Just when you think the redness, dryness and itchiness have finally gone away — there it is again. You look down at either your finger, wrist or elbow and another eczema flare-up has popped up.
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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? Eczema, also known as atopic dermatitis, may be common, 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 an eczema 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 these triggers are interacting with your skin so you can more easily identify them.
As Dr. Anthony points out that 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:
The first type of trigger that can cause an eczema flare-up is allergic contact. This trigger can be a bit tricky to identify because it 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. “Things like dust, pollen or pet fur can set off hay fever or other allergic reactions, including flare-ups,” he adds. For this kind of allergic reaction, an allergist would need to identify the causes and how to move forward.
This 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 says. “The harsh cleaner or solvent takes all the fat and oil out of the skin and damages the skin barrier.”
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 an eczema flare-up
There’s an array of treatments that are 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 explains. “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.”
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.
- Phototherapy (light therapy).
Additionally, lifestyle adjustments and proper skin care will help relieve and prevent your eczema flare-ups.
How to prevent 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.
Keep your skin moisturized
The first step may not come as a surprise to you. Even if your flare-up has calmed down, it’s important to keep up with a good moisturizing routine. Especially if you’ve identified one of your above triggers relating to temperature or weather, have a trusty lotion with you at all times to keep your skin well moisturized.
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. No matter what you choose, Dr. Anthony recommends you go for a bland, thick moisturizer that’s fragrance-free and has a short ingredient list. This is especially helpful for hand eczema.
If you get eczema flare-ups on other parts of your body, Dr. Anthony recommends using lotion after your bathing routine — so right when you get out of your shower and your skin is still wet, apply some lotion or cream to trap in that moisture right away.
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.
Adjust your shower routine
If you’ve fallen behind on your shower routine because each time the water touches your eczema it flares up, you may be wondering if there’s a way around this. Of course, we all still need to shower. But 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.
Avoid chemicals, fragrances and other irritants
A dermatologist is a great partner in identifying what your triggers are. But if you’re looking to test it out on your own, pay attention to the different products you’re using — like makeup, soaps, deodorants, etc. — and see if you can replace these with gentler alternatives.
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. As Dr. Anthony advises, the best thing you can do is pay attention to your soaps and bathing products. Go for simpler products with fewer ingredients and fewer perfumes.
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. But this varies from person to person, according to Dr. Anthony.
“If your skin tends to be more dry, the wintertime tends to be worse,” he notes. “But some people are irritated by things that happen in the summertime, like sweating. So, sports activities can sometimes flare up a person’s eczema.”
He recommends adjusting what you wear to help relieve your temperature-triggered eczema. For example, if you know you’re going to be working up a sweat, make sure you’re wearing breathable and loose clothing.
Wear loose clothing and fabrics
Do certain fabrics cause your eczema to flare up? 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.
Even the tightness of your clothing can have an impact on your skin’s sensitivity. Try wearing looser clothing, especially if your flare-up tends to be triggered by sweating and hot weather.
Decrease stress levels
Do you notice that your eczema starts to itch or get inflamed right before a stressful test or ahead of an intense meeting at work? It turns out that stress can be a cause of eczema flare-ups as well.
Like many things, stress and anxiety can have a big effect on your skin. While stress and its connection to eczema flare-ups can be difficult to measure, it’s worthwhile to check in with yourself to see if it could be a contributing factor. Plus, an eczema flare-up itself can be a cause for stress, which can add to its cyclical nature.
Relieving your stress will depend on what works best for you. 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.”
Evaluate your diet
Your diet may, in some cases, impact the frequency and severity of your eczema flare-ups, too. Especially 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, the Mediterranean diet or a gluten-free diet, but it’s important to consult your healthcare provider first.
When to see a healthcare provider
A lot of you dry-skin warriors reading this have probably shrugged off their 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.
- 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.”