Managing Eczema Flares

Table of Content

Introduction

Flare is a term commonly associated with Eczema. What is a Flare? A ‘flare’ or ‘flare-up’ is a term used in both medical and non-medical literature to refer to an exacerbation of a disease. Once someone has a flareup they start searching for a remedy to cure the flares. But perhaps it is more important to know what caused the flareup in the first place because as the adage goes “Prevention is better than cure.” Usually, Eczema flares are caused by some triggers.  There is a list of commonly known triggers. Avoiding these common triggers can prevent a flare-up and the associated symptoms.  Once you know what triggers flare your eczema, the best thing to do is to avoid those flares.

What Causes a Flare?

“What caused my Eczema to flare”, this is a question that bothers Eczema sufferers the most. It is very important for each individual to determine what causes their Eczema to flare or in other words what are the triggers that affect them the most. Usually, triggers are something that you encounter such as a certain type of clothing or something in the weather such as pollen or something that you have consumed.  Triggers are not the same for every individual. Different triggers may cause a flare in different people. Some of the most common triggers are intense sweating, scratchy woolen clothes, pet dander, hot or cold weather, harsh soaps, and cleansers.

It’s very hard to say accurately what is the exact cause of eczema for an individual. Probably the genes play a vital role. If your parents are prone to Eczema flares, you may be, too. Another reason could be a weak immune system that fails to defend the body from attacks of external factors ultimately causing a flare. This is common for both Atopic Dermatitis and Contact Dermatitis wherein the former is more thought of chronic condition and the later though not chronic as Atopic Dermatitis but occurs only when your skin touches an irritant. Nevertheless, both types get flares from Eczema triggers.

Eczema Flares are common in babies and kids too. Eczema Flares are more troublesome at younger ages because babies have very sensitive skin and it is hard to prevent children from scratching themselves. Quite often children grow out of Eczema as they grow up. It is very well known that Eczema cannot be cured. However, Eczema can be managed by reducing the number and severity of Eczema flare-ups.

How to effectively manage Eczema Flare-ups?

As mentioned earlier it is very important to try to reduce Eczema flareups by knowing and avoiding your triggers.

Prevention Measures to avoid Eczema Flares

Avoid Irritants: There are certain products that cause Eczema flares when they touch your skin. These could be cleansers, perfumes, laundry detergents, soaps or food items. To know what product actually causes your Eczema to flare, you will have to track the products and do elimination trials which means that eliminate a product from your daily routine or diet for some time and see if that helps your Eczema. It is safer to switch to odorless and colorless soaps, cleansers, or laundry detergent.

Indoor Pollutants: Often tiny particles in the environment can cause your eczema to flare. Some of these are Dust, Cigarette Smoke, Pet Dander, Mould, etc. It is always good to maintain hygiene at home and work. Dust regularly, avoid pets if you are allergic to them, quit smoking or hanging out with those who do.

Clothing: One of the common triggers and perhaps the closest one that irritates your skin are your clothes. Avoid Scratchy woolen clothes, wear breathable fibers avoiding multiple layers or the heavy ones which make you sweat.

If your skin type is dry take extra efforts to keep it moist. Use body lotion soon after the bath, use moisturizer two or three times a day. Maintain a good humidity level in your bedroom while sleeping to keep the air moist. Drink plenty of water to keep your skin hydrated.

Winter: Dry air combined with indoor heating systems robs the moisture from skin making it dry and more prone to eczema flares. Use a thick moisturizer immediately after a shower to lock moisture in the skin, avoid hot baths and keep it short (use lukewarm water). Avoid rubbing your body with rough towels, pat dry instead. Use a humidifier to maintain the humidity level and curb dry heat pumped by the heating systems.

Treating Eczema Flares

Topical Steroids: Over the counter steroid creams are vital in reducing the red, itchy flares. If they don’t work you may need a stronger dose that can be availed with the help of a physician.

Moisturise: Keep your skin moisturized as much as you can. It softens your skin relieving pain and reducing the eczema flare especially if it is caused by dry skin. Have plenty of water and other liquids to keep your skin hydrated.

Take a Bath: A look warm bath may give you relief during flares. But remember, keep the bath short (not more than 10 mins). Apply moisturizer soon after your bath so as to seal the moisture of the skin and preventing it from drying.

Avoid Scratching: Scratching usually damages the skin, which can itself cause more flares to occur. Try to reduce scratching whenever possible. You could try gently rubbing your skin with your fingers instead. Keep your skin covered with light clothing to reduce damage from habitual scratching.

Wet Wraps:  Designed for Eczema special medicated bandages, clothing or wet wraps can be used to cover the areas of flared skin. These bandages can be used over emollients or with topical corticosteroids to prevent scratching allowing the skin underneath to heal locking the skin moisture.

Antihistamines: If you have severe itching you can have a dose of Antihistamine as recommended by the physician especially during bedtime. Consider the side effects before consuming.

Care Plan: Maintain and follow a care plan created by either you or as recommended by your physician. It is very critical to take necessary action at the recommended time to overcome and manage flares effectively.

For timely recognition of flares and informed treatment decisions during clinic visits, guidelines advocate tracking of the disease by
a) monitoring possible triggers (e.g. allergens),
b) recording disease severity including specific symptoms and signs
c) response to therapy
Atopic dermatitis. The New England journal of medicine 2005; 352: 2314-24.

Manually maintaining detailed records of the triggers that you are being exposed to can be time-consuming. Also, it is important to record the regimen you are following and how well you are adhering to it. Traditionally people have maintained a paper diary to keep these records. Recently Health-Tech Companies have come up with Eczema Managing apps available that allow you to maintain digital records, tracking your regimens and triggers.

Visit a physician:

If your Flares don’t respond to your care plan, do not hesitate to visit your General physician. The Physician may recommend other topical or oral and may also recommend a referral to a dermatologist who can take a few tests and prescribe recommended medications.

High Humidity a warning alarm for Eczema

High Humidity and Eczema

People suffering from eczema are susceptible to extreme weather conditions. Skin affected with Atopic Dermatitis loses its capability of adapting to different conditions with a poor tolerance for extreme weather. Humidity is one of the vital factors in the environment, to which skin reacts almost immediately and it plays a major role in how your body handles eczema. Humidity in its extreme, no matter if it is low or high is usually a problem for Eczema. Low humidity dries the skin, especially during winter months whereas high humidity in hot temperatures may result in prickly heat-type symptoms, making eczema-prone skin itchier and more irritated resulting in a flare-up.

Effects of High humidity on Eczema

In hot and humid weather, the natural defense mechanism of the skin comes into action. To tackle the heat and keep body temperature under control, skin perspires releasing sweat. The level of sweating differs from person to person and also depends upon the extremity of the temperature. As the sweat mostly consists of water it gets evaporated cooling the body. However, sweat also consists of salts such as sodium chloride and traces of other elements such as zinc, nickel, copper, etc. which remain on the skin leading to irritation on the skin causing eczema to flareup. Moreover, the hot temperature itself can be very irritative for sensitive skin of eczema sufferers worsening the condition and triggering the itch cycle.

How to Handle Excessive humid conditions? 

How to manage Eczema in Humid condition

 

Avoid sweating conditions 

Sweating is the leading cause of Eczema Flares in hot and humid conditions. Avoid activities and situations that cause you to sweat a lot. If it is unavoidable than take shower soon after the activity causing you to sweat like a workout, playtime, etc. 

Prevent accumulation of sweat 

Body parts such as the back of knees and elbows are more prone to flareups because of the accumulating sweat in these areas which takes longer to dry. These areas should be wiped often using smooth wet clothes to avoid further irrigation or start of an itch cycle 

Wear breathable clothes 

Clothes play a vital role in the management of Eczema. Different types of clothes are suited to different weatherFor hot and humid climate, breathable cotton clothes are preferred. Also on hot weather avoid multi-layer clothing so as to prevent your body from heating up as it may cause you to sweat. Clothes made up of polyester, nylon or wool may irritate your skin and can cause an eczema flare. 

Maintain comfortable indoor condition 

Though you cannot do much about the external climatic condition, you can always control the conditions inside your home by using humidifier/dehumidifier and air conditioner, etc.  50% of relative humidity is ideal to prevent dry skin and to provide comfort for people suffering from Eczema. 

Avoid Allergens 

Take extra precaution if you suffer from an allergy. Hot temperatures usually tend to aggravate allergies. If you are allergic to pollen always keep a check on the pollen level in the air before you step out of the house and take necessary precautions. 

Monitor the temperature  

Keep a check on the temperature during daytime and avoid traveling or moving out of your house when the sun’s rays hurt you directly.  

Keep yourself hydrated 

Stay hydrated from inside to keep your skin moisture intact by consuming a lot of liquids including water, juices and other cold fluids as your body loses water in the form of sweat.  

UV Rays Boon or Bane for Eczema

Sunlight and Eczema
One of the challenges faced by people suffering from Eczema is the uncertainty in the timings of flares. For most people, Eczema flares show up without any prior warnings. While there is no complete cure for Atopic Dermatitis, knowing the triggers that evoke your symptoms may help in reducing the frequency of flares. Most people have their flares in winters and dry climate. Some people find that their eczema improves with exposure to sunlight while others experience a worsening of their condition. When exposed to sunlight, overheating may lead to excess sweating which when dries up leaves behind its salt content giving rise to itch and scratch cycle resulting in eczema flares. The type of Eczema which worsens when exposed to sunlight is called as photosensitive eczema.
 

Tips to Tackle sun  

  • Use an Eczema Safe Sunscreen with suitable SPF, when in sun for an extended period. 
  • Leave a gap between applications of emollient and sunscreen to avoid diluting the sunscreen 
  • Don’t be in the sun if it is strong especially between 11:00 am to 3:00 PM  
  • Use Hats, Shades and breathable cloths which can protect you from the sun but not heavy which may cause you to sweat. 
  • UV rays as a treatment for Eczema

In some cases, it is found that sun exposure improves eczema symptoms but the challenge is that you should be careful and do it in control. Studies reveal that exposure to sunlight triggers the release of a compound in the skin that alleviates the inflammation thereby easing the symptoms of Atopic Dermatitis.  

UV radiations from the sun can have damaging side effects too, including burning, aging and raising the risk of skin cancer. The trick here is not to overdo it. Sun exposure leads to increased vitamin D production, which can be great for the health of the skin. 

Due to the benefits of UV on eczema, it is used as a therapy wherein artificial UV waves very similar to the one produced by the sun are used to heal eczema flares. Exposure to UV waves has several benefits to the skin such as alleviating inflammation, inducing vitamin D, reducing itch, increasing the capability of the skin to tolerate foreign particles, etc. This therapy for Eczema using UV waves is called as phototherapy or Ultraviolet therapy for Eczema. 

Treatment 

Generally, dermatologist prescribes you phototherapy and is recommended only when all other treatment like applying emollients, steroids and other medications remain ineffective. The duration of the treatment depends upon the severity of the eczema symptoms. One is advised to apply moisturizer all over the body before exposure to UV lights.  The sessions may be reduced depending upon the response that one shows to UV therapy and can be stopped ultimately with a reduced cycle of once or twice a week. 

Managing Eczema in Dry Weather

Dry skin

The skin is the largest organ and the outermost layer of the body. It acts as a barrier to entry for foreign particles and is made up of cells containing water. Depending on our actions and surrounding conditions, pores in our skin allow water to evaporate. Weather conditions affect our skin and are hardest to control. Extreme weather conditions whether extreme heat or extreme cold and extremely dry or extremely humid, have a direct impact on people suffering from Eczema. In this article, we shall discuss the implications of dry weather conditions for Eczema sufferers.  

One of the most visible symptoms of Atopic Dermatitis is dry and scaly skin. It is well known that this condition in eczema worsens when the skin dries up. Dry weather combined with low temperatures especially in winters further worsens this condition causing eczema to flare. In other words, dryness acts as a trigger to cause a flare. Even people without eczema have an urge to scratch on waking up in dry weather 

It is very important for people suffering from eczema to retain skin moisture. When the weather is extremely dry, the air in the environment steals the moisture from the skin, drying it out and triggering an eczema flare-up. Moreover, alternating between cold and dry climate, when outdoors and indoors, can aggravate eczema symptoms. Often people find their dermatitis symptoms on parts of the body that are exposed to the weather elements 

How to manage eczema in dry weather? 

The best course to manage Eczema in extreme weather conditions is to make changes to your lifestyle. The quicker you adapt to the weather, the lesser the effect on Eczema. Custom care regimens given by doctors for individuals should take into account the effect of weather that the individual is exposed to.  

Managing eczema in dry weather

Moisturizing strategy 

One of the most effective, easy and cheap treatments is to use moisturizers abundantly. Moisturize skin at least twice a day. Lock the moisture in the skin to help hydration by applying moisturizer right after a bath on wet skin. This will help repair the skin barrier. Change your moisturizer strategy, especially in dry winter, use thick moisturizer instead of lotions (e.g. Petroleum jelly) soon after the bath and give a good amount of time for absorption. Though it may be tedious and time-consuming it ian effective strategy. Cover your hands and face with moisturizer before dropping out in the cold petroleum jelly and emollient can be used to cover the lips. 

Bathing  

Hot water baths heat up your body resulting in skin moisture being lost due to evaporation. Also, sudden changes in temperature may irritate skin. Use lukewarm water for bathing and keep baths short. Avoid harsh soaps with fragrance dye and alcohol, which can further dry and irritate the skin, rather use moisturizing soap. Moisturize immediately after a shower so that you can retain and lock the moisture. 

Comfortable clothes 

Use natural and fabrics and always try to dress in layers so that you can respond to changes in temperature. Do not dress too warm so as to cause a sweat which worsens Eczema giving rise to scratch and itch cycle. Avoid harsh and scratchy clothes especially woolen clothes which people wear to seek protection from cold 

Humidifier 

Generally during dry and cold weather, people use heaters and the heating system pumps in lot of hot air into the room. This hot air irritates eczema affected skin increasing the chance to flare. Use Humidifier to maintain the humidity indoors.  50% relative humidity is considered ideal for keeping eczema affected skin moist. Keep your house environment comfortable maintaining the temperature and humidity level so as to get sound sleep. 

Consume Liquids  

Even though you don’t feel thirst keep drinking water as our body tends to lose water via various processes as it is made up of 70% of water. Consuming liquids not only protect your skin from dry weather but also beautifies, gives a glow and keeps your skin supple and healthy. 

How to prevent skin allergies when pollen content is high?

Eczema Flares and Pollen content in the air

Atopic Dermatitis is a chronic skin condition that cannot be cured and has to be managed. The severity of Eczema varies over time and worsens due to some reasons which are called triggers.  There are different types of triggers and everybody is not affected in the same way by a trigger. When a person suffers from a breakout of Eczema i.e. the severity of Eczema worsens, she is said to be having a flareup.  

There’s a strong association between allergies and Eczema especially with triggers in the airCommon indoor triggers in the air include dust mites, pet dander, etc. Recent studies have also revealed a relationship between the development of eczema flares and Pollen content of the air. Pollen content and associated allergies are often seasonal and are most acute during the transition of spring to summer. 

Environmental allergens like pollen not only produce immediate allergic reactions but also interrupt the permeability barrier of the skin. The lipids released from pollen exhibit chemical and functional similarities to leukotrienes and prostaglandins (pollen-associated lipid mediators). They induce an immune response which exacerbates eczema symptoms causing flares. 

Pollen allergens enter the skin through hair follicles and generally can stay there up to 1 week. Hence, allergens penetrating the hair follicles may remain active for an extended period of time causing skin irritations and flares. 

Handling Eczema in High pollen content  

  • As the adage goes, prevention is better than cure. To prevent flares caused by pollen.

It is very important to know pollen content at your location or the place where you are planning to travel/visit so that necessary precautions can be taken.  

  • Tools such as EczemaLess which leverage AI can guide you with the pollen content of at your location and can give you a correlation between your flares and triggers. 
  • Studies have found that pollen triggers flares and exacerbates the symptoms only on the skin which gets directly exposed to it. So covering your body/skin completely while going out will prevent the direct contact of pollen to skin thereby avoiding the trigger and subsequent flares to a large extent. 
  • Avoid morning walks or being outdoor in the morning during spring as the pollen contents are high in the morning. Similarly, avoid freshly cut grass to prevent direct exposure to pollen in spring. 
  • Take a shower immediately after being outdoors for a while so that you can rinse off the allergens before they exacerbate any allergic reactions giving rise to immune response. 
  • If you the local pollen content is high keep your doors and windows shut to avoid this airborne allergen from entering your house. Keep your outdoor equipment and tools outside the house if not then at least outside your bedrooms so that you are not bringing pollen along with you in your resting place. 
  • Use Anti-allergy filters in your air conditioner to limit the exposure to pollens indoors. Using Air condition also help to keep the temperature in check thereby reducing the chance of sweat and ultimately itching.  
  • Do not forget to follow your daily care routine of applying moisturizers, wet wraps, showers, etc along with the extra care measures to manage your eczema effectively during the pollen season.
  • Keep your home clean using the tips to keep your home allergy-free.
     

Study Referred: Birch pollen influence the severity of atopic eczema Clin Cosmet Investig Dermatol. 2015; 8: 539–548.