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Those who’ve battled eczema since childhood have a type called atopic dermatitis, which is genetic. But if you experience your first flare-up as an adult, you likely have another variety that’s caused by an external irritant, and a dermatologist can identify your triggers to help you soothe your skin. The usual suspect? Contact dermatitis, says Alisha Plotner, MD, a dermatologist at The Ohio State University Wexner Medical Center. Another common type is nummular dermatitis, which appears on the lower legs as coin-shaped sores, and is more likely to affect older adults, she says. (Lose up to 25 pounds in 2 months—and look more radiant than ever—with Prevention’s new Younger In 8 Weeks plan!)
Here, dermatologists reveal 6 things your eczema might be telling you. (And always follow up with a visit to your doc.)
“It’s not uncommon for people with eczema to have a flare-up during the summer” when pollen levels are at their highest, says David E. Bank, MD, a board-certified dermatologist and founder and director of The Center for Dermatology, Cosmetic & Laser Surgery in Mt. Kisco, New York. But resist the urge to itch, he advises, or you’ll make skin even more inflamed and irritated. Instead, apply hydrocortisone cream and gentle, fragrance-free moisturizers like Cetaphil Restoraderm. “Preventing and reducing flares of eczema is really about repairing the barrier function of the skin,” Bank says. “This means minimizing things that can strip the skin, like harsh cleansers and hot water in the bath or shower, and helping to maintain and sustain the water that is already in the skin.”
“Skin irritants, such as itchy clothing, harsh cleansers, or even sweat, will trigger the inflammatory cascade that leads to eczema,” says Jessie Cheung, MD, a dermatologist at Jessie Cheung Dermatology & Laser Center in Willowbrook, IL. “The first step to determining possible eczema triggers is to avoid common irritants such as strong soaps, wool, and fragrances.”
Your derm can help eliminate the guesswork by doing patch testing to identify reactions to specific allergens, Plotner adds. Some common offenders she sees: metals (like those found in your smartphone), fragrance, certain preservatives, and antibiotics in topical ointments like Benadryl or Neosporin.
When you’re allergic to a certain food, such as soy, or have intolerance to, say, dairy, ingesting those foods can cause an eczema outbreak. If you suspect something in your diet is to blame, Cheung recommends visiting an allergist, who can perform an oral food challenge in a supervised setting. Balancing gut bacteria with fermented foods and probiotics can also help tame inflammation and eczema flares, she says. “I also recommend taking supplements with vitamin D and zinc, which modulate the immune system and the body’s inflammatory response. And eating foods rich in omega-3 fatty acids will help to support the good gut bacteria, and they help us absorb nutrients.”
“Eczema often flares in the setting of stress. No one knows why, but it is very common,” says Abby Van Voorhees, MD, chair and professor of dermatology at Eastern Virginia Medical School. “Patients often note that as they get more tense their skin gets itchier. Then they start scratching and the cycle begins.” To break it, find relief with topical corticosteroids like Cortaid or Cortizone 10, says Plotner, but stay away from antibiotic ointments like Neosporin, which can irritate skin.
Cold weather provokes eczema because the dry air sucks the moisture out of your skin. “It’s important to cover all areas of exposed skin during the colder months,” says Joel Schlessinger, MD, a board-certified dermatologist andRealSelf advisor. “Even when you’re not outside, cranking up the heat in your home can have a similar effect. Running a humidifier can restore moisture to the air around you and help ease eczema symptoms.” But be sure to set yourhumidifier below 60% humidity, Schlessinger advises, otherwise condensed moisture can lead to harmful bacteria growth. To combat winter bouts of eczema, Bank also suggests taking 5- to 10-minute warm (not hot!) showers and washing the skin with a gentle cleansing bar like Aveeno Moisturizing Bar. (And avoid these bad habits that make winter skin even worse.)
In rare cases, a bacterial infection could spur an eczema flare-up, as well as more serious complications like cellulitis, says Plotner. Though eczema doesn’t typically signal a larger whole body issue, it’s always best to play it safe and see your doctor if your skin condition isn’t improving with minor treatment.
Stasis dermatitis, a form of eczema provoked by swelling of the lower legs, could be a symptom of something worse, such as the inflammation associated with congestive heart failure, says Plotner.