A-Z

Eczema (young people)

Eczema triggers: what can make eczema worse?

Everyone we talked to could name at least one trigger which could make their eczema worse, and many different triggers were mentioned. This included people who also had asthma, allergies and/or hay fever (linked with ‘atopic eczema’). What might be a problem for one person could be completely fine for another. Molly explained that, over time and through talking to others with the condition, “you just kind of learn to realise that every single person with eczema is so different and what triggers it is so different”. 

The most commonly reported triggers by those we interviewed were:
  • stress
  • weather/temperatures
  • allergens (including pet fur/dander)
  • food and drink
  • getting the skin wet and chemicals in water
  • cleaning products
  • cosmetics and bathing products (including fragrances)
  • clothes and fabrics
  • hormones
Working out triggers and allergies could be a trial-and-error process. Some people found it hard to narrow down the possible factors. Some kept ‘food diaries’. These weren’t useful for everyone though, as it could take a lot of time and be tricky to keep track if foods contained a lot of mixed ingredients.
 

Laura has heard about using ‘food diaries’ to help identify diet triggers but doesn’t plan to try one at the moment.

Laura has heard about using ‘food diaries’ to help identify diet triggers but doesn’t plan to try one at the moment.

Age at interview: 22
Sex: Female
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See I don’t, sometimes when it comes, flares up, I wonder whether it's something I've eaten. But it's one of those things that I literally have to, I'd have to have a diary and a food diary, and I'd have to monitor everything I did and the extent that is just on my hands and the fact that I know when it flares up I can put creams and stuff on it. For me personally, I'm not going to bother, at the moment anyway. It's not worth it to spend all that time like recording everything I do and thinking about everything and, cos otherwise your life you'd be like, 'Oh should I do this, should I do that,' and you just go, like get on with it. So, I think more recently, probably there are things that might still be a problem but not that big a problem that I, it affects me too much.
 

Sarah tries to only introduce one new make-up/cosmetic product at a time into her routine so she can work out whether it causes a reaction.

Sarah tries to only introduce one new make-up/cosmetic product at a time into her routine so she can work out whether it causes a reaction.

Age at interview: 23
Sex: Female
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I think my other piece of a-, my other piece of advice would be to consider like maybe things that might be causing your eczema that you’d never think of before. So things like hairspray, spray deodorant, shampoo. You don’t even think of them as coming into contact with where you have eczema. So you don’t even think they’re gonna cause it. But then actually once you take them out you might see a change. So think a bit more ‘what-, what could this be other than what I think it is?’ And if your eczema’s really bad, I think have a real like, go through everything that you’re using and your whole routine and what you’re doing day to day. And you might just have to strip it completely back and, and start from really like the basics and then build up again until you can work out which products to use. Cos sometimes you might feel like you’re doing everything, but there’s something that you, that you’re doing that you haven’t even clicked. Or there’s something that you haven’t realised you’re doing all the time that could be making it worse. So I think you have to like look at it from a step back if you really wanna control it and manage it.
Stress

Almost everyone said stress was a trigger for their eczema, relating to different sources:
  • about their studies and exams
  • in jobs, being unemployed and money worries
  • moving home
  • arguments and break-ups
  • bereavements
Many people said that stress and eczema can be a “vicious cycle”: stress leads to itching which makes the eczema worse and causes more stress. Not being able to sleep enough could add to this cycle.
 

Studies, work and living away from family are all sources of stress that have affected Ele’s eczema.

Studies, work and living away from family are all sources of stress that have affected Ele’s eczema.

Age at interview: 22
Sex: Female
Age at diagnosis: 2
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Oh that’s the other thing it’s massively affected by stress so A-level’s actually because that’s when it got really bad because I was so stressed with academic work then my eczema got really, really bad and it’s, I’ve kind of not managed to get it back to the level it was at pre A-level because since then obviously I went straight to Uni and then I didn’t come home after University I went straight into the working environment so I've sort of got bills to pay, I’ve got rent, l've got all this living by myself and 300 miles away from my family. So it’s the stress kind of, stress levels haven’t really dropped so I think because it became so much more painful in those when I went into A-level’s I think that’s when it kind of took over from the cosmetic thing.
 

Gary says that stress, with his family and romantic relationships, is a key trigger for his eczema.

Gary says that stress, with his family and romantic relationships, is a key trigger for his eczema.

Age at interview: 23
Sex: Male
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Stress is really bad for it.

OK 

But not every kind of stress because stress at work, it doesn’t affect it. Friends – not really, only family, and I just, I just told you about, I just thought about it with my mother when I was home a couple of weeks ago that I'm kinda like-, I like to dictate and I like to be the ruler. I like to tell people what to do and I don’t really like when they tell me. And at work when they try to push me down.

I always go like, “Yeah OK,” I just let them. I smile at them and I ask like, “Yeah OK, it's alright,” and when they calm down and then I give everything back.

[Laughs]

But I cannot do this one with my parents because I love my family and they stress me a lot and my brother as well. And my brother is like the closest person for me in the world but he can stress me in such a bad way [laughs]. No-one can make me feel as stressed as him.

If I'm sad it doesn’t trigger the eczema, if I'm only sad. Only the stress and only this kind of emotional stress – everyday, driving a car; someone comes in front of me; I get angry, I push the horn – it doesn’t change my skin. Work or other stuff. It's mostly emotional, only my ex-girlfriends could trigger it, and then my family. Yeah.

Because those are the kind of relationships that I cannot push down in how I would like to. Because at work it's easy because if, even if it's my boss and tells me something really bad, I can still punch him. They're going to fire me – who cares, I'll find another job, but I cannot do this with my father or my mother [laughs], so that’s kind of really bad because I have all this pressure inside me and I just think can't get it out. And then my mother comes to me and, “Hey, talk about it.” I don’t want to talk about it because I talk about it and then I get angry again [laughs] and it makes no sense. For me.
 

One of Himesh’s teachers has talked about techniques for coping with stress.

One of Himesh’s teachers has talked about techniques for coping with stress.

Age at interview: 17
Sex: Male
Age at diagnosis: 10
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Yeh, yeh stress definitely sorry. it would definitely flare my skin up ‘cos I’m at that point where I’m panicking I guess and I can’t control myself so I don’t know what to do so then my skin will get bad and that will lead to me itching even more and then you’re getting even more frustrated and putting more stress on me basically so it’s not a good time to be honest when I’m stressed. But I do, I’m trying to control it better now but I could still do with improvement if that makes sense so yeh.

So is that some of the techniques that your drama teacher taught you?

Yeh definitely like I think one of them was to like breath in and out until ten, slowly like cross your fingers and just like tense your whole body so you feel calm afterwards once you’ve tensed it for a couple of seconds and stuff like that so yeh. I do try to do that more often now if I get stressed but I haven’t been stressed lately so yeh.
Weather/temperatures

Overall people said their eczema tended to be worse in winter and that heaters, which dry out the air, added to the problem. In contrast, being in the sun seemed to help. However, some people found that hot weather could make them sweat which would lead to itchiness, aggravating their eczema, and make their skin sting. This was especially the case in humid (damp) climates. Lots of people said they tried to keep cool, as this seemed to keep their skin less irritated, but that air conditioning could dry out the skin too. Although different seasons were expected triggers, some people found it hard to predict and prepare for the timing of changing weather. Cat said the weather didn’t seem to make much of a difference to her eczema but she thought that “you’re just happier when it’s light” in summer which might help her eczema.
 

Himesh talks about seasons and weather flaring up his eczema.

Himesh talks about seasons and weather flaring up his eczema.

Age at interview: 17
Sex: Male
Age at diagnosis: 10
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Do you get sort of a sense that a flare up is on its way or does it just come out of the blue?

Well now I can tell like, when like seasons change and weather changes I can tell that my skins going to be bad but I can control it now ‘cos I’m at that age where I can understand how to control it. So it’ll probably flare up for a week or just go bad for a week because of the weather change or season change then after that it’s alright, so yeh.

What kind of weather or season change?

Oh all sorts like if it went from really cold to really hot all of a sudden my skin would have to adjust to an extent so it would have to flare up, not too much anymore, but you would still change and go bad for around a week and then once its controlled it will be alright, back to normal if that makes sense, so yeh.
 

Air conditioning and temperature changes are a problem for Ele’s skin, making travel by public transport particularly uncomfortable.

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Air conditioning and temperature changes are a problem for Ele’s skin, making travel by public transport particularly uncomfortable.

Age at interview: 22
Sex: Female
Age at diagnosis: 2
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I have massive issues actually with air conditioning, air conditioning is absolutely terrible for my skin and central heating, just anything that monitors the temperature in any way and my skin doesn’t like it even though my skin doesn’t like the cold it doesn’t like artificial heating either and even though it doesn’t like being too warm then it hates air conditioning [laughter] 

The air conditioning systems on those as well, it’s just, when they’re not then it tends to be really, really cold on the train or uncomfortably warm just from peopled body heat so it’s never sort of a nice temperate level on the train it’s always one extreme or the other and my skin just hates all extremes of any kind, my skin just basically hates everything so it’s it does kick off a bit with public transport. But the worse thing for it I think is air conditioning.
Allergens

There are a number of triggers also associated with allergies and asthma which could set off eczema (see also ‘atopic eczema’). This includes:
  • pollen (from grass, flowers, trees)
  • dust
  • damp and mould
  • dander (animal skin/fur)
A few people had patch test for allergies done, but others had been told by their doctors that they couldn’t have one done. This is because lots of different things can irritate the skin, but not all are related to allergies and allergens. An allergy test won’t show all these other things which make the skin flare-up, so the results would be of little help for managing their eczema.
 

Dr McPherson talks about why allergy tests aren’t offered to everyone with eczema.

Dr McPherson talks about why allergy tests aren’t offered to everyone with eczema.

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So, why are people with eczema not always given allergy tests?

Because most people with eczema aren't actually allergic to anything. So mostly children with eczema, young people with eczema, have - they do have a higher risk of allergy because their skin is leaky. And we're looking at more ways of improving their- reducing their risk of getting allergies, by really directing skin- you know, sort of skin-targeted measures. So, increasing the barrier function by emollients, and reducing inflammation. Because those are the two things which happen first of all. In the most part, allergies develop on the background of bad eczema. So, I mean, we now know a little bit more about that, that actually what probably happens is that if their skin- because we know their skin barrier is, is sort of leaky, they're more prone to allergens entering the skin and developing allergies. It's very common for people with eczema to develop things like hay fever, and occasionally asthma. And really, the only reason for allergy tests is if you're going to change your management, if it's going to affect what someone does. So we know that they have a quite high risk of being sensitised to normal things in the environment such as grasses, pollens, trees. But really, that information is not going to change what you do because you can't avoid grasses, pollens and trees. So allergy testing to those is not that useful. The only time that we actually do allergy testing is when it's going to change what we do. And that's probably in the context of food allergy. 

People would love to have a test that said why they got eczema, and have one particular thing that they can avoid or change in their lifestyle. Unfortunately it's such a complex process, and they're probably over-reacting to lots of different things, and that's only part of the reason why they got eczema. So it's not that we can do a test and say, “Okay, you can avoid tomatoes, and you're not going to have eczema again.” That's not really going to be the case. So actually the only time we really do allergy testing is if they've had a, what we call an immediate response to food. And in that case, you know, they're almost- it's almost, they almost know that they've got this allergy anyway. But for very young children, allergy testing can be useful. Generally for older children, unless they, you know, they've got an immediate reaction to food, then just doing a lot of allergy tests is not very useful. There are two different types of allergy testing. So there's the one that you look the kind of immediate type response, which is something called IgE. And that would be, so food allergies can cause that, and you would be able to test that either by a prick test on the skin or a blood test, which is called a RAST test, IgE. The other type of allergy is the contact eczema that we talked about briefly. And that would be looking at doing something called patch testing, to see if there's anything that they're reacting to on the skin, left on the skin. So it's a different type of reaction that tends to take longer to come up, and it'll come up as a form of eczema. And that again is only really indicated if you've got an in depth suspicion that they might be reacting to something that's going on the skin, such as a topical treatment or something like that. It's a very complex area. And it's certainly not, you know, it's not advisable just to do lots of allergy tests if you can't use the information usefully and it's not going to change how you manage your skin and your other conditions.
Some people had to give up hobbies that involved coming into contact with things that they were allergic to. This could have a big impact on outdoor activities and hobbies. Himesh switched from playing cricket to tennis to avoid contact with grass and Laura had to stop horse riding. Dust and dirt allergies mean it’s important for some people to have a clean home but coming into contact with harsh chemicals from cleaning products could be bad for their skin. For those living in shared accommodation, such as whilst at university, it could also be difficult to get housemates to understand the importance of keeping a clean living space. (See also ‘Family life and eczema’).
 

Some of the triggers for Alice’s eczema also affect other related conditions she has, such as asthma and allergic rhinitis.

Some of the triggers for Alice’s eczema also affect other related conditions she has, such as asthma and allergic rhinitis.

Age at interview: 22
Sex: Female
Age at diagnosis: 7
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One of my other medical things is I have like a, I think it’s called allergic rhinitis where my nose is permanently blocked basically and dust and mould and stuff trigger that off so if I’m in like a kind of damp house or something, like my house in second year was really, really damp and it made that worse but I think in my mind eczema and those like the dust and mould allergies are kind of related because when I’m sneezing I get itchy as well.

So yeh so I’d consider allergies to be more of an impact on me because they’re something that I can't deal with so much.
 

Animal fur and some kinds of foods are triggers for both Laura’s eczema and asthma.

Animal fur and some kinds of foods are triggers for both Laura’s eczema and asthma.

Age at interview: 22
Sex: Female
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So like, basically I avoid a lot of things like just, just like basic things like, you know, if people are stroking horses or animals or cats or dogs, I just don’t do that because I just know it's not really worth it cos I'll get asthmatic or I’ll get really bad bumpy skin. So, like when it's, generally day to day with the eczema, it's either dry or if it's infected it will be like red and broken skin. But then, when it gets allergies it comes like bumps, like kind of like it… yeh just bumpy and like kind of white or sort of lighter skin of bumps and really itchy, yeh really itchy. And so I just avoid situations like that and actually to the point where lots of people, lots of my friends, sometimes when I've known them for a few years, they actually don’t know that I've got asthma or too many allergies because I don’t make a big thing of it, you just avoid those situations, like you just don’t touch animals. Or, for example, food types, I just don’t eat apples or unless they're cooked. It's a very strange, like plums, apples, peaches, nectarines – loads of fruit I can eat it when it's cooked. Cherries, I can eat them when they're cooked but not when they're raw.

And so it just comes up in a, and also I get like asthmatic and, yeh. And the mouth – I looked it up recently what it is; it's to do with pollen and it's very much around the mouth, like the mouth becomes really inflamed and like really tight here [gestures to throat]. And so it's just, that’s not worth it. And also, sometimes the thing that, as I was growing up, that was quite something that I sort of always had to be prepared for, was taking the antihistamines and inhaler with me to all my friends' houses because they, if they had dogs, cats or even if a cat or a dog had been in the house, I would become, especially at sleepovers there would – I've had quite a lot of sleepovers where I haven’t slept cos I've been wheezing all night and not being able to and being itchy and things like that. So, you just have to always sort of be prepared for an outbreak.
 

Aadam had immunotherapy treatment to help ease his grass allergies, which triggered his eczema and asthma.

Aadam had immunotherapy treatment to help ease his grass allergies, which triggered his eczema and asthma.

Age at interview: 18
Sex: Male
Age at diagnosis: 1
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I am also allergic to grass and dust mites. But for the trees and grass I had something called immunotherapy, which is quite a new sort of treatment that I was fortunately able to get off the NHS, because it does cost a lot. And it’s sort of helped me deal with tree and grass allergies a lot easier, so I don’t I don’t feel breathless easier, because I used to notice when I used to do cross country running that by the end of it I would find it really hard to breathe. So even playing sports in the field, I would find it really hard to breathe. But since the immunotherapy, which took which took four years, which is very long for it took a lot of dedication. Since the immunotherapy I have been a lot better. And hay fever hasn’t been a severe issue of mine anymore, which is good, because I do really enjoy the outdoors. 

Well there were two options. There was the injection option, which would mean coming into hospital and having an injection every two weeks. But me being afraid of needles, [laughs] I obviously didn't go for that option. The alternative was, these sort of mouth drops which I am guessing have like a condensed part of a tree or grass inside [laughs] or the parts that actually were I guess the allergens. So, that involved spraying or putting droplets of the substance in your mouth, once a day. The first time I tried it, I had an allergic reaction. So then, they had to give me a starter pack, which is more or less concentrated, so I was able to sort of get myself used to it a lot quicker. But yeah it was, it was very, it was hard, especially when you would forget. And then, sometimes, the underneath of my tongue where you are supposed to place the droplets and leave them for about two minutes, that part would swell up and go really numb. So, yeah, it was a very long process. It did mean I had to miss like certain amounts at school. 
Food and drink

A wide range of foods were thought to trigger eczema. Sometimes these were ‘allergies’, but other times some foods caused reactions but are not strictly allergies. Some of the most frequently mentioned food and drink triggers were: 
  • red meat
  • sweets
  • chocolate
  • fizzy drinks
  • milk/dairy
  • some kinds of fruit (e.g. peaches, melon, red berries)
  • spicy foods
  • processed foods (e.g. pizza)
  • caffeine (e.g. coffee)
  • alcohol
  • nuts
Other food triggers were considered more unusual. It could be difficult to explain this to friends when out eating with them and some wouldn’t believe it. Garlic and sushi both cause Gary’s skin to flare up, but people often challenge him on how this could be. Some people found that they were okay to eat certain foods but couldn’t touch or prepare them raw. Aisha has no food allergies but finds that cutting raw tomatoes hurts the skin on her hands. Some tried food alternatives – Himesh finds goat milk is better for his skin than cow milk.
 

Himesh stopped eating cheese for a while because it triggered his eczema. He’s now re-introducing it to his diet with antihistamines.

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Himesh stopped eating cheese for a while because it triggered his eczema. He’s now re-introducing it to his diet with antihistamines.

Age at interview: 17
Sex: Male
Age at diagnosis: 10
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I’m not allergic to the food as such but I would avoid some of the foods like cheese I would avoid but recently I’ve been trying to have like a slice of cheese a week just to see how it is, I used to love cheese let’s just put it that way I used to eat it a lot but then obviously when I had eczema it wasn’t good for my skin.

The cheese, I only had a slice a week as I said but it’s been alright to be honest and I’ve started to eat pizzas as I used to love pizza as well but I’ve started to eat pizza again but still I have that feeling that my skins going to get bad if that makes sense so I force myself once I’ve finished eating it to have Piriton so nothing gets bad, but yeh I’m not 100% sure if it’s a good, like if it’s a good thing to have pizza or cheese because I do tend to have Piriton afterwards. Not for the cheese if I’m having a slice but if I’m having quite a lot of something then I would have the Prirton afterwards.
 

Fasting for Ramadan helped Maham work out some of her dietary triggers.

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Fasting for Ramadan helped Maham work out some of her dietary triggers.

Age at interview: 21
Sex: Female
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So I was fasting this month, last month, because it Ram-Ramadan and, and that meant the whole month I was, the fasting in England is very difficult because it’s like, you eat in, at sort of sunrise and you open your fast at sunset, which meant in the, in British summer time it’s 3am to 9.30pm I wasn’t eating any food.

And that was good for me because it meant that I could isolate all of the food in my life and then I’d, I was only having one meal a day because around 9, 9.30 if you’re eating and then by 3am you’re not really hungry again. So I was only eating one meal a day but that meant I could really isolate … exactly what triggers my eczema had. 

So if I had a coffee during the fast time then and I’d get a reaction then I’d know that coffee is, is a trigger for me, then so on and so forth. So that was an experience I had that really helped with the food. So I wouldn’t, I wouldn’t suggest that people should fast, but I would say that [uh] isolation diets are something that people do so they’ll only have rice for like a couple of days and then they’ll see if they get a reaction and they’ll only have whatever else and then they can figure out if food is a trigger. 

Yeah. Yeah.

So I found the isolation diet was helpful. It, it’s quite an extreme thing to do but it’s …it, if food does seem like a trigger then it might be a good idea.
Getting the skin wet and chemicals in water

Some people said that getting their skin wet (washing/showering, swimming, doing the washing-up, being in the rain) could flare up their eczema, even though drinking water and staying hydrated really helped their skin. Many avoided swimming because of the impact of water, and especially chlorine, on their skin. However, Evie found that chlorine wasn’t a problem for her skin and in fact seemed to help her eczema heal faster. Being in the sea/salty water was another trigger mentioned by a lot of people, though Gary found that one of the best places for his skin was a salty sea on holiday. Lizzie’s skin reacts to hard water (which has a high mineral content), so she had a water filter installed at her family home. Lots of people said they used rubber gloves when washing-up so their skin didn’t get wet or come into contact with washing-up liquid. At times, Maham’s worn rubber gloves when washing her hair and brushing her teeth because getting her hands wet was so uncomfortable.
 

Laura uses hot water to stop itching, but she’s aware this might make her eczema more irritated in the long run.

Laura uses hot water to stop itching, but she’s aware this might make her eczema more irritated in the long run.

Age at interview: 22
Sex: Female
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I got into quite a bad cycle for quite a few years actually, of when it was really itching me. I'd go to the toilet, or go to the sink in the kitchen and run it under hot water cos it like soothes it and relieves it. But obviously it's not very good cos that’s like taking any moisture out of it really. And then I'd moisturise it again. Because basically I think that if it, sometimes when it's really itchy or irritated I think it's because it's just like got something irritated, that’s irritated on it. So I've touched something or, you know, food or anything. So I just like ran it under hot water and everything which, sometimes relieved and stuff and it would help cos it would dry it out completely and take anything off and then you'd put the moisturiser on. 

But it's probably not the best thing. And also like if it had been a food thing, putting hot water would continue cooking the thing on your skin rather than, cold water would probably be better. But, because it was just like, you want instant relief so, that’s what I used to do which is probably not good practice.
 

Abid talks about using rubber gloves for washing up to avoid getting his hands too wet.

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Abid talks about using rubber gloves for washing up to avoid getting his hands too wet.

Age at interview: 24
Sex: Male
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As someone who enjoys cooking so much I don’t enjoy washing up and not from just a scale of it’s not necessarily fun or whatever and I’m, I’ve just enjoyed a meal, I wanna relax or whatever, it’s actually the fact that if I get my hands wet that, that would, that’s a catalyst for my eczema to, to get worse. And I don’t feel like rubber gloves are like the best alternative I feel like I have to replace them every, y-you know, like every fortnight because there's, y-you know how it is when you, when you put in a pair of gloves and accidently some like water might leak in and like yeah it’s not fun. 
 

Rain water can aggravate Naomi’s eczema. On one occasion, she was left with a raised scar.

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Rain water can aggravate Naomi’s eczema. On one occasion, she was left with a raised scar.

Age at interview: 17
Sex: Female
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Except, when it rains and I'm wearing dolly shoes it's…that’s the bad thing about not wearing socks cos I have like sores on my ankles, so when it rains, that rainwater stings, it absolutely kills, and that’s the only…rainwater does sting. And I remember, I thought I was allergic to it once, cos when I went out and I didn’t put my hands in my pockets – my coat didn’t have any pockets and it was like a leather jacket – and when it poured it my…this, all raised up and now it's permanently like that. Apparently just cos it rained and it irritated.

Oh wow

You wouldn’t think rainwater, the most natural thing, would irritate skin.

But it does mine. Even on my face, when it rains my face is down, if I had just my scarf I'd have to cover up my face. So, I've realised my skin isn't too happy about rainwater.
Cleaning products

The strong chemicals in cleaning products could trigger some people’s eczema. These included washing-up liquids, bathroom cleaners/bleach and laundry detergent. Avoiding contact with cleaning products and keeping rubber gloves dry could be difficult, especially in shared houses. Staying over at other people’s houses was a worry for some people, because the laundry detergents used on bedding and towels might trigger their skin. (See also ‘Family life and eczema’).

Cosmetics and bathing products

Eczema can be triggered by things such as:
  • shampoos
  • shower gels, soaps and bubble baths (including for handwashing)
  • deodorants
  • sun-cream
  • perfumes
  • shaving gels
  • make-up (and make-up removers)
  • nail varnish (and nail varnish removers)
  • hair dye
  • hair styling products like gel
  • cosmetic (i.e. non-medical) moisturisers
  • face washes and scrubs
Some people found a product used on one part of the body triggered eczema on another, such as sprays (like hair spray and deodorant) or things used in the shower (such as shampoo). Most people tried to avoid things which were very perfumed and they preferred to have products with more ‘natural’ or ‘organic’ ingredients. Caution should be taken though – even if products were sold as ‘natural’, they may actually contain fragrances and some contain steroids. Bathing products for ‘sensitive skin’ were fine for some people, but still upset eczema for others. Some people knew of particular ingredients they had to avoid; for Laura, this was lanolin (a wool-based wax) and for Molly this was parabens (a range of preservatives). People often used a mix of prescribed treatments (such as emollients) in addition to shop-bought ones. 

Hair removal could also be tricky – some people found it helped their eczema as growing back hairs irritated their skin, others found it was better to let facial and body hair grow out. Instead of using shaving foams, Vicky and Himesh use one of their emollients.
 

Molly says it was a “game changer” when she learnt that she is allergic to parabens in cosmetic and bath products.

Molly says it was a “game changer” when she learnt that she is allergic to parabens in cosmetic and bath products.

Age at interview: 21
Sex: Female
Age at diagnosis: 4
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At first it was such a chore because you don't realise how much it’s in everything and it literally is in everything and actually really, really luckily – so the first year it was kind of just finding the products that didn’t have it and then now I’ve just got, I know what shampoos I can buy and what shower gels I can buy and what not. And so and kind of like 12 months after we found out about parabens, it kind of came trendy not to have parabens in because I think everyone should avoid them apparently but me especially [laughs] so that’s been really lucky and that like now brands will advertise ‘This is paraben free’ which kind of has broadened what I can use. So now it has like so little effect but for a long time it was really frustrating like taking my whole make-up bag and like chuck, chuck, chuck [laughs] and now, but now I know what to buy so it’s fine.
 

Sarah talks about cosmetic and bathing products which may be used on one part of the body but trigger eczema elsewhere.

Sarah talks about cosmetic and bathing products which may be used on one part of the body but trigger eczema elsewhere.

Age at interview: 23
Sex: Female
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And then like kind of with products, like one of the biggest things that I never realised is that like you can have eczema on your body from using products on your hair. So I, like when I was researching it online I found someone had discovered that they were allergic to shampoo. And this was kind of like one of those like ‘oh, my goodness. Like that’s probably what I’m allergic to.’ Because when you wash your hair with shampoo and then it runs all down your body. And then that’s why I think I was getting it on my back. So then like begins the process of trying to find a shampoo that you’re like not allergic to or doesn’t have sulphates in or like other like ingredients that can be quite-, what, what’s the word? Like that can cause a reaction. That’s quite difficult. There’s not many shampoos that you can buy, and when you do buy them they don’t work at all. So [laughs] that’s really annoying. And conditioners. And then mascara, definitely like eye make-up remover I think is really bad. And I always tell people who have like bad eczema on their face like, “Just stop using it.” So you can use mascara that you can take off with hot water and then you don’t even have to use eye, eye m-, make-up remover at all. I stopped using soaps and face washes for a while cos the doctors just said, “You don’t even need it.” But now I like use special ones that I don’t think cause a reaction. I think one of the other things as well people don’t think about that could be causing them eczema is hairspray and spray deodorant. So spray deodorant was giving me eczema on my eyes. I had really bad eczema on my eyes. I couldn’t think what it was. Like I hadn’t changed anything. And then I realised I’d changed my deodorant. And I think like when you spray something it can go all over and you don’t realise like that it’s settling on your skin. So then I stopped using a spray deodorant and I only use those weird roll-on ones [laughs] that don’t smell as good.
Clothes and fabrics

Some fabrics can irritate the skin and prompt an eczema flare-up, such as woolly jumpers and poly (synthetic) materials. Other fabrics mentioned by people included sequins, leather, fake fur and denim. People said that they tried to stick with wearing cotton-based clothes and some also used cotton bedsheets. Many mentioned that tight clothes flared up their eczema further but very loose clothing could make it too easy to scratch or cause friction on their skin. People had to think carefully about style and fit when choosing clothes. Alice’s childhood experiences of itchy fabric and sticky emollient (creams) on her arms have made her dislike wearing long sleeved clothes. Others, such as Katie-Lauren, prefer to layer up clothes as a kind of barrier between the skin and itchy fabrics. Clothes also made a difference to the person’s temperature. Molly layers up when walking to lectures in the winter but sometimes overheats in the process of getting there, which irritates her skin. Jewellery, especially ‘cheap’ metals, could also cause flare-ups.
 

Alice talks about clothes, including the feel of different fabrics, and her eczema.

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Alice talks about clothes, including the feel of different fabrics, and her eczema.

Age at interview: 22
Sex: Female
Age at diagnosis: 7
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I don’t like wearing long sleeves anyway just because of the residual memory of having itchiness there. But if I had my sleeves pulled down it would kind of get stuck to the inside and that would make it more itchy as well because then the fibres and stuff would get stuck to me and it’s just ergh. I tend to find it more of a problem on my upper body with the sticking to things, like if I’m wearing tights over the moisturiser or whatever – that’s okay, I can kind of deal with that but I’m not sure what it is, maybe it’s a psychological thing but having it stuck on the inside of my arms just makes me feel really horrible.

Yeh, there’s lots of different fabrics that I can’t, I just can’t wear. I can’t wear like woolly jumpers or anything like that because it’s just too itchy – it just makes my skin feel horrible and I sit there scratching constantly. even like, when I was little I couldn’t wear like thick jumpers or anything even if it wasn’t woolly jumpers and as a result I was always like running around with just a T-shirt on because when my skin got too hot my eczema would flare up and that still is something that I, I don’t know, I suppose it still has an impact on me now because I still don’t like wearing lots of layers in case my skin gets too hot and like sticky and itchy so that's the main thing. Washing my clothes I’m not really sure I don’t think that washing powder has an impact but then I noticed more recently that when I was fishing some of my like undergrad clothes out of my cupboard that were really dusty, that definitely set it off again.
Hormones

Some people said their eczema had changed during puberty, which they linked with hormones. Sometimes eczema became worse but for others, it could improve for a while. For some of the young women we spoke to there were a number of other triggers related to hormones which could flare-up their eczema such as: menstrual periods, using contraceptives such as the pill or the hormonal coil, or after sex. Some people had conditions which affected their hormone levels and seemed to be linked to their eczema, such as hyperhidrosis for George which means he sweats more, and polycystic ovary syndrome for Ele.
 

Molly talks about hormones as a trigger for her eczema and how it has affected her choice of contraceptives.

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Molly talks about hormones as a trigger for her eczema and how it has affected her choice of contraceptives.

Age at interview: 21
Sex: Female
Age at diagnosis: 4
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Went on the pill and went on so many, because one gave me migraines but, so I came off that and then every one since then gave me reacted with my eczema because I think just, I think my eczema is obviously really linked to my hormones. So now I’ve got the coil and it’s amazing, the hormonal coil as well which is great, fine. But I reckon if I got a non-hormonal one it would have been even better but I didn’t so.

It was so pivotal in my decision to get the coil cos I went to the doctor here and was like “I’m so bored with the pill, it’s so bad for my eczema” and then just like “I need an alternative” and she was like “Well, the coil’s really great – a) cos there’s an non-hormonal one and b) because the hormonal one is only the equivalent of half a pill a week, so you’re taking six and a half less pills than you would be on the pill”. So I was like “That sounds great” and it has been great, it really has been fine with my eczema, thank God.
 

George also has a condition called hyperhidrosis (excessive sweating) which he says is hormonal and upsets his eczema.

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George also has a condition called hyperhidrosis (excessive sweating) which he says is hormonal and upsets his eczema.

Age at interview: 17
Sex: Male
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And I mentioned how in hot weather when you sweat it makes it, makes it worse for me cos it dries your skin up. And there’s a pill. I can’t remember which stops you sweating. I don’t know, can’t remember the name of it and that was quite helpful.

Where did you find out about that tablet?

My dermatologist told me about it.

Ok and do you know what it’s for, what generally it’s used for?

I think it is something to do with hormones, used to treat hyperhidrosis which is excessive sweating which I think I have that but they are linked, the eczema and the hyperhidrosis.

Ok. Is that a link that your GP knew about or is it something that you?

It’s something I kind of deduced myself but the-, yeah, my GP and the dermatologist both agreed with me.
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