It's not always the obvious ones.

By Hana Hong
July 14, 2020
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Eczema is an enigma. I’ve spent the entirety of my life haphazardly slathering on thick body lotions, eliminating certain foods, and vacuuming my poor carpets to death, yet the itchy patches always resurface like an annoying ex that just won’t quit. Apparently, I’m not alone, either—more than three million people suffer from inflammation and red itchy skin due to a number of factors. We all know the common culprits—scratchy fabrics, drying soaps, and fragrant skincare—but because triggers vary from person to person, it’s impossible to pinpoint the exact reason for your flareup. To help identify what may be angering your sensitive skin, I rounded up some of the less common culprits that I’ve found to provoke my patches, and tapped some top dermatologists to explain why that may be the case. Here’s what I learned.

1

One of my favorite pastimes is simmering in a hot sauna, but while I would leave feeling more relaxed, I would also leave with more aggravated skin. According to Dan Belkin, MD, a board-certified dermatologist in New York City, heat is not necessarily a trigger, but its effects can take quite the toll on your skin. “If it's arid heat, it may contribute to water loss and dryness. The resulting sweat can also act as an irritant that affects the microflora of the skin and feeds into the eczema cycle,” he says.

Same goes for cold temperatures. According to Jeannette Graf, MD, a board-certified dermatologist and assistant clinical professor of dermatology at Mt. Sinai School of Medicine, extreme cold decreases the relative humidity in the air, worsening dry skin and triggering eczema. Try avoiding areas or treatments that expose your body to heat or cold for extended periods of time (including saunas, sadly) and limit exercise to cooler times of the day. 

2

As if heat being an eczema trigger isn’t annoying enough, standing in front of an air conditioner isn’t going to do your skin any favors either. The year in college I spent with my air conditioning vent right above my dorm bed was probably the worst facial eczema I had in my life. Why? According to Sheila Farhang, MD, a board-certified dermatologist and founder of Avant Dermatology & Aesthetics, not only can air-conditioning create a dry environment, leading to trans-epidermal water loss in your skin, there may be higher dust particles if A/C filters are not changed regularly. If you have also no choice but to sleep directly in the path of an air conditioner, Paru Chaudhari, MD, a board-certified dermatologist in California, recommends setting up a bedside humidifier to help counteract the moisture being sucked from your skin. 

3

Like most people, I prefer taking long, hot showers (the steam helps me de-stress, OK?). Unfortunately, you will have to sacrifice your steamy shower session if you want to save your skin barrier. “Imagine if it rained every day on your house and you didn’t maintain the paint. The paint would wear off and peel and the insulation would decrease. In addition, rust and erosions would develop. That is your skin with too much water—especially if it’s hot water pounding on it daily,” says Dr. Graf. Since hot water strips the skin of its natural moisturizing oils, the derms all recommend short, lukewarm showers. “If moisturizer is applied within a few minutes of exposure to lukewarm water, a shower can actually enhance moisture and help with eczema,” adds Dr. Belkin.

4

“Airborne dust consists of particles in the environment such as pollen, dust mites, and pet dander, which act as allergens and cause an eczema flare-up,” says Dr. Graf. This is possibly the trickiest eczema trigger because, well, it is literally impossible to avoid dust. However, using mattress and pillow covers, cleaning rugs (or getting rid of them entirely), and vacuuming frequently will help. And a good air purifier—my favorite is Coway Airmega AP-1512HHS Air Purifier ($272; amazon.com)—also works wonders. 

5

Exam week, busy workday, big presentation: anything that triggered stress also meant I could expect itchy patches. This pattern isn’t coincidental. As it does with pretty much everything, stress can indeed make eczema worse. “The effect this has on skin is multifold,” says Dr. Farhang. “Stress increases cortisol (stress hormones), which in turn causes an uptick of inflammation in the body. Because glucocorticoids (another stress hormone) causes a disruption of the skin barrier function, stress also leads to a weakened skin barrier.” To make matters worse, thanks to my excoriation disorder, I itch my skin more when I’m stressed, which will only make eczema angrier. Try sneaking in mindfulness practices throughout your day, and come up with a comprehensive plan with stress reduction techniques to help manage oncoming anxiety.

6

First and foremost, it’s important to distinguish between food allergies and eczema. If you find that your skin rash only comes when eating a certain food (and subsides quickly after), you may want to consult your doctor about a possible food allergy. On the other hand, research has found even food that you’re not allergic to can exacerbate existing eczema. If you notice your eczema worsening with certain foods, Justin Gordon, MD, a board-certified dermatologist in California, recommends keeping a food journal to track how your skin reacts with different things.

7

According to Dr. Farhang, chemical sunscreen may exacerbate eczema due to ingredients that play a role in UV protection. But do NOT take this to mean you should avoid SPF. Physical sunscreens don't tend to trigger my skin, and the market is chock-full of sunscreen brands specifically targeted towards eczema and sensitive skin sufferers. You’ll just have to do a bit of experimentation to find what works best for you (this guide might help).