Here’s Why Your Eczema Keeps Flaring Up

Just when you think the redness, dryness and itchiness have finally gone away — there it is again. You look down at your finger, wrist or elbow, and another eczema flare-up has popped up.

You probably have your trusty petroleum jelly at the ready to alleviate your eczema’s dryness, but wouldn’t it be great if you could just stop the flare-up before it hits?

Atopic dermatitis is the most common type of eczema, but that doesn’t make it any less tricky to manage. The key is knowing your specific triggers and making necessary changes to avoid future flare-ups.

Dermatologist John Anthony, MD, explains why these flare-ups come up in the first place and how you can take steps to prevent them.

What is an eczema flare-up?

An eczema flare-up can be characterized not only by how it looks, but also by how it feels. You’re probably experiencing an eczema flare-up if one or more areas, like your hands, feet, chest or neck, break out in an itchy or dry rash.

More specifically, an eczema flare-up can include symptoms like:

• Inflamed red, gray or brown patches on your skin
• Flaky, dry or cracked skin
• Extremely itchy skin that gets worse at night
• Blistering or bleeding
• Small bumps that crust over and leak fluid

These symptoms can occur for several weeks and then go away, or they can last for even longer in some cases. But for many, flare-ups tend to come back around like a spiral, usually in conjunction with a specific irritant, allergy or trigger.

What causes eczema to flare up?

Your healthcare provider may have asked you to pay attention to any patterns you see in your flare-up. Does it happen when the AC or heater is blasting in your room? When you go swimming in a chlorine pool? Or maybe when you use a scented hand lotion?

This will all depend on what triggers your eczema — which can sometimes be a combination of factors. So, before we get into the specific triggers and how to avoid them, it’s good to know how they interact with your skin so you can more easily identify them.

As Dr. Anthony points out, there are also different types of triggers or “contacts” that can cause an eczema flare-up. The two types of eczema flare-up triggers are allergens and irritants.

Allergens can be a bit tricky to identify because they can be an allergen in something like a specific ingredient in a soap, bubble bath or shampoo.

“This involves reactions to things like hair dye, and preservatives and fragrances,” Dr. Anthony says. “And with this one, we really have to figure out what they are specifically with patch testing.”

In addition, some people may also find that their eczema flares up when other allergies are worsened. For this kind of allergic reaction, an allergist would need to identify the causes and how to move forward.

Some common allergens that can trigger eczema flare-ups include:

• Dust
• Pollen
• Pet fur
• Cold and/or dry weather
• Hot and/or damp weather

The next type of trigger is much more common and it’s called irritant contact. “This involves things like friction when washing your hands and drying them out or using a cleanser that's harsh,” Dr. Anthony explains. “The harsh cleaner or solvent takes all the fat and oil out of the skin and damages the skin barrier.”

Some common irritants that can cause eczema flare-ups include:

• Soaps or cleansers
• Shampoo
• Detergents
• Body wash

It’s also important to note that an irritant contact trigger can weaken your skin to the point that it makes you more susceptible to an allergy. “The irritant not only causes a rash, but it also makes it more likely for you to become allergic to that irritant as well,” he says.

You should speak to your dermatologist or healthcare provider to help figure out which (if not both) kinds of triggers you’re experiencing. This will affect what steps you take to prevent future flare-ups.

Treatments for calming an eczema flare-up

How can you put the brakes on this cycle? The key approach is to take good care of your skin even after an eczema flare has gone away or subsided. It’s also important to see a dermatologist to determine whether you need to apply specific prescription creams to treat a particularly bad flare-up.

Combined with lifestyle changes, eczema flare-ups are commonly treated with:

• Topical corticosteroids
• Topical calcineurin inhibitors like pimecrolimus or tacrolimus ointment
• Immunomodulators
• Phototherapy (light therapy)

There’s an array of treatments used to treat eczema. This can range from over-the-counter creams and lotions to prescription medications.

“Our goal is to help restore the skin barrier,” Dr. Anthony states. “When the skin is inflamed, it’s partly a result of the skin barrier being compromised. And it allows things to penetrate a little more and for things to be more irritating. So, it ends up being a vicious cycle.”

Tips for preventing an eczema flare-up

Additionally, lifestyle adjustments and proper skin care will help relieve and prevent your eczema flare-ups.

Preventing eczema flare-ups is a combination of what you do as well as what you avoid, says Dr. Anthony. If you’re dealing with on-and-off visitation from eczema, you may be wondering if there’s a surefire way you can stop it from ever hitting again.

1. Use a lotion or moisturizer. Even if your flare-up has calmed down, it’s important to keep up with a good moisturizing routine. There are a lot of moisturizing products out there, but you can go for either a lotion, cream, ointment or oil to keep your skin moisturized. But Dr. Anthony recommends you go for a bland, thick moisturizer that’s fragrance-free and has a short ingredient list.
2. Moisturize after bathing. If you get eczema flare-ups on other parts of your body, Dr. Anthony advises using moisturizer after your bathing routine — so, when you get out of your shower and your skin is still wet, apply some lotion or cream to trap in that moisture immediately.
3. Use a humidifier. For bedtime, it’s also a good idea to use a humidifier in your bedroom, that way, it can moisten the air and your skin while you’re sleeping.
4. Adjust your shower routine. Dr. Anthony recommends trying to be mindful of your water temperature. Avoid taking extremely hot showers and try using a gentler water pressure setting, if possible.
5. Avoid chemicals, fragrances and other irritants. If you’ve noticed that your strawberry-scented soap or new foundation is coinciding with redness and cracking around your skin, switch out these products for gentler versions. Go for simpler soaps and bathing products with fewer ingredients and fewer perfumes.
6. Note temperature and weather. If you’ve dealt with eczema in the past, central air conditioning and heating might be one of your biggest enemies. “If your skin tends to be more dry, the wintertime tends to be worse,” Dr. Anthony notes. “But some people are irritated by things that happen in the summertime, like sweating.”
7. Wear loose clothing and fabrics. If your flare-up seems to coincide with every time you’re wearing your thick wool sweater, try switching to a gentler fabric and see if your flare-ups improve. Try wearing looser clothing, especially if your flare-up tends to be triggered by sweating and hot weather.
8. Manage your stress levels. Try stress-relieving activities that will help you be more mindful and in the moment, while also not triggering another eczema flare-up. Simple techniques like meditation or light yoga can be a good start for relieving your stress. “Stress can certainly make eczema a lot worse,” says Dr. Anthony. “And it’s not just about your skin, but your overall wellness.”
9. Evaluate your diet. If your eczema flare-ups are due to allergy contact due to certain foods, ingredients or spices, it’s important to figure out what you need to adjust your diet. You may benefit from an anti-inflammatory diet, or another specialized diet, but it’s important to consult your healthcare provider first.

When to see a doctor

Many of you dry-skin warriors reading this have probably shrugged off your eczema flare-ups at times as a “deal with it later” kind of problem. But it’s helpful to get ahead of the flare-ups before they get to a painful point. Even mild eczema flare-ups over a long period of time can affect your well-being, and seeing a healthcare provider can help.

Other signs that you need to see a provider for your eczema flare-ups include:

• Increasingly more painful flare-ups
• Crusting
• Weeping crusting that’s different
• Sleep disturbances
• The flare-up is rapidly changing and spreading to other areas
• It interferes with daily activities such as eating, hygiene or work
• You’re avoiding making plans or socializing due to fear of the next flare-up

“You might see a dermatologist or an allergist,” says Dr. Anthony. “We all work together to try and figure out if there are any factors you can modify in your lifestyle. And sometimes, there isn’t — so it’s good for people to know that recently there are new medications to treat eczema.”