Eczema is an autoimmune chronic skin disease caused by a complex interplay between a genetic predisposition and immune responses. (Learn more about eczema causes) As a result, the patients react to various triggers by developing red, itchy or oozing flare ups on the skin.
Each eczema patient is different and needs to identify his/her own triggers. However, the research can give a hint of where to start looking.
So what are the eczema triggers considered to be common among the eczema patients?
There seems to be strong evidence showing that under stress the sensitivity of the skin may increase1. 81% of patients report that stress makes their itching worse2.
The reason is the fact that the skin is not only a passive recipient of hormones. It is actually an active endocrine organ (part of the hormonal system) that responds to stress by activating / deactivating or synthesizing various hormones. 3 4
It also seems that compared to healthy individuals, under stress AD patients produce less hormones contributing to the reduction of inflammation (such as glucocorticoids).5
Dust or pollution
Dust and pollution have been proven to significantly worsen the itch-scratch cycle of patients with eczema6. The pollution causes damage to the already weakened skin barrier of the patients and increases irritation leading to inflamed skin7.
Lack of sleep
Many eczema patients report the worst itching in the evening and scratching at night causing a lack of sleep. 82% of eczema patients have been reported to have problems sleeping due to itching at night8. The poor sleep in turn seems to lead to imbalanced immune responses causing further flare ups and other associated conditions such as impetigo9.
Many eczema patients develop allergies to various triggers including pollen. 60% of eczema patients report that pollen triggers their flareups 8,10.
There seems to be a connection between atopic dermatitis, allergic rhinitis and asthma referred to as atopic march11. It describes that many eczema patients develop asthma and/or allergic rhinitis over the course of their lifetime.
A survey of 169 patients (18 years and older) with atopic dermatitis asked them about what foods they think make their eczema worse. The most noted was dairy, gluten, alcohol and sugar12. The patients also reported achieving improvements in their skin condition when removing these foods from their diet.
For many patients, sweating leads to an increased redness, irritated skin and a flare up. Especially the folds of the body may be prone to developing such irritated patches.
Identifying triggers with AppDermis
These are only a selection of triggers that may make eczema worse. But understanding our own body is the first step towards being able to manage the condition. That is why we suggest to start tracking the effect of the triggers with AppDermis to see what influence they have on your condition.
Give it a few weeks and see yourself! Good luck.
- Suárez, A. L., Feramisco, J. D., Koo, J. & Steinhoff, M. Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates. Acta Derm. Venereol. 92, 7–15 (2012).
- Wahlgren, C. F. Pathophysiology of itching in urticaria and atopic dermatitis. Allergy 47, 65–75 (1992).
- Labrie, F., Luu-The, V., Labrie, C., Pelletier, G. & El-Alfy, M. Intracrinology and the skin. Horm. Res. 54, 218–229 (2000).
- Zouboulis, C. C. The skin as an endocrine organ. Dermato-Endocrinology vol. 1 250–252 (2009).
- Lin, T.-K., Zhong, L. & Santiago, J. L. Association between Stress and the HPA Axis in the Atopic Dermatitis. Int. J. Mol. Sci. 18, (2017).
- Bonamonte, D. et al. The Role of the Environmental Risk Factors in the Pathogenesis and Clinical Outcome of Atopic Dermatitis. Biomed Res. Int. 2019, 2450605 (2019).
- Hendricks, A. J., Eichenfield, L. F. & Shi, V. Y. The impact of airborne pollution on atopic dermatitis: a literature review. Br. J. Dermatol. (2019) doi:10.1111/bjd.18781.
- Kaaz, K., Szepietowski, J. C. & Matusiak, Ł. Influence of Itch and Pain on Sleep Quality in Atopic Dermatitis and Psoriasis. Acta Derm. Venereol. 99, 175–180 (2019).
- Xerfan, E. M. S., Tomimori, J., Andersen, M. L., Tufik, S. & Facina, A. S. Sleep disturbance and atopic dermatitis: A bidirectional relationship? Med. Hypotheses 140, 109637 (2020).
- Meinke, M. et al. Birch pollen influence the severity of atopic eczema – prospective clinical cohort pilot study and ex vivo penetration study. Clinical, Cosmetic and Investigational Dermatology 539 (2015) doi:10.2147/ccid.s81700.
- Gustafsson, D., Sjöberg, O. & Foucard, T. Development of allergies and asthma in infants and young children with atopic dermatitis–a prospective follow-up to 7 years of age. Allergy 55, 240–245 (2000).
- Nosrati, A. et al. Dietary modifications in atopic dermatitis: patient-reported outcomes. J. Dermatolog. Treat. 28, 523–538 (2017).