What causes eczema to flare-up?

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Eczema is a chronic skin condition that affects both children and adults. It is extremely common and causes patches of skin to become inflamed, red and itchy, for some individuals the symptoms can be quite severe and can significantly affect a person’s quality of life.

Eczema often affects specific parts of the body including the hands, fronts of elbows and eyelids, though it can affect almost anywhere on the body, common triggers of this skin condition include irritants such as soaps and detergents, as well as environmental factors or allergens. Many eczema sufferers find they experience flare-ups during the winter months when the air is cold and dry. 

Eczema is caused by multiple factors but the core feature is a weakened skin barrier which allows allergens and irritants to penetrate the skin triggering inflammation. There is no single cause of eczema flare-ups, although there are general trends, everyone is different and these triggers are very specific to an individual, ranging from environmental factors, personal care products, and stress. 

For those suffering from eczema, it’s important to identify your personal triggers so that you can minimise exposure and reduce the frequency and severity of your flares. 

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Common triggers of eczema flare-ups 

When thinking about what triggers eczema flare-ups you can broadly divide triggers into 2 categories:

Factors that directly trigger inflammation

This includes exposure to allergens, chemical or physical irritants or anything that damages the skin. 

Factors that can make the skin more susceptible to flare-ups

This includes anything that further weakens the skin barrier function making it easier for irritants to penetrate the skin triggering inflammation. Principally this includes anything that exacerbates moisture loss from the skin including dehydration, soaps and excessively hot showers or baths.

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What can trigger an eczema flare-up? 

A variety of different factors can contribute to an eczema flare-up, including allergens, stress, anxiety, irritants, and cold weather. If you experience eczema, identifying potential triggers will help you to avoid them and manage your symptoms.

Common eczema triggers include:

Irritants:

Many household substances such as soaps, detergents, bubble baths, shampoo, washing-up liquid and fabric softeners all contain multiple chemical ingredients that when able to penetrate the skin can trigger inflammation and irritation. In skin not affected by eczema, the natural barrier function of the skin prevents this from occurring, but for individuals with eczema, even skin which may visually appear healthy may be sensitive to these products.

Allergens:

Allergens such as pollen, dust mites, mould and pet fur can cause delayed-type allergic reactions, causing your eczema to flare-up.

Food allergies:

Food allergies are an important trigger in childhood eczema but play less of a role in adult eczema. Common food allergies include peanuts, cow’s milk, wheat, soy, or eggs. 

Stress:

Stress can also trigger eczema flare-ups. Stress not only impacts your immune system but also changes the perception of your symptoms and can exacerbate the experience of itchiness triggering flares. If you suffer from eczema, learning how to manage your stress and anxiety effectively can be helpful. There are lots of tips on how you can manage your stress in a way that works for you, including mind-body and meditation techniques, lifestyle changes, and therapy approaches, such as cognitive behavioural therapy.

Weather changes:  

Changes in temperature and humidity can affect your eczema, especially dry winter air or sudden dampness.

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What can make the skin more susceptible to an eczema flare-up? 

Certain factors can also make the skin more susceptible to an eczema flare-up.

Dehydration:

‍Drinking plenty of water is integral to your general health and well-being, the average adult should drink two litres of water per day, this is especially important if you suffer from eczema. Dehydration can lead to reduced water content in the skin, stimulating itch and reducing the skin's barrier function.

Hygiene:

‍For those suffering from eczema, it’s important to consider how day-to-day hygiene can impact the skin. Increasing the temperature or the length of time you spend washing increases moisture loss from the skin, bathing is generally more dehydrating for the skin than showering. 

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Things that can do both:

Of course, certain factors can fit into both of the categories above. Soaps are a good example and are a common trigger as they remove naturally occurring protective oils from your skin, leading to further water loss and skin barrier compromise but also often contain fragrances and other potentially irritant chemicals which can trigger inflammation. You should ensure you use shampoos, soaps and other products that are designed to be eczema-friendly, often patients with eczema are advised to stop using soaps entirely and instead use their moisturiser as a soap substitute.

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Managing eczema flare-ups

From avoiding triggers completely to taking proactive action to calm and soothe your skin, there are various ways to help manage and prevent eczema flare-ups, to minimise the impact this debilitating condition has on your life. 

Avoid triggers 

If you suffer from eczema, it’s important to try and reduce your exposure to triggers. It can be quite difficult to pin down your specific triggers so keeping a diary and tracking your symptoms against your day-to-day activities can be helpful. 

Adjust your washing routine 

If you bathe, try to not do this too regularly (maybe keep it for a weekly treat). Reduce the time spent washing and the water temperature. Avoid using any harsh soaps, there are specific soaps designed for eczema sufferers which contain no irritants or try using your moisturiser as a soap substitute. Be mindful that despite the risks of washing, good hygiene is an important part of eczema skin care due to the ability to exfoliate and remove potential irritants from the skin. Moisturising immediately after washing can help minimise skin water loss.

Avoid chemicals, fragrances, and other irritants 

Avoid chemicals, fragrances, and other irritants that have caused your skin to flare-up in the past. Take note of the ingredients in these products so you can avoid them as much as possible. If using new personal care products it can be a good idea to test them on a small area of skin before general use.

Note temperature and weather

Certain weather conditions, such as cold and damp weather can cause flare-ups so to avoid these, keep your home at a regular temperature and wear thin layers of clothing to ensure you can adjust your body temperature by adding or removing these layers. 

Evaluate your diet 

Keeping a diary and tracking your diet and eczema can be helpful. If you suspect that your diet is impacting your flare-ups, you can try eliminating specific foods from your diet to see if your skin improves. If you have an established food allergy it’s best to avoid these foods entirely.

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Home remedies 

As well as avoiding the triggers of flare-ups, certain home remedies can be helpful in the management of eczema symptoms. 

Colloidal oatmeal

Colloidal oatmeal contains a concentration of the starch protein found in oats and is approved for helping to relieve itchy skin symptoms by nourishing and soothing your skin. It can be used in a bath as a soak or as an emollient (moisturiser).

Baking soda

Although baking soda is not a cure for eczema, it can help to relieve itchy skin. Try adding 1/4 cup of baking soda to a warm bath and soak for 10 to 15 minutes.

Aloe vera gel 

Aloe vera is a natural moisturiser that reduces skin inflammation and irritation. It can be used to hydrate and soothe eczema-damaged skin by promoting the growth of healthy new skin cells.

Apple cider vinegar 

Some people find diluted apple cider vinegar can be helpful to reduce eczema symptoms and restore the skin's acidity levels. Keep in mind that this remedy is not suitable for everyone and in some individuals, it can further exacerbate their eczema.

Shea butter 

Applying shea butter to the skin can help improve symptoms of eczema, creating a protective layer on the surface of the skin.

Although home remedies can help relieve the symptoms of eczema, they are best used in combination with medical treatments. If your eczema is severe or persistent, it’s important to see a doctor to confirm your diagnosis and optimise your treatment regime.

Seek medical advice

If you suspect that you have eczema or you already have a diagnosis but are struggling to control your symptoms, you should seek medical advice. 

Tend is an online healthcare service offering anytime expert advice, and personalised, affordable treatments for eczema.

Get in touch today to find out how we can help you. 

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FAQs – Eczema flare-ups

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Is it eczema or contact dermatitis? 

Contact dermatitis causes the same symptoms as eczema but is caused by direct contact with a particular substance, because of this contact dermatitis commonly occurs on the hands. Contact dermatitis will usually improve or clear up once the substance that is causing the problem is identified and then avoided. 

Eczema, on the other hand, is a genetic condition where the skin has a compromised barrier function and is susceptible to becoming irritated and inflamed. Eczema typically affects skin creases including the elbows, knees, neck and hands. Due to the condition having a genetic component individuals will often need to manage their condition long-term.

It is worth noting that both conditions can co-exist, if your eczema suddenly starts affecting a new area of your body or is suddenly not responding to treatment it could be contact dermatitis. 

How can I manage eczema flare-ups? 

There are a number of different ways to help manage eczema flare-ups and reduce the severity of symptoms, including:

• Identify and avoid triggers where possible
• Moisturise your skin at least twice a day
• Avoid scratching 
• Use flare control creams to suppress inflammation
• Apply an anti-itch cream to the affected area

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A doctor or healthcare professional will be able to provide more information on how you can effectively manage your eczema flare-ups based on your needs and triggers.

How long does an eczema flare-up last? 

This varies depending on the severity of the flare and the effectiveness of your treatment plan, with optimum management you should be able to take control of your skin in three weeks.

How do I identify what triggers my eczema flare-ups?

This is not a simple task and unfortunately, there isn’t a quick answer, the best way to identify your triggers is through keeping an eczema diary. By recording your symptoms on a daily basis while simultaneously documenting your activities, diet, season, weather, stress etc you should be able to identify trends associated with your flares. You may already be aware of general trends such as your skin worsening in winter, or improving in summer. It can also be helpful to actively remove common triggering allergens such as dust and feathers by using hypoallergic pillows and seeing if your skin improves.

What are some common irritants that can cause eczema flare-ups?

Common triggers include irritants such as:

• Soaps and detergents
• Shampoo
• Washing-up liquid 
• Bubble bath.

Can stress cause eczema flare-ups? 

In short, the answer is yes. The relationship between stress and eczema is complex, stress impacts our immune system and it also alters our perception of symptoms such as itchiness. Itchiness leads to scratching, and damage to the skin which can trigger the itch-scratch cycle. 

How does weather affect eczema? 

Given one of the core features of eczema is increased water loss from the skin, anything that exacerbated this can affect eczema. Dry weather, heat and wind can all exacerbate water loss and trigger flares. Generally, winter tends to be a worse period for eczema, due to cold and dry conditions, in the summer increased humidity reduces water loss along with increased sun exposure which suppresses inflammation in the skin.

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• Alcohol & Eczema
• Stress & Eczema