Your Season-by-Season Guide to Managing Atopic Dermatitis

For many people with atopic dermatitis (AD) — sometimes called severe or uncontrolled eczema — avoiding environmental triggers can reduce flares and keep symptoms under control. Simple swap-outs of personal products or laundry detergent are no big deal, but weather-related causes of flares are another story.

Extreme Temperatures Can Be a Problem for Skin

Most people prefer to be in temperatures between 68 and 72 degrees F, because this range allows the body to maintain its core temperature without additional stress, according to Aanand Geria, MD, a board-certified dermatologist at Geria Dermatology in Rutherford, New Jersey. “When the temperature is significantly above or below this range, it puts the skin at risk for environmental injury or damage,” he says.

In cold weather, humidity tends to be low both outdoors and indoors. The water content of the outside layer of the skin (called the epidermis) responds to the level of humidity around it, which means everyone’s skin gets drier during the coldest season. But it’s especially true for people with atopic dermatitis, who have a damaged skin barrier. When temperatures fall below the comfortable range, people with eczema can experience flare-ups, says Dr. Geria.

Weather in summer, when temperatures climb above that comfortable range, can trigger flares as well. The transitions between seasons can also bring temperature fluctuations, Geria says.

People with Atopic Dermatitis May Be More Affected by Seasonal Allergens

When exposed to allergens, skin may lose moisture and dry out, which leads to irritation that is further affected by weather, such as cold, heat, humidity, or wind. People with atopic dermatitis may face challenges as their skin transitions from summer humidity to the cold and wind of fall and winter.

Navigating all of this may seem a bit overwhelming, but it doesn’t have to be. Here are the challenges each season can bring and how to work with your dermatologist to adjust your skin-care routine and habits accordingly, which can make a big difference.

Winter Management of Atopic Dermatitis: Extra Moisturizing May Be Necessary

Winter can be tough for people with atopic dermatitis for a few reasons. “The cold air can dry the skin, causing itchiness and worsening eczema. And because it is cold outside, people tend to turn the heat up, making the environment even drier,” says Geria. “Changing between hot and cold climates, such as entering a warm house after being outside, makes the skin react.”

But there are ways to counteract these assaults on the skin:

• Keep the temperature comfortable inside. Central heat keeps you warm but also strips moisture from the air. The ideal temperature you should aim for is 60 to 67 degrees F.

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• Bump up the humidity in your home. “If you have radiators, place a bowl of water near them to help offset the drying effects on the skin, and don’t sit too close to heat sources,” says Geria.
• Stick to quick, lukewarm showers. It may be tempting to take a long, hot bath in winter. But it’s not a good idea, because it can trigger AD, says Steven Feldman, MD, PhD, a dermatologist and pathologist at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina.
• Use a winter-friendly moisturizer. When moisturizing your skin, switch to something heavier, such as an ointment, which is more effective for retaining water in the skin, says Geria. Similarly, the greasy ointment formulation of hydrocortisone will tend to be more effective than the cream version for calming AD, says Dr. Feldman.

What to Do if Springtime Allergens Trigger Atopic Dermatitis Symptoms

As winter turns to spring, increased humidity and milder temperatures can be beneficial for the skin. On the other hand, spring is also a season of allergies, which can affect many people with atopic dermatitis.

“Those with eczema could experience symptoms after exposure to tree or ragweed pollen, grass, pet dander, and dust mites during the springtime. These symptoms include an unpleasant combination of a runny nose, watery eyes, and itchy skin,” says Geria.

It’s important to see a board-certified dermatologist if you feel your atopic dermatitis is triggered by temperatures getting warmer, says Geria. “They can prescribe one or more remedies, such as antihistamines and/or corticosteroid creams, and provide individualized lifestyle tips for managing AD.”

Summer Heat and Humidity May Irritate the Skin

High temperatures and warm-weather activities, such as swimming and being outdoors for an extended period, can trigger a flare-up of uncontrolled eczema, says Geria. “Sweat contains salts that can irritate the skin, especially in areas where moisture may get trapped, such as the armpits, the back of the neck, and the backs of the knees,” he says.

Although it’s not always possible to avoid breaking a sweat in summer, try to minimize it, he suggests. This means keeping cool by staying in an air-conditioned environment, drinking plenty of water, and not spending multiple hours in the hot sun. It’s also a good idea to wear loose-fitting, breathable clothes, such as cotton or moisture-wicking shirts, Geria suggests.

There is evidence that for some people with atopic dermatitis, “doses” of sun exposure can help, but it’s important to work with your dermatologist to do this safely. Too much sun can cause a sunburn, put you at risk for skin cancer, and make AD symptoms worse.

Fall and ‘Sweater Weather’ Can Mean Itchy Skin

Allergens — both indoors and out — can be a problem in fall. If you have indoor allergies, “Open windows from time to time to allow fresh air in so that dust mites don’t collect, because they can trigger eczema,” Geria suggests.

This is the time of year when we typically begin to layer on extra clothing, such as coats, gloves, hats, scarves, and sweaters. “Some of these can be made of materials that irritate the skin and cause itchiness. Loose threads and rough seams can have the same effect,” he adds.

Any layers that are in direct contact with your skin should be made of 100 percent cotton or as close to that as possible, says Geria. “If you must wear wool, put a cotton shirt underneath to buffer your skin from the garment. When wearing wool gloves for warmth, wear cotton gloves underneath,” he says.

This recommendation also goes for nightwear, underwear, tank tops, and socks. Try to stick with cotton or another soft fabric — preferably without seams — that doesn’t irritate your skin, says Geria.

No matter what season it is, talk to your dermatologist if your atopic dermatitis is flaring up or you’re struggling with uncontrolled eczema. That way, you can stay as comfortable as possible year-round.