What is an Eczema Flare-Up?

By Irmanie Hemphill, MD, FAAFP
November 16, 2021

Eczema is a general term used to describe a variety of conditions that cause redness, dryness, and itchiness of the skin.

Atopic dermatitis, the technical term for eczema, is a common condition affecting over 30 million people each year.

While eczema symptoms can be uncomfortable, they can be managed.

A variety of factors can cause what is described as an eczema flare-up, or a return of the symptoms of eczema that may affect one or more parts of the body. 

There are a number of common causes which may prompt an eczema flare-up, but the good news is there are many ways to manage eczema if you’re aware of your triggers, and you may even be able to prevent potential flare-ups.

This article will review causes, symptoms, and treatment for flare-ups of this skin condition.

What Causes Eczema Flare-Ups?

Eczema flare-ups occur when the immune system is overloaded and unable to fight off the things that trigger inflammation for an individual and results in the red, itchy, and dry skin.

A number of factors can contribute to an eczema flare-up, from environmental factors, to internal stresses and reactions. 

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Common Triggers

Different types of eczema have different triggers.

Personal care products and food allergens may cause an allergic reaction, which is called allergic eczema.

Potential triggers for this type of flare-up include fragrances, shampoo and conditioner, hairspray, certain harsh soaps and laundry detergents, as well as metals like nickel.

Food allergens may also cause an eczema flare-up; common food allergies that contribute to eczema are sugar, milk, peanuts, and wheat.

Cigarette smoke is another common trigger for an allergic eczema flare-up. 

Weather and environmental conditions can also contribute to a flare-up.

Dry air, wind, and cold weather in the winter can contribute to dry skin which can become brittle or tight and cause a flare-up of asteatotic eczema (also known as xerotic eczema or eczema craquelé).

This type of flare-up can also occur from excessive washing, like washing the face or hands too frequently, or taking too many hot showers.

During the summer, sweat may also contribute to an eczema flare-up since the skin is moist, and you may wear wet clothes for prolonged periods of time while your body temperature fluctuates.

During allergy season, like the spring and fall seasons, eczema may also flare up as a side effect of hay fever and pollen. 

Changes to your nervous system can also contribute to an eczema flare-up.

In a recent study, stress was shown to trigger atopic dermatitis in 35.4% of participants.

Stress contributes to inflammation in the body, which can trigger eczema. The same goes for other mental health conditions like depression and anxiety.

Another study presented evidence that suggests hormone fluctuation may be another contributing factor.

This may be why some people with periods experience flare-ups or relief of eczema symptoms during certain times of their menstrual cycle, or while pregnant. 

Seborrheic dermatitis, also known as “cradle cap,” can affect infants, and other types of eczema can flare up in young children.

Common triggers for eczema in young children include dry skin, saliva from drooling, as well as allergic reactions.

Symptoms of Eczema Flare-Ups

Eczema symptoms are different for everyone, but some of the most common symptoms of an eczema flare-up include:

  • Itchiness 
  • Dry, sensitive skin
  • Inflamed, discolored skin
  • Rough, leathery, cracked or scaly patches of skin
  • Oozing from area
  • Swelling
  • Red or brownish colored patches on the skin

Treatment Options for Eczema Flare-Ups

While there is no cure for eczema, there are a number of treatments that can help you manage the symptoms of a flare-up.

There are a variety of over-the-counter therapies, as well as prescription medications that can help.

Some people find relief from natural or alternative treatments as well. 

Medications and Prescribed Treatment

A variety of over-the-counter medications, like oral antihistamines (Benadryl, Claritin, Allegra) and anti-itch cream can help manage the symptoms of a flare-up.

Symptoms of burning or inflammation can also be managed with acetaminophen (Tylenol), or an anti-inflammatory drug like ibuprofen (Advil or Motrin). 

In more severe cases, a doctor may prescribe an oral corticosteroid (such as Prednisone), or corticosteroid creams or ointments.

Topical steroids or topical corticosteroids are some of the most commonly prescribed treatments for eczema, as they can reduce inflammation and itching and allow the skin to repair and heal.

These creams vary by strength and should only be used on the affected area.

There is evidence that immunosuppressant drugs may also help manage eczema, which often occurs as a result of immune system overload.

Oral prescription options include azathioprine, cyclosporine, methotrexate, and mycophenolate mofetil. 

Natural and At-home Treatment

There are a number of treatments for eczema that many people find helpful for managing the symptoms of an eczema flare-up outside of “conventional” medication.

Plant-based essential oils and topicals, like coconut oil, sunflower oil, and topical creams with B12 may help manage your symptoms due to their anti-inflammatory properties.

Some vitamins and supplements may also help manage eczema, such as vitamin D, fish oil, zinc, probiotics, and CBD.

Always be sure to check with your health care provider before adding new supplements or vitamins to your routine. 

A variety of bathing treatments may also help with eczema flare-up symptoms.

Soaking in a warm bath (rather than in hot water) can help the skin absorb moisture and ease stress.

By adding specific ingredients to your bath treatments, you can also help relieve some unpleasant symptoms.

Unscented bathing oils, baking soda, and oatmeal baths may help relieve itching and provide moisture. 

During severe eczema flare-ups, a wet wrap can help relieve symptoms and calm the skin so topical creams and treatments can be better absorbed.

To create a wet wrap treatment, moisten a clean cotton wrap or gauze with warm water. Wrap it on the affected area, and then wrap a dry layer over the wet area.

Do not disturb the area while it’s being treated. Wet wraps can be left for several hours or overnight, so long as they do not dry out.

Be sure to consult your doctor before performing a wet wrap treatment on your eczema flare-up. 

To treat cradle cap in infants, try shampooing with a mild soap and gently rubbing the area with a soft towel. 

How to Prevent Eczema Flare-Ups

The best way to prevent eczema flare-ups is to become familiar with your personal triggers so you can avoid any products, foods, or conditions that may cause eczema symptoms to flare up.

Some general tips include using mild, unscented soaps and developing a consistent bathing and moisturizing schedule.

Use moisturizers that work for you, especially on eczema-prone skin and areas of the body. For best results for long-term eczema, be sure to always use medications as prescribed.

When the weather changes and the air becomes more dry and cold, it can also be helpful to wear gloves to keep skin moisturized and prevent flare-ups. 

Another good way to combat eczema flare-ups is to address stress, which is a common trigger.

Some wellness practices and systems, including yoga, Ayurveda, and meditation, have been shown to help manage emotional stress, as well as the nervous system in general.

Acupressure and massage can also help relieve symptoms and keep the general nervous system in check and inflammation at bay. 

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When To See a Doctor

While most eczema can be managed, severe cases may require a visit to the dermatologist or an allergy specialist, and certain flare-ups may require further treatment.

If you experience symptoms for a prolonged period of time, if you develop new symptoms or worsening symptoms, or if your eczema is spreading to new places on your body, it may be time to visit the doctor. 

If itching is severe or has caused an open wound, seek medical attention.

It is possible for eczema to cause a secondary infection of staphylococcus aureus, or a staph infection, which requires immediate medical attention.

A doctor may be able to prescribe an antibiotic to prevent an infection from developing on the open area of the skin. 

How K Health Can Help

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Frequently Asked Questions

What is the most common eczema trigger?
Common triggers for an eczema flare-up include the environment, personal care products, food allergies, and stress. Changes in weather can contribute to dry and eczema prone skin. Certain scented personal care products and food allergies can trigger eczema. For many individuals, stress is an extremely common trigger for an eczema flare-up.
How long can it take for an eczema flare-up to go away?
With proper treatment, most eczema flare-ups should clear up in one to three weeks. If symptoms persist, seek medical attention.
What does an eczema flare-up feel like?
Common symptoms of an eczema flare-up include red, itchy skin, and dry skin. An eczema flare-up may also make skin feel bumpy, inflamed, and sometimes painful when touched.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Irmanie Hemphill, MD, FAAFP

Dr. Hemphill is an award winning primary care physician with an MD from Florida State University College of Medicine. She completed her residency at Halifax Medical Center.