• Reviewed on 12/12
    By Dr. Boguniewicz

Atopic Dermatitis (Eczema): Lifestyle Management


Avoid Things that Make Itching and Rash Worse

There are many things that worsen the itching and rash of eczema (atopic dermatitis). These are different for each person. It's important to work closely with your healthcare provider to try to figure out what makes your itching, rash, and other symptoms worse. Common irritants include: 

 

Itch-Scratch Cycle
Almost everyone with atopic dermatitis has had itchy skin at some time. It is not known why skin feels itchy. What is known is that scratching or rubbing leads to even itchier skin. This is called the itch-scratch cycle. Scratching and rubbing irritates the skin and can cause or worsen the rash. Over time, scratching and rubbing may cause thickening of the skin.

Actions you can take:

  • Keep fingernails very short, smooth and clean to prevent damage from scratching.
  • Apply moisturizer when you feel itchy, instead of scratching or rubbing.
  • Use medicines prescribed by your health care provider.
  • Keep hands busy.

Many things can make the itch and rash of atopic dermatitis worse. These are different for each person. Ask your healthcare provider about what makes your itching or rash worse. Irritants, extremes of temperature and humidity, allergies, emotions and stress can worsen itching and rash. Infections and extremely dry skin also can be a problem.

 

Chemical Irritants
Things that cause burning, itching or redness are called irritants. Chemicals, solvents, soaps, detergents, fragrances, ingredients in skin care products, some fabrics and smoke are things you may need to avoid. Your healthcare provider may recommend special patch testing to see if products you use or are exposed to may be causing an allergic skin reaction.

Actions you can take:

  • Wash all new clothes before wearing. Formaldehyde and other irritating chemicals are present in new clothing.
  • Wear cotton or cotton-blend clothing that may be less irritating than other fabrics. Remove labels if they bother you. If seams cause itching, try wearing clothes inside-out while at home. Avoid wool and irritating fabrics.
  • Use fragrance-free, dye-free liquid detergent, if laundry detergent is irritating to you. A second rinsing may help remove residual laundry detergent.
  • Avoid sunburn. Use a sunscreen with SPF 15 or higher. If your sunscreen is irritating, try different products or sunscreens made for the face.
    Sunscreens that have been tolerated by people with atopic dermatitis include:
    • Eucerin® facial sunscreen SPF 30
    • Vanicream® SPF 35 or 60
    • Neutrogena® Sunblock SPF 30
  • Shower or bathe after swimming or using a hot tub. Use a mild cleanser for sensitive skin to remove chemicals and apply moisturizer.

 

Temperature and Humidity
Extremes of temperature and humidity can be a problem for people with atopic dermatitis. Sweating caused by overheating and high humidity can irritate the skin. Low humidity causes water to be lost from the skin. This can lead to dryness and skin irritation.

Actions you can take:

  • Try to keep your surroundings at a comfortable temperature and humidity.
  • Wear loose fitting, open-weave clothing during hot weather and exercise.

 

Allergens
If you have a reaction to something you touch, breathe or eat, you might have an allergy. Allergies can trigger or worsen your atopic dermatitis symptoms. Common allergens are:

Allergy testing may include skin testing, blood tests or patch tests. Many measures can be taken to avoid things to which you are allergic. Although many of the measures can be done for the entire home, the bedroom is the most important room to make skin friendly. Talk with your healthcare provider about what measures you can take to avoid your allergens.

 

Food Allergies
Food allergies may be the cause of itching or rash that occurs immediately after eating, especially in children. Some common food allergens include milk, eggs, peanuts, wheat, nuts, soy and seafood. Most people are allergic to only one, two or at the most three foods. Positive allergy tests do not always indicate clinical allergy. An allergy specialist can help sort this out. Food challenges may need to be done under medical supervision. Be aware that diet restrictions can lead to poor nutrition and growth delay in babies and children, so talk with your health care provider about maintaining a well-balanced diet.

 

Emotions and Stress
Emotions and stress do not cause atopic dermatitis, but they may bring on itching and scratching. Anger, frustration and embarrassment can cause flushing and itching. Day-to-day stresses as well as major stressful events can lead to or worsen the itch-scratch cycle.

Actions you can take:

  • Learn as much as you can about your disease and how to manage it.
  • Allow family members and friends to be supportive.
  • Learn coping and relaxation skills.
  • Ask your health care provider if you need help dealing with emotions and stress.

 

Infections
Skin infections are often a problem for people with atopic dermatitis. Infectious organisms (bacteria, viruses, fungi) are often present in higher than normal numbers on the skin. Skin that has been scratched or has a rash is more easily infected. Signs of skin infection include:

  • Increased redness
  • Pus-filled bumps or oozing
  • Cold sores or fever blisters

Actions you can take:

  • Call your health care provider right away if you have any signs of infection.
  • Follow your health care provider's action plan to treat the infection.

NEXT: Action Plan

BACK: Soak and Seal

 

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