For anyone who is living with eczema, they are more than aware of how unpleasant a flare-up can be. Causing incredibly itchy and dry skin all across the body, a person’s eczema symptoms can range from mild irritation to profound discomfort and disability. And while every person has their own unique triggers that can lead to the onset of a flare-up, it appears that eczema may also be heavily impacted by the change of the seasons.
No matter where you live in the world, the changing of the seasons results in new average temperatures and weather. For those living with eczema, these changes are felt more viscerally, as their disease begins to flare up at the beginning of the cooler winter months. This phenomenon is so common that asteatotic eczema, one of the common forms of the disease, is often nicknamed “the winter’s itch.”
Because of the connection to the weather, many people living with eczema go through prolonged periods of disease dormancy during periods of mild weather. But, when we begin to transition into summer or winter (when the weather is commonly the hottest or coldest it will be throughout the year), flare-ups become more frequent and severe. Looking to find a way to break the cycle of flare-ups with the start of a new season, many researchers are interested in finding ways to reduce the severity of eczema flare-ups caused by extreme weather.
So, why is this the case? Why does the weather have such a strong impact on the health of our skin, and what can people with eczema do to mitigate severe flare-ups as the seasons change?
Eczema, also known as atopic dermatitis, is a common non-infectious skin condition. It is an autoimmune and genetic disease, thought to be caused by the immune system attacking and causing chronic inflammation in specific areas of the skin. The true underlying cause of eczema is still not fully understood. Commonly diagnosed in childhood, more severe cases of eczema can persist into adulthood, causing significant discomfort and irritation. While eczema can cause inflammation and itchiness anywhere on the body, it is most common for adults with the disease to experience symptoms on their hands, feet, neck, scalp, elbows, and behind the knees¹.
Currently, over 10% of the American population (over 36 million people) are affected by some form of eczema². Additionally, 1 in 10 American citizens will develop eczema symptoms during their lifetime². Globally, these numbers are unfortunately similar. With an estimated 20% of children and 3% of adults around the world experiencing eczema symptoms, management of this disease is becoming more important than ever³. On average, children and adults living in cold climates or developing countries are more likely to be diagnosed with eczema compared to the rest of the global population⁴.
As the largest organ in the human body, our skin is an incredibly important tool in our fight against pathogenic bacteria. Our skin is made up of three primary layers: the epidermis (the outermost layer), the dermis (the middle layer), and the subcutaneous layer (the innermost layer)¹. The healthy function of each of these layers of our skin is necessary to create a strong protective layer that covers our entire body.
In people with eczema, the outermost layer of the epidermis is unable to provide adequate protection from environmental bacteria due to chronic inflammation caused by their overactive immune system. This, paired with a possible genetic predisposition to create less of the protein filaggrin (which is responsible for creating the outermost layers of our skin), people with eczema develop incredibly dry and itchy skin¹.
As a result, it is very common for people with eczema to scratch their skin in an attempt to alleviate their discomfort. This scratching causes cracks in the skin, which allows microorganisms to enter and cause additional inflammation and infection in the already irritated skin.
Depending on where you live and what time of year it is, the temperature and weather your skin are exposed to vary significantly. Generally speaking, human beings enjoy being at a consistent ambient room temperature of 20-22 degrees Celsius (68-72 F), as this range allows us to maintain our core body temperature without any additional stress⁵. When temperatures get significantly above or below these values, our skin is at risk of experiencing environmental damage and injury. For people with eczema, these risk factors are dramatically increased, as they already have pre-existing impaired integrity of the outer layers of their skin.
Because of this, it is highly advised that people living with eczema avoid direct exposure to prolonged heat or cold to prevent additional drying or burning of their skin.
During the winter and summer months, the ambient temperatures of both indoors and outdoors are more likely to fall outside of comfortable ranges. Because of this, it is common for people with eczema to experience flare-ups during these months. Depending on the severity of a person’s disease, the intensity of their symptoms can vary during a flare-up. Commonly, the most debilitating and severe symptoms reported by people with eczema during these times are itchiness, inflamed/painful skin, sleep disturbances, and increased skin sensitivity⁶.
Winter, which is the coldest and driest season of the year across the globe, poses many additional challenges for people with eczema. Moving from extremely cold and windy winter conditions outside to the warm and heated indoor temperatures adds a ton of additional stress to our skin — and for people with eczema, this can be enough to cause a flare-up.
In addition to the dry and cold weather, it is also common for people to develop a vitamin D deficiency during the winter due to less exposure to sunlight. While there is still more research needed to be done to prove the connection between vitamin D and eczema flare-ups, it is known that having low vitamin D levels has an impact on the overall health and function of our skin⁷.
In a study conducted from August - October in 2019, it was found that 30% of participants from around the world reported that, in the past month, their eczema had resulted in a significant negative impact on their health and wellbeing⁸.
Showing how detrimental this disease can be during more favourable weather conditions associated with the fall or spring seasons, additional stress from extra cold weather leads to increased flare-ups and worse symptom severity in the majority of people living with eczema.
Even when the extreme cold weather fades away with the beginning of spring, it doesn’t necessarily mean that people with eczema are 100% in the clear for experiencing severe flare-ups. As we all know, April showers bring May flowers — and a massive increase in pollen and other allergens. This increase in environmental irritants is not great for anyone already struggling with the health of their skin, making the transition period from winter into spring another common time for eczema flare-ups.
So while it may seem like there are more times of the year when the weather is trying to induce eczema flare-ups than not, there are ways to minimize your risk factors even during the most extreme environmental conditions.
Being diagnosed with eczema does not mean you have to dread certain times of year for the rest of your life. There are many ways to reduce your symptoms by being mindful of your personal triggers and environment. Through trial and error, finding out what substances or temperatures induce eczema flare-ups is a great way to identify situations you should avoid. Documenting your triggers and doing your best to create a trigger-free environment whenever possible can greatly help in the management of eczema flare-ups, no matter the time of year.
In addition to trigger monitoring, here are some other helpful tips for betting controlling eczema:
Buy a humidifier — During the cold winter months, the air both inside and outside becomes exceptionally dry. Capable of drying out the outer layer of our skin, this dry weather can cause significant discomfort and irritation for someone living with eczema. Because of this, it is highly recommended that eczema patients use a humidifier in their homes (especially where they sleep) to add some extra moisture into their air and skin. Research has shown that regular use of humidifiers during dry times of the year has had an overall positive impact on eczema flare-ups⁹.
Avoid scalding hot showers — As tempting as it may be to draw yourself a super hot shower or bath when it is cold outside, this extreme temperature may actually be causing more damage to your skin. Hot water, especially hot water from a shower that is hitting your body at a high velocity, can actually cause significant damage to the outer layer of your skin. For those living with eczema, this heat can cause significant skin drying, which in turn leads to more irritation and itching.
Stick to a consistent moisturizing routine — Acting as a protective layer for dry and irritated skin, moisturizers can provide the additional support your skin needs to begin the healing process. For people living with eczema, sticking to a regular moisturizing routine is essential to keep their skin from getting so dry that it cracks. With some moisturizers created specifically for people with eczema, these thick hydrating creams can sometimes contain topical steroids to provide some additional support to the skin. It is advised that you consult with your primary care provider prior to beginning any topical steroid treatment for eczema.
Stay super hydrated — Just like every other organ in our bodies, our skin cells need to be hydrated in order to function at their best. Recommended for those living with or without eczema, drinking plenty of water throughout the day is a great way to boost your overall health and provide your skin with a little extra support¹⁰.
Bundle up when you head outside (no matter the weather) — Protecting your skin from the elements is a must for anyone living with eczema. During the winter months, it is advised that people with eczema should bundle up - wearing gloves, hats, jackets, and warm sweaters to prevent any direct exposure of their skin to the cold weather. Limiting your exposure to cold and dry air can reduce your risk of developing a flare-up. On the flip side, staying protected from the sun is equally important during the hot summer months. While getting some sun can help increase vitamin D levels, avoiding extreme heat that can cause burns is a must to prevent additional skin drying and injury. Protecting your skin by covering inflamed areas of your skin from prolonged sun exposure is a great way to reduce your risk of developing a flare-up.
Keep your home ambient temperature at a comfortable level — When you come home from a busy day, having a space that is set to a comfortable temperature can help to reduce the risk of a flare-up. Setting your home temperature to hover around 20-22 degrees Celsius (68-72 F) can help to reduce profound temperature jumps and prevent unneeded stress on your fragile skin.
With these tips in mind, it is possible for people living with eczema to better manage their risk of developing a severe flare-up. Unfortunately, due to limited education and increased prevalence of common irritants and environmental pollution, many people living with eczema currently rate this disease as either poorly or moderately controlled at best¹¹.
As the number of people living with eczema continues to rise around the world, the need for more research into its specific cause, prevention techniques, and treatment options has never been more important. As a portion of our global population continues to experience severe eczema flare-ups as the weather changes every single year, finding a way to break the cycle is mandatory to increase the quality of life of the children and adults diagnosed with eczema.
Eczema: overview | InformedHealth.org
Eczema stats | The National Eczema Association
Eczema statistics | MG217
Atopic dermatitis: Epidemiology & beyond | MauiDerm
Room temperature | The American Heritage Dictionary of the English Language
Can using a humidifier treat the symptoms of eczema? | Healthline
4 things your eczema can tell you about your health | Ascension Seton
The author, Claire Bonneau, is a medical writer and certified trauma operating room nurse.