9 Lifestyle Changes That Can Help Manage Atopic Dermatitis
Small tweaks to your daily routine may be just what you need to fight the itch.
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If you’ve ever fallen down a #SkinTok rabbit hole (guilty), you’ve probably heard of atopic dermatitis (AD). But even if your feeds tend to be of the fitness or OOTD variety, odds are you or someone you know has the condition.
More commonly known as eczema, atopic dermatitis is a common inflammatory skin condition that causes dry, itchy skin, explains board-certified dermatologist Mariano Busso, M.D., F.A.A.D., who practices in Beverly Hill, California and Miami, Florida. “This widespread, chronic condition affects a sizable portion of the world’s population,” he says, with research suggesting that up to 10 percent of individuals will have some form of eczema at some point in their life.
While the condition is common, it is anything but comfortable. “Uncontrolled eczema can cause very uncomfortable symptoms that interfere with sleep, cause emotional stress, and impede day-to-day life,” he says. In short, “it’s a condition that can have a huge impact on someone’s life and well-being.”
The good news? While the condition cannot be cured, it can be managed. Ahead, learn more about atopic dermatitis, what causes it, and exactly how it can be treated with a combination of at-home remedies, lifestyle adjustments, and medical interventions.
Atopic Dermatitis, Explained
Atopic dermatitis is a chronic, inflammatory skin condition that makes the skin unable to maintain moisture, explains Dr. Busso.
Eczema flare-ups come and go in response to environmental and lifestyle factors, he says. During flare-ups, however, individuals with atopic dermatitis get non-contagious splotches on their skin that can itch, swell, blister, and sometimes even ooze. “These patches can pop up anywhere on the body, and severity can range from mild to severe,” he says. Typically, the splotches are red but can also appear dark brown, grey, or purple, depending on a person's skin tone, he says. (FTR: The times when an individual does not have an outbreak is called being in remission.)
One important thing to note: While the condition may cause skin reactions that look similar to poison ivy and poison oak, it is not contagious, says Dr. Busso. It cannot be passed through skin-to-skin contact, sexual contact, or any other means, he says.
What Causes Atopic Dermatitis, Exactly?
Ultimately, the exact cause of atopic dermatitis is not known. These days, experts say that atopic eczema is not caused by just one thing but rather a combination of genetic, environmental, and biological factors.
In some but not all cases, the condition is thought to be caused by a gene mutation that can be inherited, explains board-certified allergist and immunologist Martin Smith M.D., a practitioner with Cleveland Clinic and the founder of Untoxicated skincare. “The most frequent cause is a mutation in the FLG (Filaggrin) gene, which is responsible for producing something called natural moisturizing factor,” he explains. As you might guess, when this gene is compromised, the amount of moisture your skin can produce is reduced, which leads to dryness.
Similarly, individuals with a family history of eczema, as well as hay fever or asthma, are thought to be at a much greater risk for atopic dermatitis for similar reasons, according to Dr. Smith. “If a child has one parent with [one of these conditions], they are three times more likely to have eczema, while if both parents have either eczema, allergies, or asthma, the child is five times more likely to have eczema,” he says.
The thing is, not everyone with a gene mutation will automatically break out with eczema flare-ups. Instead, the disease has to be “activated” through environmental factors (like temperature drops, season changes, or exposure to allergens) or biological factors (like high stress, immune dysfunction, or inflammatory foods). Simply put, eczema flare-ups are thought to be caused by an interplay of genetic, environmental, and lifestyle factors, says Dr. Smith.
Lifestyle Changes and Atopic Dermatitis
“A person's lifestyle can absolutely have an impact on the intensity and frequency of atopic dermatitis flare-ups,” says Dr. Busso. Lifestyle factors like diet, activity level, hygiene practices, stress, and products used can all impact the condition, making symptoms worse or better, he says.
Therefore, modifying some or all of these factors isn’t just recommended for individuals with the conditions but part of their prescription. While some people will also need medical interventions (like topical non-steroidal creams or oral JAK inhibitors), others can see some major improvement just by making lifestyle modifications like the ones below.
Change #1: Find An Exercise Routine That Works For You
Amongst people with eczema, exercise sometimes gets blamed for causing flare-ups. But it’s not actually exercise that can lead to eczema — it's the sweat. Exercising increases your internal body temperature, explains board-certified internal medicine physician Zion Ko Lamm, M.D., who regularly debunks skin-care myths on TikTok. This causes the body to release sweat onto the skin, which creates a sensation of coolness when it evaporates. While this effectively helps you maintain a healthy internal body temperature, it can strip the skin barrier’s natural oils and ultimately exacerbate dryness and itchiness.
But the solution isn’t to go without exercise — doing so can increase your risk of flare-ups in its own way. “Exercise is very effective at reducing stress, which itself can lead to a flare eczema,” says Dr. Smith. Instead, your solution is to limit how much you sweat during exercise and change out of damp clothing ASAP after you’re done working out. In practice, that means doing outdoor workouts in the morning or night rather than mid-day, opting for (room-temp) rather than hot yoga, and exercising someplace with a shower so you can wash away the sweat stat. And if you swim as exercise, rinse off immediately in the shower. “The residual chlorine can flare eczema,” Dr. Smith explains.
Change #2: Wear Breathable Workout Gear
Whether you’re lifting at the gym, walking your dog, or hiking with a friend, make sure to wear breathable clothing, says Dr. Smith. “It’s best to avoid clothing made out of nylon and polyester,” which can trap your sweat, make you hotter, and therefore make you sweat more. Instead, opt for clothing made out of natural fibers, which will be breathable, he says. Merino wool and bamboo are both good options.
In addition to choosing clothing that is made of the right material, Dr. Smith recommends wearing clothing that isn’t too tight. This can trap moisture, as well as create unnecessary friction between the skin and fabric, both of which can increase symptoms of eczema.
Related: The 17 Best Places to Buy Workout Clothes for Women, Tested and Reviewed
Change #3: Do Your Best Not To Scratch
There may not be anything more annoying than a person telling you not to scratch when you have an itch — but you really should try to avoid using your claws. “Scratching an itch may actually cause the itch to spread to other parts of the body,” says Dr. Smith.
How? Well, the physical action of scratching causes the chemical interleukin 31 — colloquially known as the itch factor — to release into the bloodstream, he explains. “This chemical then binds to nerve endings in the skin, even at sites different from the original itch, and causes more itching,” he explains. Further, itching can make flare-ups worse by weakening the skin barrier, which increases inflammation, Dr. Busso explains.
Change #4: Try a Cream or Compress
Good news: You don’t have to rely exclusively on self-control to stop that scratch! There are many anti-itch protocols you can implement to stop the scratch before it starts. For mild itching, Dr. Smith recommends applying a cold, wet cloth or ice pack to the area of the itchy skin for 5 to 10 minutes. The cold offers a numbing effect to the problem area while also helping decrease associated swelling and inflammation, he says.
You can also apply an anti-itch cream. “An over-the-counter cream that contains 1% hydrocortisone may help,” says Dr. Smith. Some options include Cortizone 10, Aveeno Anti-Itch, and CeraVe Anti-Itch. Note: While short-term use of these products can be helpful if you find yourself using them day after day, Dr. Busso suggests talking to your healthcare provider to find an alternative treatment.
Another option is to pop a non-sedating antihistamine such as Allegra or Zyrtec. Dr. Busso says these medicines block the effects of an itch-inducing substance in the blood called histamines, which exist in higher amounts in people with eczema than people without.
Related: All the Ways You Can Use Cortisone Cream, According to a Derm
Change #5: Moisturize, Moisturize, and Moisturize Some More
If you have eczema, moisturizer is your BFF. The right cream will help seal water into your skin, which helps compensate for the low levels of natural moisturizing factor, explains Dr. Smith. When shopping for a moisturizer, Dr. Zion recommends looking for one rich in ceramides, fatty acids, glycerin, panthenol, and hyaluronic acids. All of these trap moisture against the skin while working to repair the skin barrier. Some options include Eczema Honey, CeraVe Eczema Relief Creamy, and Vaseline Eczema Calming Therapy Cream.
“Apply this moisturizer every time after you wash your hands, as well as immediately after a bath or shower,” says Dr. Smith. Heck, you might as well re-apply anytime you’re at a stop-light, waiting for your Zoom meeting to boot up, or while on hold with your bank, too. There is no such thing as being too moisturized when you have eczema.
Change #6: Work With A Nutritionist
Eczema is an inflammatory condition, so implementing an anti-inflammatory eating protocol can be helpful for some people, according to Dr. Busso. The best eating plan will vary from person to person as specific inflammatory triggers can vary, he says, so it’s best to consult with your healthcare provider and a nutritionist prior to upheaving your current diet. Generally, adopting an atopic dermatitis-friendly diet will require an individual to keep track of their food so they can identify triggers and avoid them in the future.
Common atopic dermatitis trigger foods include:
cow’s milk
processed meats
wheat
soy
eggs
sugary sodas
non-dairy creamers
peanuts and tree nuts
In addition to eliminating inflammatory foods, experts recommend adding anti-inflammatory foods and ingredients, which can “limit your inflammation burden,” says Dr. Smith. Foods that may help lower inflammation include fresh fruits and vegetables, olive oil, and whole grains. “Omega-3 fatty acids, which are often found in fish such as salmon, mackerel, and sardines, are also anti-inflammatory,” he says.
Related: 15 Best Anti-Inflammatory Foods You Should Be Eating Regularly
Change #7: Manage Stress Levels
Widely known as public enemy number one, it should come as no surprise that stress can also negatively impact individuals with eczema. “Stress can lead to flare-ups in a few ways,” Dr. Zion says. First, when stress levels are high, cortisol levels are too. Cortisol is the stress hormone, and when there’s a lot of it in the body, it can disrupt the immune system, she says. “This can make the body more susceptible to inflammatory triggers, as well as weaken the skin barrier.”
Further, when individuals are chronically stressed, they are more likely to neglect their bodies and hygiene habits, which can exacerbate the eczema. Often, stressed individuals will neglect their bodies by getting inadequate sleep, making poor dietary choices, and possibly neglecting their skincare routine,” she says. For these reasons and more, it’s essential that people with eczema implement stress-relieving protocols into their daily routines.
Effective stress-relievers include:
meditation
yoga
reading for enjoyment
therapy
Related: The Best Guided Journals for Stress-Reduction, Goal Setting, and Gratitude
Change #8: Give Wet Wraps a Whirl
Wet wrap therapy, a treatment for severe eczema, is currently being studied by the National Institute of Allergy and Infectious Diseases — if you love a bath, this innovative eczema treatment may appeal to you. Wet wrap therapy involves taking a lukewarm bath and then applying a combination of topical medicine and moisturizer to your skin. It is then sealed in place with a wrap of wet gauze. “The aim here is to lock moisture into the skin to repair the skin barrier and prevent evaporation,” Dr. Smith explains.
Typically, it is recommended that individuals take a bath and apply the wrap three times a day. “It is a time-consuming process,” he says. “But it can also be done for a short period of time (15-30 minutes) twice a day, or even overnight.”
Change #9: Edit Your Hygiene Routine
You can make a few easy edits to your bath and wash routine that may help reduce your risk for flare-ups. First, check the ingredient list of your soaps, washes, shampoos, conditioners, and lotions to ensure they don't contain any potentially irritating ingredients.
Ingredients that may cause eczema flares include:
sulfates
cocamidopropyl betaine
fragrances
lanolin
propylene glycol
ethanol
Opt instead for scent-free washes and products, like Dirty Labs Laundry Detergent, Dove Sensitive Skin, and Free & Clear Shampoo for Sensitive Skin. “If you must wear perfume or cologne, spray it on your clothing to keep from inducing a flare-up,” Dr. Smith says.
You'll also want to avoid really hot showers and baths and limit your time in the water to 10 minutes. “Hot water can strip the skin barrier of its natural oils, leading to significant damage that increases the risk for flare-up,” says Dr. Zion. When you get out of the shower, pat yourself dry with a towel and then liberally apply a thick, non-fragrant moisturizing cream, she says. Again, you want a moisturizer that contains ingredients (like petroleum) that will lock in hydration.
Related: Here's Why Your Skin Is So Itchy After a Shower, According to a Dermatologist
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