Eczema or atopic dermatitis is a chronic skin condition that can be debilitating. Many children (about 85%) who have eczema develop this condition by age 5 years old (1). Children’s quality of life is greatly affected due to sleep deprivation, activity restrictions, bullying, etc. (2) Despite all the negative aspects of eczema, finding what triggers eczema in toddlers and other children can dramatically improve the quality of your child’s life and also the parent’s well-being.
Why does it happen?
There are multiple causes of eczema. Some studies show that eczema is due to a defect in skin barrier. More specifically, there is a deficiency of ceramide, a fatty acid that plays a role in the skin barrier. Products containing ceramide can be helpful. Another cause of eczema is due to an excessive immune response that is involved in the inflammatory response. (3)
What triggers eczema in toddlers and other children?
There are many triggers for eczema. For every unique child, there is a unique trigger. This article will discuss as many triggers that are known to exacerbate eczema. I will continue to update, but if you see a trigger that is not in this article, please let me know and I will research it. If we can find the trigger, we can prevent an eczema exacerbation.
Weather and Temperature
Humidity can help protect eczema by improving the skin barrier function. (4) I have noticed this myself in my children. I currently live in a desert climate area where the winter is dry and windy. My child’s eczema invariably gets worse during the winter. When I visit coastal areas near the ocean where the humidity is higher, my child’s eczema greatly improves and he is much happier.
Interestingly in this same study, low temperature (50s Farenheit) is associated with eczema. I have noticed myself when I take my child outdoors at low temperatures but not windy, his eczema calms down. This is not a contradiction to the study. An explanation for why low cool temperature can exacerbate eczema in this study is that people tend to stay indoors with the heater on. This causes the air to be drier and worsen eczema. (4)
One tip is to moisturize right away after bathing your child to lock in the moisture. It is recommended to moisturize within 3 minutes of bathing your child.
Excessive Heat and Sweat
Excessive heat and sweat can also trigger eczema flare-ups, especially in the summer. Keeping your child cool and having them wear cotton clothes will help. Avoid clothing that traps in heat, such as synthetic fibers (i.e. polyester, nylon, acrylic, etc).
Chemical Irritants
There are certain chemicals that should be avoided in those with eczema or skin conditions. Cleaning products commonly have chemicals such as ammonia and hydrochloric acid. Most children will obviously not be using these intentionally. The reason why I mention this is because some people use products that contain chemicals that can irritate those with sensitive skin (i.e. eczema, dermatitis, etc). For example, you may clean the windows with ammonia. When you use this product, ammonia scatters around and touches various surfaces. If your child comes and touches the surfaces and then touches their face, the chemicals can affect your child with eczema. Consider looking for products that are friendly to sensitive skin (5).
Also, another precaution is that children will sometimes open cabinets out of curiosity. They may expose themselves to these chemicals inadvertently while playing with them. It’s important as parents to install safeguards and precautions to prevent children from doing this.
Food Allergies
Eczema and food allergies go hand in hand. It is important to know what foods trigger your child’s eczema so you avoid giving it to them. Many children outgrow their food allergies. Common food allergies include dairy, eggs, tree nuts, shellfish, peanut, soy, wheat, fish, and sesame. (6)
Clothing
Clothing that is rough, tight or traps heat can cause eczema to flare. Wool is well known for irritating eczema skin. For this reason, clothes made with wool should be avoided. Cotton is very good for eczema because it conducts heat very well and absorbs moisture easily. Silk is good as well, but depending on the type of silk it can actually reduce transpiration and cause discomfort when touching skin directly. (7)
Stress
The relationship between stress and eczema is not straight forward. I have anecdotal evidence, even personal experiences, of stress causing eczema. One study showed that stress can provoke an immune response in people with eczema by increasing certain immune cells. Overall, I think it’s important to keep your baby stress free, which is not easy sometimes. I have found that my child becomes more frustrated and stressed when he is itchy so I try my best to distract him from scratching. I know once he starts scratching, it will further exacerbate the itch-scratch cycle. (8)
Phthalates/BPA
Phthalates and bisphenol A (BPA) can cause eczema. These chemicals are used to make plastic and are found in plastic household items such as baby bottles and pacifiers, among other products. There is more awareness of this hormone disrupting compound and many manufacturers have gone to great deals to not use them. (9), (10)
Metals
Metals such as zinc, chromium, cobalt, nickel which are present in jewelry, cloths, cosmetic products, and dental fillings can cause contact dermatitis. As the name implies, dermatitis happens after these metals rub against the skin. Nickel is commonly cited as a metal to trigger eczema. It is not clear for the other types of metal whether they can exacerbate eczema, but they can cause contact dermatitis. (11), (12)
Infections
This is not a trigger for eczema, but it is worth noting that those with eczema may be more likely to have a respiratory infection. An interesting question to note is whether controlling eczema and allergies (since they are related) can prevent respiratory infections. (13)
Smoking
Tobacco smoke is another trigger for eczema whether it is first hand or second hand (inhalation of smoke) smoking. We already know that smoking is bad for cardiovascular health. This is another reason for parents to stop smoking if they have children with eczema. (14)
Conclusion
Unfortunately, there are many eczema triggers. The good news is that once you find out what triggers eczema in toddlers and other children, you can avoid them and prevent flare-ups up to a certain extent. Knowledge is power. Don’t let eczema get the best of you. Fortunately, many children do outgrow their eczema. Every child is different and part of the journey is learning what your child’s unique triggers are. Hopefully, this article helps you identify some of the common triggers. Let us know if you have found other triggers that are not mentioned in this article!