What to Wear When You Have Atopic Dermatitis: 5 Tips to Protect Your Skin
If you have atopic dermatitis, certain fabrics and clothing styles can trigger intense irritation and itch. Here’s how to dress right to protect your hypersensitive skin.
When you have atopic dermatitis, the most common form of eczema, your skin can be so sensitive that wearing a scratchy sweater or a garment with a tag or rough seam can lead to a flare-up.
Atopic dermatitis is marked by symptoms such as itchiness, dryness, rashes, scales, oozing patches, blisters, and infections — and clothing that is rough on skin, or that causes overheating, sweating, and irritation, only makes these issues worse.
Here are some tips on how to make the best clothing choices to help avoid triggering atopic dermatitis symptoms and protect your sensitive skin.
1. Dress in Soft, Breathable Fabrics
Although conventional wool is notoriously itchy, one study found that merino wool, which is thinner and softer than most wool, not only improved atopic dermatitis symptoms when compared with standard clothing but also boosted the study subjects’ quality of life.
Organic textiles are grown without pesticides and typically aren’t treated with harsh chemicals. Some — like lyocell and modal — are known for being soft and breathable, making them especially atopic dermatitis–friendly.
Cotton
It’s soft, durable, and breathable. Although 100 percent cotton is optimal, cotton blends can be okay too; just check the label to make sure there isn’t a high percentage of polyester, which can aggravate atopic dermatitis.
Bamboo
Bamboo is a plant that grows in hard stalks, yet somehow it produces soft textiles. Some apparel and textile companies tout bamboo as being softer than cotton, on par with silk or cashmere — and more breathable as well. Research confirms that bamboo fiber is highly absorbent and naturally hypoallergenic (meaning it does not cause allergic reactions). The processing needed to make bamboo fiber can be chemical-intensive. While these chemicals may not irritate skin, they can be detrimental to the environment, leading some consumers to opt for the eczema-safe fabric lyocell (often branded as Tencel), which is generally more environmentally-friendly in its manufacturing methods.
Silk
Silk is another soft, breathable fabric. Unfortunately, it stains easily — a particular problem if you use a lot of moisturizers or topical atopic dermatitis treatments — and can be expensive to buy and care for. While it’s common practice to dry-clean silk, it’s possible to gently hand-wash many silk garments.
2. Layer Up in All Types of Weather
Cold weather can mean wearing wool for warmth. Because many types of wool can be scratchy, layering is a good strategy if you have atopic dermatitis. For instance, wearing a cotton shirt underneath a wool sweater can reduce friction and irritation.
In general, layering is a useful tactic for people with atopic dermatitis, no matter the weather. “It gives a person more control over their environment,” says Bruce Brod, MD, a clinical professor of dermatology and the codirector of the occupational and contact dermatitis program at Penn Medicine in Philadelphia. “A person can sense when they are feeling uncomfortable and adjust accordingly, whether that’s putting on more layers in the winter or shedding layers in the summer.”
It’s important not to overheat in warm weather, because sweat contains sodium and other minerals and metals that can trigger flare-ups. “Some patients with atopic dermatitis are aggravated by perspiration — it makes them feel really itchy,” says Dr. Brod. “Some say they actually feel like they’re allergic to their own sweat.”
3. Be Cautious About Certain Textile Colors and Dyes
Jenny Murase, MD, a dermatologist at the Palo Alto Medical Foundation Medical Group in Mountain View, California, warns that certain fabric colors and dyes can trigger flares in people with atopic dermatitis. She advises against wearing dark clothes in the summer, for instance, because they absorb sunlight and may contribute to overheating.
Plus, she says, “Different textile dyes like blue, black, orange, and red can trigger an allergic skin reaction.”
Research indicates that natural dyes, such as those derived from plants and minerals, are less likely to cause allergic reactions than synthetic versions. People with atopic dermatitis may want to ask their dermatologist about allergy testing.
4. Aim for a Loose and Airy Fit
Close-fitting clothing that rubs against skin can aggravate atopic dermatitis. Tight workout wear can be especially troublesome because physical exertion produces both friction and sweat. Sweat gets trapped against the skin, increasing the potential for irritation.
People with atopic dermatitis tend to do better when their skin gets more air, so loose-fitting garments are best.
But even loose-fitting clothing can rub against skin. Dr. Murase urges patients to be aware of problem areas, such as the fronts of the shoulders, armpits, and along the waistline where a shirt may be tucked in against the belly.
People with atopic dermatitis should check clothing for features that may cause irritation, such as tags, rough seams, fasteners, and loose threads.
5. Launder Away Irritants
New clothes should be washed before they’re worn to eliminate problematic chemicals used in manufacturing — but be careful about what cleaning products you use.
It can help to use detergents and fabric softeners that are free of dyes and fragrances and formulated for sensitive skin. People with eczema are advised to avoid fabric softeners and dryer sheets due to added their fragrance, and because they’re also harder to rinse out of fabrics. People who are extra sensitive may consider giving their garments a double rinse after washing.
The Takeaway
What you wear can really affect your atopic dermatitis symptoms and flares.
As a general rule, wear soft materials and avoid scratchy ones like traditional wool, keep your clothes loose, and layer up in winter.
Choose eczema-friendly detergents, such as fragrance-free and dye-free formulas, to wash your clothes.
Talk to your doctor about your symptoms if you’re unable to find a specific trigger for atopic dermatitis flares that seem to be clothing-related.
Amy Spizuoco, DO, is a board-certified dermatologist and dermatopathologist. Dr. Spizuoco has been practicing medical, surgical, and cosmetic dermatology, as well as dermatopathology in New York City for 12 years.
She did her undergraduate training at Binghamton University, majoring in Italian and biology. She went to medical school at the New York Institute of Technology College of Osteopathic Medicine. After medical school, she completed her dermatology residency at Lake Erie College of Osteopathic Medicine–Alta Dermatology in Arizona. During that time she studied skin cancer surgery and pediatric dermatology at Phoenix Children’s Hospital and attended dermatology grand rounds at the Mayo Clinic in Scottsdale. After her residency, Spizuoco completed a dermatopathology fellowship at the Ackerman Academy of Dermatopathology.
She was previously an associate clinical instructor in the department of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. She is on the editorial boards of Practical Dermatology and Dermatology Times.
Don Rauf has been a freelance health writer for over 12 years and his writing has been featured in HealthDay, CBS News, WebMD, U.S. News & World Report, Mental Floss, United Press International (UPI), Health, and MedicineNet. He was previously a reporter for DailyRx.com where he covered stories related to cardiology, diabetes, lung cancer, prostate cancer, erectile dysfunction, menopause, and allergies. He has interviewed doctors and pharmaceutical representatives in the U.S. and abroad.
He is a prolific writer and has written more than 50 books, including Lost America: Vanished Civilizations, Abandoned Towns, and Roadside Attractions. Rauf lives in Seattle, Washington.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Fowler JF et al. Effects of Merino Wool on Atopic Dermatitis Using Clinical, Quality of Life, and Physiological Outcome Measures. Dermatitis. June 1, 2019.
