Learn about the five types of hand eczema, how doctors diagnose it, current treatment options, as well as medications in development.
Published On: Sep 30, 2022
Last Updated On: Oct 7, 2022
Life with eczema can sometimes seem like an endless search for triggers. And though we’re often familiar with the culprits that cause our skin to flare, sometimes they remain a mystery. Eczema triggers look different for everyone and, over time, your usual triggers can fluctuate and change. The next time you experience an unexpected flare, keep in mind these five surprising eczema triggers.
Living in an area with high pollution can trigger an eczema flare. Major metropolitan areas that receive low rainfall and have warmer weather, such as Los Angeles, tend to have lower air quality. This combination keeps air stagnant and increases the number of irritating particles in the air.
“As far as triggering eczema, it is likely more particulate matter landing on the skin than breathing it in,” explained Dr. Anna Fishbein, associate professor of pediatrics at Northwestern University’s Feinberg School of Medicine. “Investing in a simple HEPA filter can clear pollutants in the air of your bedroom and potentially help your skin.” Wildfires that now dominate much of the West Coast during late summer also pollute the air and can trigger an eczema flare. Watch out for increased dryness and itchiness if you find yourself in more polluted environments and make sure to have lotion handy at all times.
Viral illness is one of the most common triggers that most people don’t realize is causing their eczema to flare, Dr. Fishbein noted. “If you get something like the common cold, it can cause all the inflammation in the body to uptick, which also causes eczema inflammation to uptick on the skin where it is visible as a general eczema flare.”
The herpes simplex virus, for example, is most identifiable by its primary symptom: cold sores. For people with more vulnerable skin barriers, however, a viral illness that impacts the skin can cause pre-existing patches of eczema to swell and itch. Molluscum contagiosum, which produces small, raised bumps on the skin that can turn red or pink, and eczema herpeticum, a painful, blistering rash that can accompany a herpes virus, are other viral illnesses Dr. Fishbein cautions can aggravate existing eczema symptoms.
Exams, recitals, championship games and work presentations — any event that increases your level of stress can trigger an eczema flare. “All my college students flare during finals,” shared Dr. Fishbein. “It’s amazing (and true) how much our mental health plays into our skin health. Even one night of bad sleep increases inflammatory cytokines and can trigger a skin flare.”
Earlier this year, researchers noted that both acute and chronic stress can weaken our immune systems and increase inflammation. When a flurry of cortisol, cytokines (small proteins that control immune system cells) and hormones encounter an already compromised skin barrier, they can prompt an eczema flare. The next time you’re surprised by a new rash or two, be aware of your current mental health and take necessary steps to reduce your stress.
Extreme temperature changes can also provoke a flare. Whether you’re spending time in an air-conditioned home on a hot summer day or transitioning to cooler fall weather, a sudden drop or increase in temperature can be the underlying cause of an eczema flare. “Some people have skin that is sensitive to temperature shifts, which might be related to nerve endings or receptors in the skin that, when exposed to major temperature shifts, will trigger a general eczema flare,” noted Dr. Fishbein.
Most often, shifts to cold weather that dry out the skin can trigger eczema symptoms. As humidity levels fall in winter, the moisture in the air decreases, which can inflame already dry and sensitive skin. Notice which temperature settings are more soothing to your skin and prepare to combat the effects of the upcoming cooler weather with loose-fitting clothing and a non-irritating moisturizer.
Turning your hair a new, vibrant color to match your costume seems a fun prospect until dry, itchy patches begin to form on your scalp. Hair dye is a common but often unexpected trigger for eczema. A chemical compound in many types of hair dye, p-phenylenediamine (PPD), can cause allergic reactions in many people, but can trigger worse symptoms, such as excessive itching and flaking, for those with eczema.
“Atopic individuals are at an enhanced risk for cosmetic contact sensitivity because of increased allergen penetration through impaired skin barriers,” cautions researchers from a 2015 study investigating the connection between PPD and allergic reactions. Before you reach for that box of dye on the shelf or head to the salon, check the list of ingredients.
NEA’s free app, EczemaWise, can help you keep track of your triggers and work with your doctor to get to the bottom of what’s making you flare.