What Triggers an Eczema Flare?
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Medically reviewed by Susan Bard, MD
Eczema is a chronic skin condition that causes discolored, inflamed, and dry patches on your skin. The condition occurs in about 15% to 30% of children and 2% to 10% of adults. Eczema patches tend to come and go. Symptoms often develop when you're experiencing a flare—or, a period where your symptoms worsen. A variety of environmental, medical, and lifestyle factors can trigger these flares. But knowing the common triggers can help you avoid them and prevent severe flares from occurring.
Common Eczema Triggers
Certain factors can aggravate (or, worsen) inflammation and cause eczema flares to occur. When you're experiencing a flare, it's common to have symptoms like itchy and dry skin that often occur in the form of inflamed patches. Sometimes, these patches can also be painful to touch or cause bleeding if you're scratching them. It's worth noting that while not every person with eczema has the same triggers, the following factors are common examples of what can worsen your symptoms.
Skin Irritants
Skin irritants or allergens can be present in personal care products, fabrics, or metals (like nickel) in jewelry. Harsh soaps, detergents, and cleaners are common types of products that can cause your skin to become inflamed and worsen your eczema. Many of these products contain chemicals (like formaldehyde), fragrances, preservatives, or dyes that irritate the skin. Wool or synthetic fabrics can also worsen symptoms by rubbing against your skin or trapping heat and moisture in the skin.
Environmental Allergens
Inhaling environmental allergens can trigger internal inflammation and cause eczema symptoms to flare up. Common allergens include:
Pollen
Pet dander (e.g., fur)
Cigarette smoke
Diesel exhaust
Climate
Extreme temperatures and climate changes can affect your skin's moisture balance. Cold, windy, or dry conditions can strip the skin of natural oils. On the other hand, hot or humid weather can cause excessive sweating, which can irritate sensitive skin.
Food Allergies or Sensitivities
Young children are especially prone to food allergy triggers. About 30% of children with eczema have at least one food allergy. While this is not an exhaustive list, common examples of foods that may trigger a flare include:
Eggs
Soy
Fish
Citrus fruits
Tomatoes
Stress
Eczema is an inflammatory condition, meaning your skin becomes inflamed, red, or swollen when you're experiencing a flare. When you're feeling stressed out, your body releases stress hormones, such as cortisol. These hormones can worsen inflammation and trigger swelling. As a result, your skin becomes more prone to itching and redness.
Dry Skin
While dry skin can be a symptom of eczema, not taking care of your dry skin also increases the risk of flares. Dry skin weakens the skin’s natural barrier and allows irritants and allergens to enter your skin and further irritate your symptoms. Moisturizing your skin with an eczema-safe lotion, using anti-itch cream, and washing your skin with a gentle cleanser can keep your skin hydrated.
Scratching
It can be tempting to want to scratch your eczema patches—often because the condition causes itchy skin. But, scratching damages your skin's protective barrier and increases the risk of irritation, swelling, and infection.
Infections
Viruses (such as the cold, flu, and COVID-19), bacterial infections, and fungal infections can contribute to eczema flares. You can prevent viral infections by methods like washing your hands properly and staying away from people who are sick. Washing food and cooking meat properly, alongside avoiding food or water that is contaminated, can reduce your risk of a bacterial infection. While the causes of a fungal infection vary, having good personal hygiene can lower your risk of contracting fungi.
Hormones
People assigned female at birth may note that flares tend to appear during specific times of their menstrual cycle and pregnancy. Symptoms often worsen due to fluctuations in hormones like estrogen and progesterone.
How to Identify Your Eczema Triggers
Once you understand your triggers, you can slowly learn to avoid them and reduce your risk of experiencing an eczema flare. Consider keeping a log in a journal or on your phone to track when your symptoms worsen. Record the date and time of each flare and make a note of any patterns you're noticing. It may help to include the following types of details in your tracker:
Symptom severity
Area of skin that's affected
Daily activities
What you eat and drink
Clothing or linen material
Skincare routines and products
Detergents and soaps
Stress levels
Menstrual cycle (for females)
Environmental allergens
Indoor and outdoor climate
You might also consider writing down any adjustments you made to the above factors that helped your symptoms go down. It can also help to consult with a healthcare provider who specializes in dermatology (skin) or allergies, as they can help you look for patterns, examine your skin, and perform allergy tests to pinpoint specific triggers.
Tips for Avoiding Eczema Triggers
Hydrating the skin is one of the best ways to prevent eczema. Moisturize at least twice daily with a gentle lotion, cream, ointment, balm, or body butter. If you take a bath or shower, apply it within three minutes of getting out. Moisturizing right when you get out of the water helps trap moisture in the skin and keep it hydrated.
Finding the best option for you or your loved one may require experimenting with various moisturizers. Many people prefer ointments to creams because they contain less water and create a strong skin barrier. Other people prefer something lighter, like lotion, especially in hot weather or at bedtime.
The following adjustments can help create a skin-friendly environment, avoid triggers, and minimize flares.
Personal care: Choose soaps, lotions, and makeup that is free of harsh chemicals or fragrances
Lukewarm water: If hot showers or baths trigger eczema, stick with lukewarm water and keep your bathing time brief
Laundry: Opt for fragrance-free laundry detergents and softeners
Natural fabrics: Consider wearing loose-fitted clothing and using bedding made from natural, breathable fabrics like cotton or bamboo
Indoor climate: Maintain a consistent and pleasant indoor temperature, avoiding extreme cold or heat, or use a humidifier to add moisture to the air, especially if you live in a dry climate
Clean living space: Keep your living space clean to reduce potential allergens like dust mites or use air purifiers to reduce the presence of indoor allergens
Protect your skin: Wear sunscreen and loose-fitted clothing if you're spending time outside during hot days and wear hats, scarves, and gloves to protect your skin when it's cold
Public spaces: Try to avoid public spaces where you may encounter potential irritants like smoke
Food allergies: When dining out, communicate dietary restrictions to help prevent potential food triggers
Reduce stress: Incorporate stress management techniques like mindfulness, exercise, or journaling into your daily routine
Treatments for Eczema
Sometimes, despite your best efforts, eczema flares still occur. You may be able to treat some flares at home. But if home care is ineffective, a healthcare provider can recommend other treatments.
At-Home Remedies
The following treatment options may help improve flare symptoms at home:
Cool compress: Soak a clean cloth or gauze with cool water and place it on the skin for about 15 minutes. Pat the skin dry and avoid rubbing as it can irritate the skin.
Colloidal oatmeal: Add colloidal oatmeal to a lukewarm bath and soak in the bath for 15 to 20 minutes.
Corticosteroid cream: Over-the-counter (OTC) corticosteroid creams are ointments you can apply directly to your skin. Applying a small amount of cream to your patches can help relieve itching.
Antihistamines: Antihistamines help reduce allergic reactions and itching. OTC antihistamine creams help relieve itching in small areas. Your healthcare provider may also recommend oral antihistamine pills to take at night.
Prescription Medications
If at-home remedies aren't improving your symptoms, your provider may recommend prescription-strength medications such as:
Corticosteroids: Prescription-strength corticosteroid creams can reduce swelling throughout your body.
Antibiotics, antivirals, or antifungals: Medications to combat infections that could be worsening your eczema symptoms.
Phototherapy: Uses controlled exposure to ultraviolet (UV) light to help reduce inflammation and redness on your patches.
Immunosuppressants: If other treatments are ineffective, your provider may suggest topical immunosuppressants. also known as immunomodulators, such as Protopic (tacrolimus) or Elidel (pimecrolimus). In rare cases, they may prescribe oral immunosuppressant medications.
How Do Immunosuppressants Work?
The immune system releases inflammatory chemicals (like cytokines) to protect against harmful germs. But, for those with eczema, the immune system can become overactive. Immunosuppressants reduce this immune response to break the cycle of inflammation and in turn, improve symptoms.
When to Contact a Healthcare Provider
Consult a healthcare provider if you experience consistent eczema flares that do not improve with avoiding triggers or using at-home treatments. It's also important to seek medical attention if your symptoms worsen, you develop signs of infection such as oozing or swelling, or when symptoms are significantly affecting your quality of life.
A Quick Review
Eczema is an inflammatory skin condition that causes swelling, redness, and itching. Common triggers of eczema flares include skin irritants, weather changes, and food allergies. Keeping a diary of potential triggers and consulting with a healthcare provider can help you pinpoint your triggers. Managing eczema involves gentle skincare, moisturization, and avoiding triggers. Treatment includes corticosteroid creams, anti-allergy medications, and immunosuppressants.
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