I have had considerable success in having patients wear boxing gloves upon retiring. Because they cannot remove them without aid, little, or no damage can be inflicted on the skin.
Many patients state that they awaken themselves scratching after the damage has already been done. Others find their bed linens, or night garments, soiled with blood, or serum from a scratching episode.
Patients with emotional disturbances are the most common offenders. Wearing gloves, or mittens, to minimize excoriation is not effective since the patients remove them in their sleep.
Wearing boxing gloves usually will prevent continuous traumatization of the skin, and thereby render it less irritable which is conducive to a good therapeutic response. I keep a set of boxing gloves in the office, they come four to a set, and loan a pair to patients for one week when indicated. If they prove beneficial, the patient has no hesitancy