Bed Sheets : A complete guide to choosing bed sheets with your skin in mind

Bed Sheets : A complete guide to choosing bed sheets with your skin in mind

March 10, 2021

Disclaimer : This page contains affiliate links to products.  We may receive a commission for purchases made through these links.

 

You may not have thought about the role bed sheets play in your skin care routine, but consider this:  Your skin is in contact with these sheets for hours on end!  Understanding your options from the perspective of skin care as well as implications for products you may wear to bed is important. Believe it or not, many of the studies on textiles for bedding are focused on the impact on the skin for bedridden patients.


From a textile perspective,  bed sheets are broken down into these most common textile categories:


Cotton and Cotton blends


Not all cotton sheets are the same- there are huge variations based on the construction, weave and thread count of the textiles. The variations result in different “feel” against the skin in terms of softness. The type of cotton used -  Tencel, Egyptian cotton, Organic cotton, Pima cotton, 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 in heat.  Think of flannel, sateen and jersey knit as examples of weaves. The thread count is, 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 touch. 


When it comes to choices with your skin in mind, consider your preferences when it comes to warmth overnight.  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.

However, many people in cooler and colder climates may prefer these to stay warmer at night.




Percale

 

Percale is another type of textile weave that affects the way the fabric feels.  Most Percale tends to still be cotton, most are 100% cotton although there are some that are cotton blends.  The weave reminds me of an Oxford shirt- criss cross 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.

 

 

 

Sateen has that classic luxurious look and feel while still being made of primarily cotton.  The difference with sateen is in how the cotton is prepared as well as the weave. The cotton tends be mercerized which is a finishing treatment that improves the strength of the cotton fibers. The weave is still a criss cross weave 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 it tight. This leaves more yarns exposed to be felt as softer and smoother.  This also leave more yarn exposed to give it a sheen and silky look. Sateen is tightly woven giving it warmth for cooler climates. 

 

Jersey

 

 

Jersey sheets are made of primarily 100% cotton or cotton blends and constructed like a T shirt. The construction of jersey is knit, not woven.  Just like a T shirt, jersey is soft and breathable.  It is 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.  

 

Flannel 

 

Flannel sheets can be cotton, cotton blends, wool or made of other synthetics. Flannel is known for its warmth and soft feel. Although it is considered breathable, it is not the choice for those that struggle with hot flashes or getting too warm 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 benefits of breathability and even moisture wicking while still offering warmth.

 

Organic Cotton

 

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 labelled 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 another example of speaking to intent- if your goal is to buy organic cotton sheets to avoid added chemicals in the production process, look for undid organic cotton to meet your goals.

 

Supima Cotton

 

Supima cotton is a 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.


Silk


Silk is a textile with some interesting properties.  It is considered hydrophobic compared to other textiles in that  it repels and prevents 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 with acne prone or eczema prone skin.  The other category of patients that can consider this material would be those with a tendency towards sweat acne or folliculitis.


Linen


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 ecofriendly 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.   

 

Bamboo

 

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, or Bamboo Linen.  It is very common for companies to boast bamboo in their products but each of these forms is very different. 

 

Most Bamboo in bedding is likely Rayon from Bamboo.  Although the 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 the bamboo may be considered eco-friendly, the production process 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 from 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.  



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.

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. 

 

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 its 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

 

Microfiber textiles are often made of synthetics materials or blends.  The fibers used to make the textile are very fine - on the order of microns not milimeters! 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 sleeping bag lining 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 micro plastics into the environment from washing, I recommend the use of a Guppeyfriend washing bag when laundering. 

 

 

Hemp 

Hemp is increasingly used in the textile industry with 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 for coarse to soft. One of the advantages to using Hemp fabric is that it is naturally antimicrobial.  

Hemp is considered eco-friendly given the small amounts of water needed, 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.

Related : Dr Ilyas discusses Hemp

 

----
From a skin care product perspective, it is very common for us as 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 if these will ruin their bed sheets!  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 oil the entire length of a bedsheet! For these cases, cottons, cotton blends and linen may be better options.  


Just a special mention to another type of product in the bedsheet world are antimicrobial sheets.  These are often treated, infused or woven with metals such as silver and copper to make them antibacterial.  This is a challenging question to answer in terms of long term effectiveness and benefits simply due to the lack of studies available.  Our skin’s bio flora is a balance of bacteria and yeast.  The use of antimicrobial sheets “sounds good” but it is has yet to be determined if the routine use for the average person can serve as an actual benefit.  


Textile finishes are not necessarily regulated by the FDA and studies are lacking on the impact on human health and the environment. We have plenty of textile choices that, if cleaned and maintained, should serve the role they were meant to! From a research perspective, I wonder if these products may end up playing a role in specific medical or surgical circumstances  as opposed to routine use.

 

 

A note on OEKO-TEX Certified

 

The goal of this certification process is to try to add another level of consumer confidence for a growing concern about textiles, human health and our environment.  This certification refers to checking materials for harmful substances, considering the facility it was produced in as being environmentally friendly, and also the workplace for production as safe and socially responsible.   I consider this one more bonus to look for.

 

 

A note on 'Wrinkle - resistant': 

 

Wrinkle resistance can be achieved with certain compositions - in other words synthetic textiles, wools and cotton blends may be naturally more wrinkle resistant than cotton and linen based on qualities of the fibers themselves. The other ways that fabrics can be make wrinkle resistant is to treat them with a chemical finishing process. This process may use formaldehyde. Unfortunately, as a Dermatologist I do patch testing for contact allergens routinely and do often find formaldehyde come up as a trigger for some skin rashes and sensitivities.  Although other chemical finishes such as titanium can be used to achieve wrinkle resistance, the chemical finishing process is not disclosed on packaging.  The product claim “wrinkle resistant” is not necessarily regulated.  For my patients with concerns about formaldehyde exposure, since we cannot necessarily determine directly if formaldehyde was used, I think it is safest to choose sheets that make no claims to wrinkle resistance.  The thought is that if they make the claim, they more than likely treat the fabric unless they say otherwise!

 

A note on Thread count:

 

For years, before I studied textiles, I remember thinking the thread count was an important indicator to quality.  Thread count references the concentration of fibers per square inch; I.e., the number of yarns or threads per square inch.  If there are more yarns per square inch, then it stands to reason that the textile is softer and perhaps more durable. Given the different types of weave and fiber processing, the thread count is not necessarily as important as it once was to find a soft durable sheet.  Often higher thread counts come at a much higher cost without necessarily achieving the look and feel you may be looking for.  Once I discovered Sateen sheets, I stopped looking at thread counts as the weave gave me a better sense of what I was seeking.

 

A note on Fiber / Weave

 

Fiber refers to what the actual composition of the textile is.  Cotton, linen, bamboo, silk, polyester, microfiber are examples of the fiber.  

Weave refers to how these fibers are brought together to construct the final textile. Woven, knit, tightness of the weave are examples of how the weave impacts the final textile.

 

Why are sheets important and how can they impact sleep?

 

Until you have tried out different sheets, you may never realize just how impactful they are to a good night’s sleep.  Of course mattresses and mattress quality matter, however, your skin serves as a thermoregulator for your body.  If your bed sheets are not supporting your skin’s ability to do its job, you will find your sleep may not be as restful.  

 

The feel of the sheet against your skin in terms of softness or comfort can contribute to how “aware” you are of your skin.  My patients that struggle with itching will almost always say, no matter the cause, that their itching is worse at night.  When your mind is finally at rest from the stresses of the day, it has the ability to focus more on your skin.  To avoid aggravating this tendency, softer sheets can make a world of difference.

 

If you tend to flush or get warm overnight, choosing sheets that are cooling such as Percale or linen can be ideal.  The tendency to get a little hot somewhere around 2am is a common phenomenon for a variety of reasons- hormonal, medication related, etc.  If you choose sheets that keep your skin cooler, you are less likely to wake up to physical throw the sheets off.  If you can avoid waking up, then you are more likely to sleep through the night and feel more rested the next day!  

 

For couples that disagree on temperatures at night, a nice workaround is to consider the role the bed sheets can play.  Many of the annual skin cancer screenings I perform have couples that come in together for their skin checks.  Since I often discuss the impact of moisturizers, sunblocks and thinning of our skin over the years during these visits, I also often open a can of worms when couples disagree on temperatures to keep the thermostat on!   If she wants it cooler and he wants it warmer, perhaps choose percale bed sheets with an added blanket for him.  There are lots of ways to work together here!

 

When people think of luxurious hotel sheets, what type are they usually thinking of?

 

Sateen is the most common variety of sheet to be found in hotels, especially high end hotels.  The luxurious feel, silky look, durability and breathability all factor in here.  Often times, Egyptian cotton is used as it is a high quality long staple cotton fiber. This means the fibers can be as long as 2 inches making them more durable and less likely to pile.  Piling is what makes textiles look worn or older.  Fuzz balls form when loose fibers clump together.

 

Specific recommendations 

 

Best affordable

 

Target carries Hearth and Hand :

Organic Cotton Sheet Set by Hearth and Hand with Magnolia

This sheet set is made with Organic cotton which is highly breathable and great for couples that disagree on temperatures and children that feel warm overnight. They carry the OEKO TEX Certification and are 100% organic cotton.

BIOWEAVES 100% Organic Cotton Sheets 300 Thread Count 4-Piece GOTS Certified Bed Sheet Set Fits Mattress Upto 17" Deep Pocket, Soft & Silky Sateen Weave (Queen, Undyed Natural)

 

 

 

Best overall

Nordstrom  400 Thread Count Organic Cotton Sateen Sheet Set

These sheets have a luxurious look and feel, and cover multiple categories. 100% organic cotton (GOTS Certified), high thread count at 400, and sateen for the weave.  Breathable, durable, comfortable and look luxurious!

 

Nisaki Sateen Cotton Queen-Sheets-Sets White, 100% Long Staple Cotton Bedding Sets Queen, Sateen Sheet Set Soft & Breathable Deep-Pocket Sheets fits Upto 15 inch (100% White Cotton Bed Sheets Set)

 

 

 

Best high-end/splurge

Pottery Barn  Belgian Flax Linen Sheet Set

These sheets are splurge but it is very hard to find linen bed sheets that are soft and durable.  Linen is a great textile for bed sheets for those that tend to be too warm or hot overnight. The textile is highly breathable and permits air flow.  The challenge with linen is that it tends to wrinkle or crease so easily!  

DAPU Pure Stone Washed Linen Sheets Set 100% French Natural Linen European Flax (Queen, Natural Linen, Flat, Fitted and 2 Pillowcases

 

 

 

Best for hot sleepers (best cooling)

 

Brooklinen Classic Percale Sheets

 

These are supersoft made with 100% cotton and carry the OEKO TEX certification.  Percale carries the cool crisp feel that is great for hot sleepers.

Amazon Basics Organic Percale Cotton Sheet Set with Frayed Hem - Twin, Soft Pink

 

 

Best for cold sleepers

Garnet Hill Hemstitched Supima® Flannel Bedding

 

When it comes to choosing flannel bedding, warmth and softness are key.  These bedsheets are 100% Supima Cotton (American grown!) and brushed on both sides. Flannel sheets or textiles are brushed on both sides (this is what distinguishes it from brushed cotton which is only brushed on one side). 

Bare Home Flannel Sheet Set 100% Cotton, Velvety Soft Heavyweight - Double Brushed Flannel - Deep Pocket (Queen, Grey)

 

 

Best Percale

Brooklinen Classic Percale Sheets

 

These are supersoft made with 100% cotton and carry the OEKO TEX certification.  Percale carries the cool crisp feel that is great for hot sleepers.

Amazon Basics Organic Percale Cotton Sheet Set with Frayed Hem - Twin, Soft Pink

 

 

 

Best Sateen

 

Nordstrom  400 Thread Count Organic Cotton Sateen Sheet Set

 

These sheets have a luxurious look and feel, and cover multiple categories. 100% organic cotton (GOTS Certified), high thread count at 400, and sateen for the weave.  Breathable, durable, comfortable and look luxurious!

 

Best Jersey

Target’s Solid Jersey Sheet Set - Room Essentials

 

These affordable and soft sheets are Jersey knit and carry the OEKO TEX.  If you are seeking 100% cotton be sure to check the label as the composition can vary across the brand. 

 

Best Linen

Pottery Barn  Belgian Flax Linen Sheet Set

These sheets are splurge but it is very hard to find linen bed sheets that are soft and durable.  Linen is a great textile for bed sheets for those that tend to be too warm or hot overnight. The textile is highly breathable and permits air flow.  The challenge with linen is that it tends to wrinkle or crease so easily! 

 

Best Flannel 

 

Garnet Hill Hemstitched Supima® Flannel Bedding

 

When it comes to choosing flannel bedding, warmth and softness are key.  These bedsheets are 100% Supima Cotton (American grown!) and brushed on both sides. Flannel sheets or textiles are brushed on both sides (this is what distinguishes it from brushed cotton which is only brushed on one side). 

 

Best Bamboo

 

100% Organic Bamboo Sheets Set 4 PC - Natural Softest Cooling Christmas Bedding (Queen, Charcoal Grey)

Truthfully, I find it very difficult to evaluate Bamboo products as it almost requires a law degree to decipher the convoluted ways that companies twist and hide the messaging in terms of production.  With my meager medical degree and bachelors in philosophy I believe that this brand is likely complying with FTC guidelines and not misrepresenting the use of bamboo in their product.  That being said, bamboo is highly durable and has antimicrobial qualities that can be of benefit for those that sweat when they sleep.

 

 

 

 

 

 

Leave a comment

Please note: comments must be approved before they are published.