How to Recognize and Avoid Common Eczema Triggers

There are several possible culprits for your dry, itchy skin.

When you have eczema, you already know that preventing flare-ups requires some vigilance. After all, everyday things — such as cigarette smoke, pollen, and even your clothes — may cause symptoms, and no two skins are identical. “It’s important to know that people with eczema have different triggers, and the combination of triggers won’t be the same for everyone with the condition,” says Debra Wattenberg, MD, a board-certified dermatologist in private practice in New York City.

When eczema flares up, causing a red and itchy rash, what’s going on? Simply put, an external or internal trigger kicks the immune system into overdrive, causing inflammation, as the National Eczema Association (NEA) notes. Sometimes, eczema — which is often referred to by its most common type, atopic dermatitis — causes problems besides noticeable skin symptoms. “One of the most important things people should know about atopic dermatitis is that the skin barrier is not as intact as in someone without the condition — even where there is no visible rash,” says Margaret Lee, MD, PhD, a dermatologist and director of pediatric dermatology in the department of dermatology at the Boston University School of Medicine. “So the skin is much more vulnerable to drying out, irritation, infections, and developing new allergies.”

Atopic, Contact, and Seborrheic Dermatitis: How Their Underlying Causes Differ

As mentioned, atopic dermatitis is the most common type of eczema. But there are other types of eczema to be aware of, as their triggers differ.

Atopic Dermatitis

This type of eczema is linked to asthma and hay fever, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). Atopic dermatitis may have a genetic component, as it often runs in families, notes the NEA. The NEA also adds that triggers can include allergens like pollen or pet dander, dry skin, stress, and even soap and certain laundry detergents.

Contact Dermatitis

Then there is contact dermatitis, where a trigger makes contact with the skin and a rash typically appears at the point of exposure.

This type of eczema can be allergic; for example, some people have a nickel allergy and they get eczema rashes from their belt, earrings, or other items, notes the Mayo Clinic.

Contact dermatitis can also be irritant, and it affects everyone to a certain degree. This is the type of eczema you may see from soaps, fertilizers, and detergents.

Seborrheic Dermatitis

Another type of eczema, seborrheic dermatitis affects 11 percent of the population and may be caused by yeast growth, or a higher level of certain hormones or skin lipids (fats), according to the Cleveland Clinic. This type is typically seen on the scalp as mild dandruff but can spread to the face, ears, and chest. As the Cleveland Clinic notes, dry and cold weather can exacerbate this type of eczema.

Treating Eczema Rashes After Trigger Exposure

Anyone can get eczema, from newborn babies to elderly adults. While eczema may go away periodically, it is a chronic condition that can come back.

If you or a loved one has eczema, talk to your doctor. There is no cure for the condition, but as the AAAAI notes, there are over-the-counter and prescription treatments that may ease the symptoms, including:

• Emollients (moisturizers)
• Topical steroids
• Oral steroids
• Topical immunomodulators

The Importance of Eczema Symptom Prevention

In addition to treating eczema, preventing flare-ups is crucial. Prevention tips from the Mayo Clinic include:

• Choose mild cleansers and creams without dyes or fragrances.
• Manage your stress and anxiety.
• Shower in warm — not hot — water.
• Use a moisturizer all over your skin twice daily, especially after showering.
• Wear gloves to wash dishes.
• Wear soft gloves at night to avoid scratching.
• Use a humidifier to add moisture to the air in your home.

Here, discover which triggers may lead to an eczema flare-up, so you can better understand if one (or more) may be your personal trigger.

Protect Against the Cold to Prevent Eczema Symptoms

When the temperature drops, eczema symptoms may show up, according to the National Eczema Society. In many people, extreme cold can parch skin — and this is one of the most common atopic dermatitis triggers, according to the Asthma & Allergy Network. (The Cleveland Clinic notes that cold, dry air can also make seborrheic dermatitis worse.) “The key is to prepare your skin before winter by keeping it in really good shape, so that it’s well hydrated and moisturized,” says Dr. Wattenberg. “If your skin barrier is intact, it's less likely to cause problems.”

Moisturizers are an important eczema treatment, especially in cold weather. They help keep skin from drying out, cracking, and itching. In the winter, a moisturizing ointment or a humectant cream (which pulls moisture into the top layer of the skin) is most effective in preventing moisture loss, the National Eczema Society notes. Use a humidifier to add moisture to dry indoor air — the Mayo Clinic recommends you aim for humidity levels of 30 to 50 percent.

Wash Soft Furnishings Regularly to Prevent Dust Mites

“While allergies are not the primary cause of atopic dermatitis, exposure to allergens like dust mites cause allergic dermatitis and itch, so this tends to flare atopic dermatitis,” says Dr. Lee. Thus dust mites can be a problem for people with allergic contact dermatitis and atopic dermatitis.

If dust mites are a problem for you, there are steps you can take to minimize your exposure to them in your home. The Mayo Clinic suggests washing bed linens and curtains weekly in hot water, opting for allergen-proof bedcovers, and thoroughly cleaning your room to keep it free of clutter and dust. You may also choose to remove carpets, upholstered furniture, blinds, and unwashable curtains from your room, as these can collect dust and harbor dust mites.

Make Over Your Wardrobe to Prevent Flares

Time to clean out your closet: Garments made of wool, synthetics, or other rough materials can be eczema triggers (particularly atopic dermatitis and both types of contact dermatitis), according to the Cleveland Clinic, while loose-fitting cotton clothes are less likely to cause eczema symptoms to flare up.

If you buy new clothes, wash them before you first wear to get rid of dye residue or other potential irritants, advises the NEA. Tags can irritate your skin, too, so make sure to cut them out of clothes, notes the Eczema Foundation.

Be Choosy About Cleaning Products

“Laundry detergent can flare atopic dermatitis or it can cause irritant hand dermatitis, for example, from hand-washing clothes and not wearing gloves and not moisturizing afterward,” says Lee.

She advises choosing a laundry detergent that’s labeled “fragrance-free,” not “unscented.” That’s because fragrances can cause skin reactions for someone with eczema, according to the NEA, and “unscented” detergents may still have fragrances; they’re just masked. Dyes can also cause irritation for those living with eczema, per the NEA, so look for a laundry detergent that’s dye-free, too.

Make sure you get all the soap out of your clothes by choosing the 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 try “fold- fashioned” cleaners like white vinegar and soda crystals, which don’t contain any added chemicals, according to the National Eczema Society. “Personally, I think all people — with or without eczema — should use skin-care products, cosmetics, and laundry detergents with as few chemicals as possible,” adds Lee.

Sideline Stress to Avoid Eczema Symptoms

It’s an understatement to say life is stressful these days. But someone with atopic dermatitis may want to make sure they’re keeping their stress levels in check. “Stress does flare eczema for probably more than one reason, and for different reasons for different people — so they need to address those individually, and find stress-reducing techniques that work for them or their situation,” says Lee.

It’s nearly impossible to remove all stress from your life, but a few tried- and-true techniques may help you get the upper hand. Deep breathing, yoga, and mindful meditation are a few options the NEA suggests. Wattenberg advises doing whatever helps you relax, whether that’s exercise, acupuncture, or another stress-busting approach.

Stay Out of the Heat to Avoid Itching

The summer months are usually given a warm welcome, but dry summer heat can be a real issue for many people dealing with eczema. Dry air can trigger an atopic dermatitis flare-up, according to Harvard Health Publishing, while Wattenberg points out that extremely high or low temperatures can have the same effect.

Sweat can be an eczema trigger, too, thanks to the trace minerals found in perspiration (including zinc, copper, iron, and nickel), which may be irritating, according to the NEA. And while normal levels of humidity are fine, high levels of humidity can also be an atopic dermatitis trigger, because they can cause more sweating, the NEA also notes.

The Mayo Clinic also notes that products that create a reaction in the sun, like certain chemical sunscreens, may trigger allergic contact dermatitis as well. Aim for physical or mineral sunscreen, which contains the ingredients zinc and titanium, which are less likely to cause allergic contact dermatitis.

Get Tested to Identify Allergies

There’s a close association between food allergies and atopic dermatitis, according to the AAAAI. Specifically, food allergies may worsen an eczema flare- up, according to the AAD. If you suspect you may have a food allergy, ask your dermatologist or allergist about performing a skin prick or blood test. A patch test may also be helpful to identify any chemical or substance being applied to your skin that causes the atopic or contact dermatitis rash. The doctor will apply a number of small stickers on your back; each contains a potential allergen (such as latex, fragrances, or preservatives), according to the Mayo Clinic. They will then check your skin for a reaction, typically over the course of several days. If you test positive to any of the substances, strictly avoiding that substance is key to avoiding future flares.

Avoid Pollen During Peak Months

When spring is in the air, pollen is, too. For people with atopic dermatitis and allergic contact dermatitis, pollen is a common eczema trigger, according to the Asthma & Allergy Network. Pollen can also be a trigger for people with allergic contact dermatitis, the Mayo Clinic notes. Stay indoors when pollen counts are high and keep your windows closed, suggests the Eczema Foundation. If you have to go outside, take a quick shower when you come in to remove pollen from your skin and hair, and wash your clothes. Ask your doctor about whether to add an antihistamine to your treatment for eczema.

Check Your Cosmetic Bag for Triggers

Finding cosmetics that don’t aggravate atopic dermatitis and contact dermatitis can be challenging. Products containing alcohol, fragrances, lanolin, or retinoids may cause eczema breakouts for many people, according to the NEA. Carefully check labels: “Unscented” does not mean the product does not contain fragrance; it could mean the fragrance is masked. Look for “fragrance-free” instead. When trying out a new cosmetic, cleanser, or lotion, the NEA 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.

Banish Pet Dander From Your Home

Your furry and feathered friends are cherished family members, but they can also cause atopic dermatitis and allergic contact dermatitis to flare. If your animals are indoor pets, keep them off sofas and chairs and ban them from the bedroom — the Mayo Clinic recommends limiting exposure to your pets as much as possible. Frequent vacuuming of carpet and rugs may help keep a handle on pet dander, a common eczema trigger, the American College of Allergy, Asthma & Immunology notes. Regular bathing and grooming of pets may also reduce pet allergy flare-ups, per the Humane Society of the United States.

Be Gentle on Your Skin While Bathing

A long, hot bath might be relaxing at the end of the day, but avoid the temptation of this potential atopic dermatitis trigger. Keep showers or baths as short as possible and use only lukewarm water, advises the NEA. Hot water can dry the skin and cause atopic dermatitis to flare, notes the Cleveland Clinic.

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. While your skin is still damp, apply a rich moisturizer to trap moisture in the skin — an essential part of treatment for eczema, the NEA notes.

Quit Smoking to Prevent Symptoms

You know that smoking is linked to lung cancer and other health problems. But did you know tobacco smoke can also worsen atopic dermatitis symptoms? One past review of research 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.

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