When you have eczema, you already know that preventing flare-ups requires some vigilance. After all, everyday things — cigarette smoke, pollen, and even your clothing — may cause symptoms, and no two people have identical triggers or reactions.
“Eczema can be exacerbated by increased skin dryness, skin infections, travel to areas with different environments, and reactions to new skin-care products,” says Brendan Camp, MD, a dermatologist at the Medical Dermatology & Cosmetic Surgery Centers in New York City. “Some people may react more to one trigger than others as a result of genetics, skin-care routines, and variations between each person’s skin microbiome.”
No human body is exactly the same, and when it comes to eczema flares, what can be triggering for one person may not be for another. Trigger response varies because of internal factors like genetics, and external factors, such as things in the environment, says Gary Goldenberg, MD, an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. “This is different for each patient and can change depending on their age or living conditions. I tell patients they have to become detectives, keeping a diary and documenting what they believe may be triggering their flares.”
The specific type of eczema you have can also contribute to what exactly might trigger a flare.
Atopic Dermatitis
This type of eczema is linked to asthma and hay fever. Atopic dermatitis may have a genetic component, as it often runs in families. Triggers can include dry skin, stress, hot or cold temperatures, infections, and even soap and certain laundry detergents.
Contact Dermatitis
Contact dermatitis can be triggered by skin contact with an allergen (allergic contact dermatitis). This typically causes a rash to appear at the point of contact. For instance, people who have a nickel allergy may experience eczema rashes from their belt, earrings, or other items.
Contact dermatitis can also occur when skin comes in contact with a harsh substance (irritant contact dermatitis); it can affect anyone, and it’s more common than allergic contact dermatitis. This is the type of eczema that’s often triggered by chemicals in soaps, fertilizers, and cleaning solvents.
Seborrheic Dermatitis
Seborrheic dermatitis can occur anywhere on the body; symptoms can be varied and widespread. It affects about 11 percent of the population and may be caused by yeast growth, higher levels of the hormone androgen, or excess skin lipids (fats that protect the skin barrier). This type of eczema is typically seen on the scalp, commonly known as dandruff, but it can also appear on the face, ears, chest, and other areas with a lot of oil gland activity. Stress, dry weather, and cold temperatures can exacerbate seborrheic dermatitis.
When eczema flares up and symptoms become apparent, what’s going on? Simply put, an external or internal trigger kicks the immune system into overdrive, causing inflammation that can lead to itching, scaly skin, swelling, or other symptoms. Triggers can range from topical irritants to stress, so it’s important to work with your dermatologist to establish a plan of action to prevent and treat symptoms.
Sometimes, eczema — which is often referred to by the name of the most common type, atopic dermatitis — causes problems besides noticeable skin symptoms. “Eczema is more than just dry skin,” says Asmi Berry, DO, a dermatologist at BHSkin Dermatology in Los Angeles. “It’s a chronic condition that needs daily care, not just during flares. A board-certified dermatologist can help you build a personalized plan that actually works for your skin.”
“Most eczema patients have multiple triggers,” says Dr. Goldenberg. He explains that common triggers of eczema can include the following:
Irritants including soaps, detergents, and fragrance, as they disrupt the skin’s barrier, leading to inflammation
Allergens, including pollen, certain foods, or dust mites
Weather changes, from dry to humid or cold to hot
Certain fabrics, like wool or synthetic fibers, that irritate the skin
Stress: “Whether it's emotional stress or physical stress, such as illness, overall inflammation can increase, triggering an eczema flare,” he says.
Infections, including bacterial or viral, can increase inflammation in the body, leading to a flare.
When it comes to preventing eczema symptoms, there are ways you can change your environment to alleviate flares. While these tips might not completely eliminate eczema from your daily life, they may help lessen the severity of your diagnosis.
“Most patients with eczema will experience flares,” says Goldenberg. Decreasing the frequency and severity of those flares is important. This can be done by consistently using the right skin-care products, managing stress, hydration and diet, and overall well-being.”
1. Protect Against the Cold to Prevent Eczema Symptoms
Temperature changes can play a role in eczema symptoms, especially cold weather. When the temperature drops, eczema symptoms may show up. In many people, extreme cold and wind, plus dry, hot indoor air can parch skin, and it’s a common atopic dermatitis trigger.
To prevent the cold from drying your skin, moisturizer and other steps are important. “Cold weather and dry heat can strip moisture from the skin, weakening the barrier and making eczema worse,” says Dr. Berry. “That’s why flares often spike in winter. A thicker cream and a humidifier at home can help offset that dryness.”
Aim for humidity levels of 30 to 50 percent indoors to keep your skin hydrated.
2. Wash Soft Furnishings Regularly to Prevent Dust Mites
Dust mites, the microscopic pests that feed on dead skin cells, don’t just make you sneezy — they can impact eczema, too, especially if you have allergic contact dermatitis and atopic dermatitis.
If dust mites are a problem for you, you can minimize your exposure to them in your home. Wash bed linens and curtains weekly in hot water, opt for allergen-proof bedcovers, and thoroughly clean your home to keep it free of clutter and dust.
You may also choose to remove items that can collect dust and harbor mites from your home, such as carpets, upholstered furniture, blinds, and curtains that can’t be laundered. Air purifiers with HEPA filters in rooms you spend a lot of time in will also help clean the air and lower the risk.
3. Make Over Your Wardrobe to Prevent Flares
Have you found that certain pieces of clothing leave you feeling itchy, sweaty, or irritated? If so, it might be time to clean out your closet. Garments made of wool, certain synthetics, or rough materials can be eczema triggers, while loose-fitting cotton clothes are less likely to cause eczema symptoms to flare up.
If you buy new clothes, wash them before the first wear to get rid of dye residue or other potential irritants. Tags can irritate your skin, too, so cut them out of clothes if that’s the case for you.
4. Be Choosy About Cleaning Products
Be aware of what’s in the cleaning products you’re using and how they impact your health. Many laundry detergents and soaps contain added fragrance, which can be irritating to those with eczema. Make sure you get all the detergent out of your clothes by choosing a double rinse cycle.
Be careful with other household cleansers, too. To prevent eczema flare-ups, look for natural alternatives to products with harsh ingredients, or opt for tried-and-true cleaners like white vinegar or baking soda, which don’t contain added chemicals. Also wear gloves to protect your hands.
5. Sideline Stress to Avoid Eczema Symptoms
Stress can significantly impact anyone’s health, but it’s known to be an especially potent trigger for those with eczema. “Stress triggers inflammation and can weaken the skin barrier, making it more reactive,” says Berry. “I see flares often around big life events, lack of sleep, or burnout.”
While it might not be possible to remove stress from your life, there are techniques to help manage it and lessen the severity of symptoms. “Stress can heighten eczema-related symptoms, such as itch, which can impact one’s quality of life and sleep,” says Dr. Camp. “Addressing stress through exercise, yoga, meditation, breathing exercises, or therapy may help manage eczema-related symptoms.”
6. Stay Out of the Heat to Avoid Itching
Just as cold weather can cause flares, heat can also exacerbate eczema. If warmer temperatures leave you feeling itchy or experiencing other symptoms, you’re not alone.
Sweat can be an eczema trigger, thanks to the irritating trace minerals found in perspiration (including zinc, copper, iron, and nickel). High levels of humidity can also be an eczema trigger, because they cause more sweating.
With allergic contact dermatitis, certain products can cause a reaction when they’re exposed to sun, like some sunscreens or cosmetics, particularly if they contain the ingredient octocrylene. Mineral sunscreens, such as zinc oxide or titanium dioxide, are less likely to cause a reaction.
If summer weather seems to be triggering your flares, planting yourself indoors in front of an air-conditioned breeze for a few months is one option. But if you’d like to spend time outside, focus on keeping your body temperature regulated — look for areas of shade, and choose clothing that won’t make you sweat.
7. Get Tested to Identify Allergies
It’s generally a good idea for most people to use gentle and hypoallergenic products. Allergies and atopic dermatitis can often go hand-in-hand.
“Certain tests, such as blood tests or patch testing, can identify allergens in patients,” says Goldenberg.
A patch test can be used to identify allergens. During this test, a number of small sticky patches containing various potential allergens (such as latex, fragrances, or preservatives) are applied to the skin. After 48 hours, the patches are removed and the person administering the test will check for any reactions. A positive result may indicate an allergen, though skin tests aren’t always accurate. You and your doctor will use the results to come up with a plan of action.
8. Avoid Pollen During Peak Months
For people with eczema, pollen is a common trigger. To lessen the chances pollen will trigger a flare, limit time outdoors when pollen counts are high; keep your windows closed, and consider using air conditioning and HEPA purifiers.
When you come home after being outside, wash your face, hands, and hair — or even take a quick shower — to remove pollen. It can’t hurt to change your clothes. Ask your doctor about whether to add allergy medications, such as antihistamines and nasal sprays, to your treatment plan.
9. Check Your Cosmetics Bag for Triggers
Irritating chemicals aren’t limited to household cleaners, so pay attention to what cosmetics you use. It can be challenging to find cosmetics that don’t aggravate eczema. Products containing alcohol, fragrances, lanolin, retinoids, or other common triggers may cause eczema outbreaks in many people.
Carefully check labels: “Unscented” means a fragrance is masked, while “fragrance-free” means none have been added. When trying out a new cosmetic, cleanser, or lotion, the National Eczema Association advises testing it on a small patch of skin (such as your wrist or your inner elbow) and watching for any reactions after 48 hours before applying it to larger areas.
10. Banish Pet Dander From Your Home
Pets are some of our best companions, but they can also contribute to eczema flares, especially if you’re sensitive to pet dander. If you have indoor pets, consider keeping them off your furniture and limiting their time in your bedroom. Frequent vacuuming of floors, especially carpeted areas, can help keep pet dander to a minimum. It’s also important to keep your pet regularly bathed and groomed to reduce dander. A HEPA air cleaner may also be helpful.
11. Be Gentle on Your Skin While Bathing (and Care for Your Skin After)
A long, hot bath might be relaxing at the end of the day, but avoid the temptation of this potential atopic dermatitis trigger. “Address dryness by keeping showers and baths short, no longer than ten minutes,” says Camp. “Use lukewarm water and a gentle cleanser that is free of dyes and fragrance. On a daily basis apply a hydrating lotion or cream to the skin after a shower when skin is still slightly damp.”
Also, be gentle on your skin when bathing — don’t scrub or rub with a washcloth or loofah, and pat skin with a towel after bathing.
12. Quit Smoking to Prevent Symptoms
We’re all aware that smoking is linked to lung cancer and other health problems, but did you know tobacco smoke can also worsen atopic dermatitis symptoms, even for those who aren’t smokers? A review of people with eczema found that people who smoked, and people who were exposed to secondhand smoke, were more likely to be diagnosed with atopic dermatitis than those who did not. So if you smoke or live with a person who smokes, consider quitting or encouraging them to quit.
While understanding your triggers is important for managing the condition, experts say it’s also important to work alongside your dermatologist. “Eczema that does not respond to over-the-counter treatments and has a negative impact on the quality of one’s life should be assessed by a board-certified dermatologist for evaluation and treatment,” says Camp.
Eczema is a chronic condition that can be managed by understanding your personal triggers.
Triggers can be determined by genetics and environmental factors.
Work with a dermatologist to help define your triggers and minimize eczema flares and symptoms in the future.
