review

Abstract

Wet wrap therapy, based on skin application of a double layer of tubular bandages or gauze with a moist first inner layer and a dry second outer layer, is utilized to treat various pruritic conditions, in particular severe and refractory atopic dermatitis. This review, by literature search, evaluates current knowledge about wet wrap therapy. Wet wrap therapy superimposed topical corticosteroids appears more efficient than emollients only, at least for short-time treatments. Despite higher efficacy, there is a tendency towards more frequent infections when topical corticosteroids are covered with wet wrap bandages compared to emollients only. While temporary suppression of hypothalamic-pituitary-adrenocortical-axis was seen due to systemic bioactivity of corticosteroids, no long-term observation studies on putative adverse effects were identified. One hypothesis suggests that wet wrap therapy may trigger increased lamellar body secretion resulting in recovery of the damaged intercellular lipid laminar structure. Otherwise, little investigation on mechanisms exists.