Why Is My Eczema Flaring? 

Five Eczema Flares to Watch For

Atopic dermatitis, or eczema, is characterized by red, itchy rashes and oozing. These lesions are not indications of infection, nor is eczema a disease in and of itself. It is the result of inflammation, and it arises from a combination of diminished skin barrier function and a heightened immune response to any number of environmental triggers. 

Learning about eczema’s triggers can help you manage its symptoms better–or even prevent future flares. Below are five triggers to watch out for. 

 

1: Dry Skin

 

A variety of things can contribute to dry skin (xerosis, in medical terms). A significant number of eczema sufferers have a genetic mutation that contributes to poor protein synthesis in the skin. This weakens the skin’s defense against environmental stressors and leads to moisture loss. 

 

Even without this mutation, certain factors can contribute to dry skin and increase the chances of an eczema flare for anyone. Dry climates, exposure to temperature extremes, use of harsh soaps or cleansers, and inadequate moisturization are all risk factors. Dry skin is more vulnerable to eczema flares.

 

Keeping skin moisturized can prevent eczema from flaring up, and it is an important part of healing skin during a flare. Below are some best practices for preventing dry skin:

 

• Moisturize your hands after washing them. Your hands are especially vulnerable to dryness. Applying a lotion such as CeraVeⓇ Daily Moisturizing Lotion after drying off your hands can help lock in moisture and keep the skin healthy and resilient.
• Avoid long showers or soaks. It might seem paradoxical, but staying in the bath or shower longer than ten minutes at a time can contribute to skin drying out. As with handwashing, you should apply lotion to your skin after baths and showers, preferably while the skin is still damp (not dripping; briefly patting yourself dry is enough).  
• Wash in warm water. During an eczema flare, a hot shower or a splash of cold water can provide a few minutes respite from unbearable itching. Unfortunately, this can lead to greater moisture loss and even worse rebound itching. 
• Develop a good moisturizing routine for facial skin (including the lips! They can be vulnerable to dryness and eczema, as well). Moisturize your skin twice a day (or even more if you are in the middle of an eczema flare!). Look for moisturizing products that contain humectants, such as hyaluronic acid and glycerin, to help draw moisture into the skin cells, and emollients such as shea butter to maintain hydration. Especially dry skin may need heavier occlusive ingredients, such as dimethicone or petrolatum, to prevent moisture loss. 
• Use sunscreen with an SPF of at least 30 daily. Over time, sun damage can cause skin cells to lose moisture more rapidly. Avoid tanning beds and limit exposure to ultraviolet radiation from products like nail polish dryers and curing lamps for resin crafts.

2: Excess Stress

Stress in itself does not cause eczema, but about 73% of adults diagnosed with eczema report that stress triggers or exacerbates flares. The link between stress and eczema is well-established. 

 

Eczema is an immune system-related condition, and stress impacts the immune system in a number of ways. During periods of stress, the body produces higher-than-usual levels of a hormone called cortisol. At normal levels, cortisol acts as an anti-inflammatory–in fact, exacerbations of eczema are frequently treated with hydrocortisone, a synthetic cortisol. 

 

However, when cortisol is produced at excessive levels, its anti-inflammatory function is impaired. Proinflammatory mast cells in the skin are activated. The inflammatory symptoms of eczema are the result.

Stress also correlates with higher blood levels of both immunoglobulin e (IgE), an antibody responsible for defending the body against pathogens and irritants, and special disease-fighting white blood cells called eosinophils.  

Both IgE and eosinophils are associated with inflammation, and they are both found in higher levels in people with eczema.

Life is full of unavoidable stressors. Acting proactively can help us diminish the body’s stress response and help us limit stress-related eczema flares that you'll need good eczema cream to manage. If you notice that your stress levels are rising, or you anticipate a period of increased stress (such as a project deadline or an exam), try to minimize other stressors. 

Take breaks as regularly as possible to stretch, do deep-breathing exercises, or play a calming game on your phone (and consider putting your phone on do-not-disturb mode). A brief burst of physical activity–even just 10 or 15 minutes of movement–can help decrease the circulation of cortisol. 

Numerous studies suggest that journaling helps relieve stress. Journaling can be as involved as writing and illustrating long narratives about your stressors or as simple as scribbling your thoughts down on a sticky note. 

 

3: Allergies

 

Allergies, like eczema, are the product of an immune response, and exposure to allergens can trigger eczema flares.

 

Common allergens include pollen, dust mites, molds, and pet dander (cat dander in particular seems to be a frequent culprit). If an allergen has triggered an eczema flare, then removing either yourself or the allergen from your environment should be one of your first priorities whenever possible. For example, people whose eczema is triggered by cat dander should not have cats in their homes. 

 

In cases where the allergen cannot be eliminated or avoided, some steps can be taken to reduce exposure. Swift repairs of plumbing leaks are a key part of keeping a home mold-free, and dehumidifiers help in spaces like basements where moisture is unavoidable. Regular dusting, followed by vacuuming with a HEPA-filter-equipped vacuum cleaner, can reduce the presence of dust mites. 

 

Regular washing of hair and clothing when pollen counts are high can reduce the amount of pollen brought in from the outdoors. Bedding should be equipped with waterproof mattress protectors, and pillows should have allergen-reducing protective covers–both of which should be laundered frequently. 

 

Limit your exposure to any foods to which you are allergic. If you have symptoms of food allergies or sensitivities (gastric discomfort, difficulty swallowing, rash, itching, and swelling after eating, for example), then identifying and eliminating the offending food is key. According to the Food and Drug Administration (FDA), the ten most common food allergies in the United States are milk, eggs. fish, crustacean shellfish (e.g., crab, lobster, shrimp), tree nuts (e.g., almonds, walnuts, pecans), peanuts, wheat, and soybeans.

4: Irritating Chemicals

 

Some common chemicals can trigger flares for eczema patients. 

 

Many of these chemicals come from air pollution. Benzene, formaldehyde, nitrogen dioxide, and carbon monoxide are common outdoor air pollutants with a demonstrated link to eczema flares. One study showed that exposure to formaldehyde and nitrogen dioxide increased transepidermal water loss in eczema patients. 

 

Indoor pollutants include cigarette smoke, volatile compounds in paints, glues, or varnishes, and combustion pollutants such as natural gas, wood fires, and kerosene.

 

Other irritating chemicals can include those found in cosmetics, such as parabens, fragrances, coloring agents, and preservatives. Fragrances used in colognes, hygiene products, and detergents often aggravate eczema-prone skin. Nickel, a common metal found in jewelry, is another frequent irritant. Compounds in many household cleaners can also aggravate eczema flares. 

 

Take steps to limit your exposure to any chemicals that trigger your eczema. Where possible, avoid the outdoors on days when air quality is poor. Especially avoid exercising outdoors near industrial plants or busy roadways. 

 

Keep indoor areas well-ventilated. Put filters on your climate control system and replace them often. During winter, when combustion pollutants are at higher levels indoors, ensure that air is circulating properly. Open a window periodically. Take outdoor breaks frequently for doses of fresh air. 

 

Allow the home to air out after painting, putting up new wallpaper, or installing new flooring. Open windows, turn on fans, and use an air purifier with a HEPA-quality filter. 

 

Do not smoke in your home or allow others to do so. Look for fragrance-free detergents and bath products, and if you notice any sensitivity to household cleaners, find alternatives that are less irritating. Use gloves and protective equipment when you must use irritating cleaning compounds.

 

Jewelry and clothing accents should be free of nickel if you are sensitive to that metal; be sure you inform your healthcare providers of this sensitivity, also. 

 

As a side note, be wary of anyone advising “chemical free” products or protocols for the treatment of eczema. Everything we eat, drink, or inhale is a chemical. “Chemical free” labels or claims often signify that a product has not been subjected to rigorous scientific study. Instead, look for products that are hypoallergenic and/or dermatologist-approved. 

 

5: Excessive Sweating

 

Sweating is normal. It is the body’s way of regulating its temperature. When we  sweat, the moisture evaporates and creates a cooling sensation. Just like a long, hot bath can lead to rapid evaporation of moisture from the skin, sweating can dry out the skin and leave a salty residue. You’ve already read about dry skin’s connection to eczema flares. 

 

On hot, sweaty days or trips to the gym, be sure to wear breathable, moisture-wicking clothing. Take a brief, warm (not hot!) shower at the end of the day and use gentle bath products to wash off. Moisturize your skin–all of it, not just your face–afterwards. Launder your gym clothes after each workout. 

 

Conclusion

 

These are just a few common eczema triggers. While we can’t avoid all of these triggers, we can take steps, in most cases, to limit or mitigate our exposure. 

 

Anyone who has been diagnosed with eczema should be especially vigilant with their skincare.  Moisturize often (men, this goes for you, too! Moisturizing is important for all eczema sufferers)--at least twice daily, and more frequently during flares. Use lotion after every hand wash or shower. Protect your skin from the sun and apply sunscreen daily. 

 

Be mindful of stress. A good sleep schedule will help you manage stress more ably, as will regular exercise–even a short walk or a good, satisfying stretch can help decrease cortisol levels. Confide in a trusted friend and/or a talk therapist or journal your thoughts. Make time for relaxing, enjoyable activities regularly. 

 

Limit your exposure to allergens and air pollutants, indoor or out. Those whose eczema is triggered by pet dander should not live with the associated animals; children, in particular, should be able to live in a home that is as free from eczema triggers as possible. 

 

An ounce of prevention is worth a pound of cure–but no matter what steps we take to prevent eczema flares, they can still occur. When they do, arm yourself with supportive therapies. SmartLotion®, the brainchild of board-certified dermatologist Steve Harlan, MD, has helped hundreds of people manage their eczema symptoms and heal their skin–with a 95% success rate. 

 

SmartLotion®’s prebiotic formula helps to restore and maintain the skin’s optimal microbiome. This enables it to shorten healing time while using a minimal amount of hydrocortisone. When used under a physician’s guidance, it is a safe and effective treatment with almost no unwanted side effects. 

 

As a final note, remember that eczema is not a sign of an impure diet or unhealthy lifestyle; it’s impossible to avoid 100% of your triggers 100% of the time. Support your skin’s health to the best of your ability and consult closely with your dermatologist to manage flares when they occur–and remember that SmartLotion® is there to help you manage your symptoms and hasten your healing.