When you have atopic dermatitis (AD), your skin can be extra sensitive to anything irritating, including the fabric of your clothing. AD damages the surface of the skin, making it more susceptible to irritants, which is a broad term that includes any substance that is irritating. Common irritants include detergents, soaps, cleaners, and some fabrics.
Depending on where AD affects your skin, and depending on the weather, you may be able to avoid contact with clothing some times of the year. But clothing can also be protective and help children and adults with AD avoid triggers such as allergens, dust, or sand. When you do need to cover that sensitive skin, which fabrics are best for someone with AD?
What not to wear
Some fabrics are known to be itchy – like wool – and that can trigger the whole itch-scratch cycle that can worsen AD. Other fabrics that may cause irritation to someone with AD include man-made or synthetic fabrics, like rayon, acrylic, nylon, polyester, spandex, or modacrylic. (Modacrylic is frequently used in children’s sleepwear as it is flame-resistant.) Any material that irritates your skin should be avoided, as it can aggravate or trigger a flare of AD.
What to look for
Experts generally recommend looking for clothing made from fabric with natural fibers such as cotton or silk. While natural fibers typically do not cause irritation to the skin for most people with atopic dermatitis, keep in mind that it is possible that these fabrics won’t work for everyone and sometimes you may have to go through some trial and error to figure out what works best for you.
Cotton is generally a good choice, although everyone is different and some find that cotton can be irritating. Researchers believe that it’s the short fibers in cotton that expand and contract and can create a slight rubbing movement. Also, cotton garments may be dyed with a coloring agent that causes irritation.
Silk may be a good choice for most people with AD, although some people are allergic to the sericin protein found in silk. There has been research done on a specially treated silk material, called DermaSilk, which is loosely knitted, has had the sericin removed, and includes an antimicrobial agent (AEM 5772/5) bonded to the fabric. Studies have shown that DermaSilk is well-tolerated by both children and adults with AD, and the treated fabric seems to have beneficial effects on their skin.
Since people with AD are at a greater risk of skin infections, due to the damage to the skin’s barrier and the increased scratching, researchers have investigated several fabrics with antimicrobial agents, including clothing that’s been infused with silver. However, these materials are still unproven and there is some concern that silver in clothing might increase bacterial resistance.
Trial and error
While researchers continue to search for which textiles, including specially treated materials, work best for people with AD, most people with AD use a trial and error approach. Make note of which fabrics irritate your skin, and avoid them whenever possible, especially during times when your symptoms are at their worst.