Hydrotherapy: Wet Sheet Wraps

Hydrotherapy is a medicinal technique of using water as an application of heat or cold to the body. It has been used therapeutically for hundreds of years. Many practitioners and healers have used this technique, which was first written about in western Europe in the 17^th century. As a medical intervention, hydrotherapy has historically been used to help a wide variety of conditions, from injury recovery to pneumonia.

This technique is commonly used in modern naturopathic medical practice around the world. There exist various methods to employ hydrotherapy therapeutically. Some examples of particular hydrotherapy techniques used in medical disciplines include Cold Water Immersion (CWI) and Contrast Water Therapy (CWT). We discuss one particular technique, termed “wet sheet wraps” and explore its use for skin healing and wellness.

Wet Sheet Wraps

Otherwise known as a wet sheet pack, this hydrotherapy technique involves wrapping the full body (leaving the head out) in a cold wet sheet, with a series of dry blankets wrapped around it to create a humidified environment that is insulated.^[1] A heating application, such as an infrared lamp or hot water bottle, is applied to the feet so they stay warm during treatment. 

This treatment is simple to perform and requires very little equipment. During the treatment, the body wrapped in the cold sheet and blankets will slowly warm up the cold sheet. The idea here is to allow heat to accumulate in the blankets to the point where the patient begins to sweat. Sweat is one of our body’s physiological methods of eliminating toxic substances, such as heavy metals like arsenic and lead, from the body.^[2] The increased sweat levels allow for elimination of toxins and for the blood to increase in circulation.

Use for the Skin

Wet wrap therapy (WWT), a modified localized version of a wet sheet wrap, may be beneficial to conditions with severe dryness and itching such as atopic dermatitis (eczema).^[3] 

In a group of children with moderate to severe atopic dermatitis, wet wrap therapy, when included in a multidisciplinary treatment approach to atopic dermatitis, lead to a 60% improvement in atopic dermatitis (measured by the SCORAD grading scale).^[4] In a randomized, double-blind, placebo-controlled trial of children with severe atopic dermatitis, wet wrap therapy helped to enhance the effects of standard treatments with topical steroids or moisturizers/emollients.^[5]  Subjects administered a combined treatment of the wet wraps with corticosteroids showed greater clinical improvement in markers; however, all subjects receiving wet wrap interventions indicated significant clinical improvement in atopic dermatitis.^[5]

Other conditions, aside from atopic dermatitis, have been studied with the use of hydrotherapy treatments. In a Swiss study, patients with burn wounds benefitted from daily use of localized hydro-mechanical stimulation of burn sites for 3-6 months duration.^[6]

While wet wraps have been used for many years, there is a growing body of research showing that wet wraps may have an important role in skin care. It may be important to assess each case of skin disease individually, as symptoms may vary widely. These preliminary studies warrant further discussion about how to incorporate hydrotherapy treatments into a skin disorder treatment plan. For individual inquiries, consult with a licensed healthcare provider.

1. Boyle W, Saine A. Lectures in Naturopathic Hydrotherapy. Buckeye Naturopathic Print; 1988.
2. Sears ME, Kerr KJ, Bray RI. Arsenic, cadmium, lead, and mercury in sweat: a systematic review. J Environ Public Health.2012;2012:184745; PMID: 22505948 Link to research.
3. Andersen RM, Thyssen JP, Maibach HI. The role of wet wrap therapy in skin disorders – a literature review. Acta Derm Venereol.2015;95(8):933-939; PMID: 25940919 Link to research.
4. Nicol NH, Boguniewicz M, Strand M, et al. Wet wrap therapy in children with moderate to severe atopic dermatitis in a multidisciplinary treatment program. J Allergy Clin Immunol Pract.2014;2(4):400-406; PMID: 25017527 Link to research.
5. Janmohamed SR, Oranje AP, Devillers AC, et al. The proactive wet-wrap method with diluted corticosteroids versus emollients in children with atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol.2014;70(6):1076-1082; PMID: 24698702 Link to research.
6. Moufarrij S, Deghayli L, Raffoul W, et al. How important is hydrotherapy? Effects of dynamic action of hot spring water as a rehabilitative treatment for burn patients in Switzerland. Ann Burns Fire Disasters.2014;27(4):184-191; PMID: 26336365 Link to research.