Common Eczema Triggers

There is no single cause of atopic dermatitis (eczema). Instead, experts think a combination of several factors is at play. Each person’s risk factors will be different. But many people with eczema share common triggers. When these triggers occur, eczema symptoms can get worse. People often refer to these times as symptom flare-ups or flares.^1-5

Eczema triggers can come in different forms and impact people differently. A trigger for one person may not affect another. Identifying and avoiding your triggers can help you plan for treatment and manage your symptoms. Several common eczema triggers are described below.^2-4

Stress

Stress affects your hormones and immune system. When you are stressed, a stress hormone called cortisol increases in your body. Proteins called cytokines that play a role in inflammation also become more active. Both of these processes can lead to changes in your immune system that pave the way for an eczema flare.^2,3,6

Allergens and irritants

Allergies and eczema often go hand in hand. While one does not necessarily cause the other, certain allergens can increase the risk that eczema symptoms will get worse. Allergies to food, things in the environment like pollen or dust, or chemicals that come in contact with the skin can all lead to flare-ups.^2-5

However, not all reactions are allergic reactions. In some cases, a flare-up of symptoms might be caused by irritation. Some fabrics, soap ingredients, and perfumes can be skin irritants. When these things come in contact with the skin, they can lead to inflammation.^5-8

In some cases, rashes and irritation can be unrelated to eczema. This is called contact dermatitis. But scratching at itchy contact dermatitis can make eczema symptoms flare up.^5-8

Dry skin and scratching

Skin dryness and itching are 2 of the most common symptoms of eczema. When your skin is inflamed and dry, it becomes itchier. As you scratch more, your skin gets drier. Drier skin has more cracks and is weaker. This can increase the risk for reactions to allergens, irritants, or germs. These reactions then continue to make the skin itchier and dryer.^1,3,7

This is called the itch-scratch cycle, and it can lead to eczema symptom flares. Excessive scratching may even lead to skin thickening (called lichenification). It can also lead to scars on the skin.^1,3,7

Infections

When your body is fighting an infection, your immune system is very active. And when your immune system is active, eczema symptoms can get worse.⁶

Also, the itch-scratch cycle and weakened skin can increase the risk of developing infections. This is another cycle that can lead to flare-ups. An example of this is eczema herpeticum. Eczema herpeticum occurs when infection with the herpes simplex virus (HSV) occurs in areas affected by eczema. Severe infection and complications can arise as a result.^1,6,9

Hormones

Hormone changes, especially in people with a uterus, may increase the risk of eczema flares. Some people may notice that their symptoms get worse around their period when they are pregnant, or during menopause.⁵

Weather and climate

In some people, eczema flares can be triggered by temperature changes. This could be related to sensitive nerves in the skin or moisture changes in the air. When the weather gets colder, humidity tends to decrease. The same thing happens when you sit inside in air conditioning all day. Both of these situations can lead to drier skin.^1,6

On the other hand, warm temperatures may cause sweating. This can irritate the skin too.^1,6

Some areas of the world also have other climate-related triggers. These triggers may include air pollution or less rainfall, which reduces air quality. Certain places may also have “harder” water, which can be irritating to the skin. Hard water has higher levels of minerals like calcium in it.^1,6

Sweat and saliva

Sweat naturally collects in areas that are affected by eczema. This includes areas around the elbows and knees. Sweat can irritate the skin and lead to eczema flare-ups.^3,7

Saliva can cause a similar issue. When babies are teething, they produce extra saliva. This moisture around the mouth can be irritating and lead to worsening eczema symptoms.^3,7

Identifying and avoiding triggers

Each person’s triggers are different. Writing down times when your symptoms get worse can help you identify and avoid the specific things that affect your eczema. You can also bring this record with you to doctor’s appointments for their review.²

But not all triggers can be avoided. In these cases, practicing general flare-prevention strategies can still help. These strategies include:^2,4,7,8

• Keeping the skin clean and bathing in lukewarm (not hot) water
• Using gentle, irritant-free soaps and washing the skin gently
• Moisturizing the skin regularly, especially after baths and showers
• Keeping the skin dry with a towel during exercise or when out in the heat
• Eating a diet focused on anti-inflammatory foods, like fruits, vegetables, and whole grains
• Decreasing stress through exercise or mind-body methods like yoga and meditation
• Working closely with your doctor on your treatment plan, and using all treatments as directed