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Eczema is a chronic skin condition that affects one in ten Americans. There is no cure, but you can help yourself by knowing which eczema triggers affect you. Perhaps it’s something simple to change like your soap or lotion. For some, avoiding their eczema triggers is not so easy to do, especially if those triggers are climate-related. Read on to learn more about eczema triggers and what you can do to keep your eczema in check.
What is eczema?
Eczema is a group of skin conditions whose symptoms include red, peeling, cracked, or itchy skin; the affected skin may also have blisters or feel scaly. When people talk about eczema, they are usually referring to atopic dermatitis or atopic eczema.
Eczema often appears in skin folds, like on the elbows, knees, face, and neck. It occurs more in children and teenagers, but eczema can also affect adults. Around 10% of Americans (over 31 million people) have some form of eczema, and it affects people of all skin colors (Silverberg, 2013).
People with atopic dermatitis are likely to develop other “allergic” conditions, like food allergies, asthma, or hay fever (Weston, 2021).
What causes eczema?
Scientists don’t know what causes eczema or atopic dermatitis. Most likely, it is due to the interplay of multiple factors like your genes, your environment, and how your immune system works.
People with eczema tend to have drier skin than others because of problems in the cells that make up the skin layers, allowing water to evaporate more easily. Also, if you have eczema, chances are your immune system is more likely to be active and causing inflammation—people with eczema have sensitive skin that is easily irritated by perfumes and allergens (Nemeth, 2020)
While we don’t know the exact cause, several risk factors are associated with eczema.
The biggest risk factor for eczema is genetics. If you have a close family member with eczema, you are more likely to have it. Parents with eczema are 2–3 times more likely to have a child with eczema; that chance goes up to 3–5 times as likely if both parents have eczema (Weston, 2021).
Eczema is closely linked to other allergic (atopic) disorders like food allergies, allergic rhinitis (hay fever), and asthma—people with atopic dermatitis are at higher risk for getting these other allergic conditions (Paller, 2019). However, it is important to remember that while food allergies and atopic dermatitis often occur together, one does not cause the other.
Other risk factors for eczema include urban vs. rural living, climate, water hardness, and air pollution.
7 potential eczema triggers
Eczema is an allergic skin condition that has several common triggers. These are not actual causes of eczema, but they may make your skin condition worse.
To identify what’s triggering your eczema, you can remove potential triggers one by one and see if your condition improves. That can be easier said than done if something like the weather or allergens are the culprit. In these cases, it can be helpful to visit your healthcare provider or an allergist, who can conduct a skin prick test to see what common allergen (or allergens) bother your skin.
Potential eczema triggers include skin irritants, foods, inhaled allergens, climate, environmental factors, hormones, and stress (NICE, 2007).
1. Skin irritants
Things that irritate your skin, like harsh detergents, soaps, chemicals, perfumes, metals, latex, etc., may aggravate your eczema. Certain fabrics, like wool or synthetics, can also trigger flare-ups (NICE, 2007).
While food allergies do not cause eczema or vice versa, certain foods may worsen your eczema, especially cow’s milk, eggs, wheat, tree nuts, peanuts, soy products, fish, and shellfish (NICE, 2007).
3. Inhaled allergens
Many of the allergens that cause allergic rhinitis and seasonal allergies may also trigger your eczema. The most common culprits are mold, pet dander, pollen, and dust mites (NICE, 2007).
Both hot and cold weather may aggravate eczema. If it is hot and dry, your skin can lose moisture leading to an eczema flare-up. In addition, the areas where sweat collects—like your armpits, around your neck, crooks of the elbows, and behind the knees—may become irritated by the sweat and trigger your eczema. Some people with eczema feel a “prickly heat” sensation when they sweat (NICE, 2007).
Similarly, cold and dry weather also dehydrates your skin. Dry skin becomes itchy, rough, and tight, making your eczema worse (NICE, 2007).
5. Environmental factors
Aspects of the environment we live in may trigger eczema flare-ups, including bathing in hard water, living in an area with air pollution, and secondhand tobacco smoke (NICE, 2007).
Like many other medical conditions, hormones may play a role in your eczema. Some women with eczema find their skin condition worsens around their menstrual cycle or during pregnancy (Kandra, 2019).
Scientists aren’t sure why stress triggers eczema, but there is certainly a connection. Experiencing emotional stress may lead to an eczema flare-up. In addition, having eczema can create stressful feelings, also leading to a worsening of your skin condition (Lin, 2017).
How to avoid eczema triggers
To reduce your exposure to eczema triggers, you can opt for dye-free, fragrance-free soaps, cleansers, or laundry detergents. Check the ingredients of lotions and moisturizers to see if they may contain irritants; brands labeled “hypoallergenic” are less likely to irritate sensitive skin.
If inhaled allergens are causing your eczema symptoms, regularly cleaning your home and using HEPA filters in your home’s heating/cooling system can help remove dust and other small particles from the air.
Avoiding extreme temperatures and not wearing harsh fabrics like wools and synthetics can prevent two common sources of skin irritation.
Keeping skin clean and moisturized can also help. Experts recommend bathing in lukewarm water—not hot—and for no longer than 10 or 15 minutes. Hot water dries out your skin, so avoid taking long hot showers. Apply a gentle, moisturizing lotion to your skin after bathing or anytime your skin feels dry.
Eczema can be treated, but not cured. The goal is to manage the condition and decrease flare-ups and symptoms. The good news is that many effective treatments are available. Seek medical advice from your healthcare provider or dermatologist about eczema treatments and ways to avoid relapses.
- Kanda, N., Hoashi, T., & Saeki, H. (2019). The roles of sex hormones in the course of atopic dermatitis. International journal of molecular sciences, 20(19), 4660. doi: 10.3390/ijms20194660. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802354/
- Lin, T. K., Zhong, L., & Santiago, J. L. (2017). Association between stress and the HPA axis in atopic dermatitis. International Journal of Molecular Sciences, 18(10), 2131. doi: 10.3390/ijms18102131. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666813/
- NICE Clinical Guidelines from National Collaborating Centre for Women’s and Children’s Health (UK). (2007). Atopic eczema in children: management of atopic eczema in children from birth up to the age of 12 years. London: RCOG Press (NICE Clinical Guidelines, No. 57.), Identification and management of trigger factors. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK49357/
- Nemeth V, Evans J. (2020). Eczema. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538209/
- Paller, A. S., Spergel, J. M., Mina-Osorio, P., & Irvine, A. D. (2019). The atopic march and atopic multimorbidity: Many trajectories, many pathways. Journal of Allergy and Clinical Immunology, 143(1), 46–55. doi: 10.1016/j.jaci.2018.11.006. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30458183/
- Silverberg, J. I., & Hanifin, J. M. (2013). Adult eczema prevalence and associations with asthma and other health and demographic factors: A US population–based study. Journal of Allergy and Clinical Immunology, 132(5), 1132–1138. doi: 10.1016/j.jaci.2013.08.031. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24094544/
- Weston, W.L. & Howe, W. (2021). Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis. In UptoDate. Dellavalle, R.P., Levy, M.L., Fowler, J., and Corona, R. (Eds.). Retrieved from https://www.uptodate.com/contents/treatment-of-atopic-dermatitis-eczema
Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.