Bed Sheets | A complete guide to choosing bed sheets with your skin in mind
Consider this: Your skin is in direct contact with these sheets for hours on end. Read more...
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Have you ever given much thought to the role bedsheets play in your skincare routine?
What should I think about when it comes to choosing bed sheets?
Flannel sheets sound like they would keep you pretty warm, right?
Is organic cotton a better choice when it comes to bed sheets?
Microfiber sheets are also advertised. Any advantages to these?
When people think of luxurious hotel sheets, what type are they usually thinking of?

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Have you ever given much thought to the role bedsheets play in your skincare routine?
Consider this: Your skin is in direct contact with these sheets for hours on end. Perhaps even as much as a third of your life, or even more! Understanding your options from the perspective of skin care as well as implications for skin care products you may apply and clothing you may wear to bed is important. Many of the medical studies on textiles for bedding are focused on the impact on the skin of bedridden patients.
What kinds of bedsheets are available?
From a textile perspective, bed sheets are broken down into these most common textile categories:
Cotton and Cotton blends
Percale
Sateen
Jersey
Flannel
Organic Cotton
Supima Cotton
Silk
Linen
Bamboo
Microfiber
Hemp
Even though there are a number of different types of cotton and cotton blend sheets, the main way that they differ is in the patterns of textile weave or how they are knit together. This can impact how the textile feels as well as how they retain or release heat.
Are cotton sheets all the same?
Not all cotton sheets are the same. There are variations based on the construction, weave, and thread count of the textiles. The variations result in a different “feel” against the skin in terms of softness and a different experience in how they retain or release heat and moisture. Also, the type of cotton fibers used - Tencel, Egyptian cotton, organic cotton, Pima cotton, and American Upland - have varying qualities that influence how they “feel” against your skin. The way the textile is constructed – woven versus knit – can impact how warm the cotton keeps you by trapping or releasing heat. Think of flannel, sateen, and jersey knit as examples of how when the fibers are brought together or constructed in different ways this impacts the feel and warmth. The thread count, as it suggests, is somewhat like the concentration of threads in the fabric which relates more to durability. Blends with polyester and other materials make these sheets a little more wrinkle-resistant and softer to the touch. Cotton blends tend to contain formaldehyde resins which are important to note for those with skin sensitivities or allergies.
Related | Dr. Erum Ilyas discusses bed sheets with NBC News
What should I think about when it comes to choosing bed sheets?
When it comes to bedding choices with your skin in mind, consider asking yourself the following questions.
What are your personal preferences when it comes to warmth overnight?
Do you have any skin sensitivities or allergies to keep in mind?
Do you tend to favor a softer textile at night or one with more texture?
For example, many of my patients that struggle with hot flashes in the middle of the night may find cotton sheets more likely to trap in moisture and heat and not love this material.
Related: Dr. Erum Ilyas discusses bed sheets with Syracuse.com
However, many people in cooler and colder climates may prefer to stay warmer at night.
What are percale sheets?
Percale is another type of cotton textile weave that affects the way the fabric feels. Most Percale tends to still be cotton with most as 100% cotton although there are some that are cotton blends. This type of weave reminds me of an Oxford shirt- a crisscross weave that gives the textile a crisp look and feel. Percale usually has a matte-like finish since it does not take on the shine of sateen or other cotton weaves. Due to the construction, the fabric is lightweight and very breathable. Warmer climates and months and/or humid environments may be ideal for these. These sheets are also durable through multiple washes.
Incidentally, I have many patients that sleep with a humidifier on for eczema and other skin conditions. I tend to find that percale is a good option here too because some patients will feel like their sheets feel damp if they choose a different weave or blend. Overall benefits to Percale:
Lightweight
Breathability
Durability
Less likely to retain heat and moisture
Ideal for hot flashes, and skin sensitivities (avoid cotton blends, stick with 100% cotton percale)
Related | Dr. Erum Ilyas discusses skincare with Domino
What are sateen sheets?
Sateen sheets have that classic luxurious look and feel while still being made of primarily cotton. The difference with sateen is in how the cotton fibers are prepared as well as the weave of the fibers. The cotton tends to be mercerized which is a finishing treatment that improves the strength of the cotton fibers. The weave is still a criss-cross weave pattern, however, instead of taking on the checkerboard look of Percale, sateen can have multiple- often three or four- yarns cross over for each one that crosses under. The weave is tight. This leaves more yarns exposed which provides a softer and smoother feel. With more yarns exposed, the textile has a sheen and silky look. Sateen is tightly woven giving it warmth for cooler climates.
Overall benefits to sateen:
Luxurious look with a sheen
Soft, silky feel against the skin
Retains warmth with a tight weave
Ideal for cooler months or climates
What about Jersey sheets- are there some benefits to these?
Jersey sheets are primarily made of 100% cotton or cotton blends. These sheets are constructed like a T-shirt. The construction of the jersey is knit, not woven. Just like a T-shirt, jersey sheets are soft and breathable. These are meant for warmer climates as it keeps your skin a little cooler. Jersey sheets are not as durable as Sateen or Percale given the knit construction.
Overall benefits of jersey sheets:
Soft to touch
Comfortable against the skin
Less likely to retain warmth with knit construction
Flannel sheets sound like they would keep you pretty warm, right?
Flannel sheets can be made of cotton, cotton blends, wool, or made of other synthetics. Flannel is woven as a simple weave pattern or as a twill weave. Flannel is known for its warmth and soft feel. Although considered a breathable textile because of its weave construction, it is not the textile of choice for those that struggle with hot flashes or excess warmth at night. Flannel tends to be loosely woven while still offering warmth. The final textile is brushed to lift the fibers of the textile to add a fuzziness or softness when felt. The loose weave offers the benefits of breathability and even moisture-wicking while still offering warmth. Overall benefits of flannel sheets:
Soft to touch
Comfortable against the skin
Warmth with breathability
Is organic cotton a better choice when it comes to bed sheets?
Organic cotton has gained in popularity owing to the fact that it is grown without the use of toxic synthetic pesticides and fertilizers. However, to be labeled as organic, the only criteria to meet is to utilize USDA-certified organic crops in production. The word organic can still be ascribed to cotton that utilizes certified organic crops even if it has been chemically modified with finishes or dyes. (USDA, 2019). This is an example of speaking to intent- if your goal is to buy organic cotton sheets to avoid added chemicals in the production process, then it is important to look for undyed organic cotton to meet your goals. Remember that organic cotton is the fiber, however, it can be woven or knit to form jersey, percale, flannel, or sateen sheets.
What is Supima cotton?
Supima cotton is durable soft cotton with a soft luxurious feel. Just like Egyptian cotton, it is thought to get softer over time. It is also considered highly breathable.
Are silk sheets good for your skin?
Silk is a textile with some interesting properties. It is considered hydrophobic compared to other textiles in that it repels and prevents the absorption of droplets. It has good breathability and can be cleaned easily. Silk has been studied if, when treated with antimicrobials, can reduce inflammation in the skin including acne. Studies looking at how much bacteria colonizes silk compared to cotton for coliform bacteria (from the colon) have been unclear in that although some show bacteria are less likely to colonize silk compared to cotton, it is not certain if this is a property of the silk itself or other aspects to its production. What does this mean when it comes to your skin? Seeking silk sheets may be of benefit to acne-prone or eczema-prone skin. The other category of patients that can consider this material would be those with a tendency toward sweat acne or folliculitis.
What about linen sheets?
Linen is made from flax plant fibers. It has a high tendency to crease or wrinkle, however, it may be treated with added finishes to improve its appearance. Linen is considered an eco-friendly product given its recyclable and biodegradable quality. In the medical literature, linen has been shown to have antimicrobial and wound-healing properties. Its lightweight quality makes it a favorable option for those that tend to get “overheated” at night. It is also highly durable given the high tensile strength of the flax plant fibers.
Are bamboo sheets good for your skin?
Bamboo in textiles is an important topic for discussion as it is often misrepresented by the industry. Bamboo itself is a very fast-growing and renewable resource and does not require pesticides or fertilizers to grow. This is why it is often considered eco-friendly. Bamboo, when used in textiles, is often in one of four forms.
Bamboo rayon
Bamboo lyocell
Bamboo blended with cotton
Bamboo linen
It is very common for companies to boast bamboo in their products however each of these forms is very different.
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Most Bamboo in bedding is likely bamboo rayon. Although bamboo may be used initially, it is processed in a manner similar to rayon. Rayon, although made from cellulose harvested from wood pulp (in this case the pulp would be from bamboo), it is chemically converted into the final product. Although bamboo itself may be considered eco-friendly, the production process for bamboo rayon is not. Although made from regenerated cellulose using bamboo pulp, the FTC fined four major retailers in 2013 for false advertising stating their products were made from bamboo when in fact they were made from “rayon made from bamboo.” (Commission, Bamboo Textiles, 2019) Lyocell has become very popular in recent years given its soft feel and comfort. It is derived from regenerated cellulose using bamboo pulp. 99% of the solvent used in production, N-methyl-morphine-N-oxide (NMMO), is recycled earning this textile a more favorable environmental rating. There are studies that show that people with eczema or atopic dermatitis favor lyocell. It tends to cause less itching, it is softer and it can regulate temperature and moisture more effectively than cotton.
Bamboo linen is produced in a manner similar to linen from flax. However, it is a durable and coarse textile and not as soft as Lyocell or Rayon from Bamboo. The softness of rayon from bamboo and lyocell tends to give textiles a feel similar to silk making it very favorable for linens. I think it's important to not assume that if a company states it uses bamboo is using it in the most eco-friendly manner. If your goal is to choose bamboo products for the environmental benefit, it would be worthwhile to review what type of bamboo product you are investing in to avoid a false sense of security in a buzzword.
Microfiber sheets are also advertised. Any advantages to these?
Microfiber textiles are often made of synthetic materials or blends. The fibers used to make the textile are very fine - on the order of microns, not millimeters! The fibers are tightly woven or knit together making the fabric durable, soft, and moisture-wicking. Bed sheets made of microfiber can offer warmth because of the tightness of the weave. Sometimes microfiber is added to the lining of a sleeping bag to add warmth as well. Commonly polyester and other synthetics are used to create these. When it comes to polyester and polyester blends that can potentially release microplastics into the environment from washing, I recommend the use of a Guppeyfriend washing bag when laundering.
Is hemp a better choice when it comes to skincare?
Hemp is increasingly used in the textile industry with the lack of widespread use likely linked to other uses for hemp outside of clothing, namely recreational drug use. The texture of hemp varies based on the environment in which it is grown and can range from coarse to soft. One of the advantages of using Hemp fabric is that it is naturally antimicrobial.
Hemp is considered eco-friendly given the small amounts of water needed, its natural tendency to resist pests requiring little pesticide use, and little fertilizer use.
In terms of texture and feel, cotton most often has a much better feel. In terms of cost, hemp is more expensive to work with.
From a manufacturing point of view, hemp is a coarser and stronger fiber and more expensive to work with. To attain a truly softer feel is difficult. I have tried to do so for sun-protective textiles and it is difficult to work with.
Aside from overall comfort and body temperature, are there any other reasons to consider the type of textile chosen from a skincare perspective?
From a skin care product perspective, it is very common for Dermatologists to recommend certain overnight treatments when it comes to acne, rashes, or eczema. Some acne products run a risk of bleaching or discoloring bed sheets. I tend to preemptively remind my patients to choose white sheets or sheets they are not worried about ruining so there are no surprises when this occurs! For patients with a tendency towards dry, itchy skin, we often recommend nightly moisturizers or other medicated products. One of the most common worries expressed by patients is whether these products will ruin their bedsheets. If they have silk sheets, this can pose a challenge. If you have ever spilled oil on silk, then you know what I mean! Although there are methods to remove oil from silk, it's not a simple process. Cleaning a drop of oil off a silk tie is a more straightforward process compared to oiling the entire length of a bedsheet! For these cases, cotton, cotton blends, and linen may be better options for ease of product removal from the fibers during the wash.
What are antimicrobial bed sheets?