Flare-ups can be one of the most frustrating parts of atopic dermatitis (AD). Even when you follow a consistent prevention plan with a good skincare routine, a bad flare-up can still set you back.

You can minimize the occurrence and severity of flare-ups by understanding what worsens AD. These are the external and internal triggers that transform AD-prone skin from dry and flaky to an itchy, red rash.

External triggers like allergens and irritants may make contact with your skin and start a flare-up. Internal triggers like food allergies and stress may cause an increase in inflammation in the body that leads to a bad rash.

Becoming aware of different AD triggers is key to managing your symptoms. It can help to take note of internal and external conditions at the time of a flare-up. The better you understand what causes your symptoms, the easier it is to avoid them.

Physical irritants

When you make contact with physical irritants, your skin may immediately start to itch or burn. The skin may also turn red. There are many common household and environmental irritants that may trigger AD flares including:

  • wool
  • synthetic fibers
  • soaps, detergents, cleaning supplies
  • dust and sand
  • cigarette smoke

You may experience an AD flare-up when you’re in a new environment with different irritants. For example, if you’re staying at a hotel that uses a harsh detergent on the linens, you may experience a flare-up of your facial AD. The soaps in public restrooms can also cause flares for many people.

Exposure to allergens

Pollen, animal dander, mold, and dust mites can worsen AD symptoms. Keep your home and work environments as free of allergens as possible. This may involve frequent laundering of fabrics and daily vacuuming.

If you’re sensitive to mold and dust, you might find that used bookstores, libraries, and vintage shops are triggers. If you can’t spend time in a library without scratching your skin, you might need to find a new place to work or study.

Other physical factors

Heat, humidity, and temperature changes can all trigger AD flare-ups.

When bathing resist the urge to take hot baths or showers. Hot water makes your skin’s oil break down faster and leads to a loss of moisture. Just one shower in excessively hot water can cause a flare-up for people with AD.

As part of your daily routine, you should replenish the moisture to your skin after a shower or bath using lotion, cream, or ointment.

Overheating when you’re outside or physically active can also cause a flare-up. If you feel yourself overheating on a hot day, find a shady or indoor spot to cool down. Apply sunscreen if you know you’re going to be in the sun for an extended period of time.

A sunburn will cause inflammation and almost certainly lead to an AD flare-up. If you’re overheating during exercise, take a short break and drink some water to lower your body temperature.

Food triggers

While food allergies don’t cause AD, they can trigger a flare-up. Some foods can cause flare-ups just from making contact with the skin. Some of the most common food allergens are milk, eggs, peanuts, wheat, soy, and seafood.

Of course, it can be difficult to accurately identify a food allergy on your own. It’s probably best to have a list of suspected food and then have your doctor do testing. Your doctor may run skin tests to rule out foods that aren’t triggers.

Testing positive for an allergen on a skin test doesn’t necessarily mean you’re allergic. There are many false positives, which is why it’s important for your doctor to conduct a food challenge. In a food challenge, your doctor will watch you eat a certain food and look for signs of eczema to develop.

Remember that food allergies or sensitivities can change as you age, so you and your doctor may need to reevaluate your diet. Never stop eating entire food groups without discussing it with your doctor. That could lead to malnutrition and other health issues.

Stress

You may notice that your AD flares up during times of stress. This may be from daily stressors or at times when you’re frustrated, embarrassed, or anxious. Emotions like anger that cause flushing of the skin can trigger the itch-scratch cycle.

During times of stress, the body responds by increasing inflammation. For people with skin conditions, this can mean red, itchy skin.

If you’re experiencing acute stress and find yourself starting to itch, try to take a step back. Before you soothe with scratching, try to stay calm by meditating or just stepping away for a quick walk.

Takeaway

When your next flare-up happens, consider all of the above factors and see if you can pinpoint your triggers. You may also want to go through the following mental checklist:

  • Did I spend time in a new environment where I may have been exposed to new allergens or irritants?
  • Did the flare-up happen during a specific activity like cleaning or exercising?
  • Did the flare-up happen when changing into a specific item of clothing like a sweater or a new pair of socks?
  • Did I eat something different today?
  • Was I stressed or mentally anxious about a specific event or relationship?

Having the answers to these questions will help you narrow down your list of possible AD triggers. You can also take these answers to your next doctor’s appointment if you’re having trouble identifying your personal triggers.