Eczema Risk Factors

What is eczema?

Eczema is a chronic skin disease where the skin has a rash, inflamed, itchy and typically red, cracked and dry, also known as atopic eczema or (atopic) dermatitis. Sometimes the skin will also have scaly patches or small blisters and if you are a long-term sufferer, your skin may become thickened as well.1
What causes eczema is as of yet unclear despite the progressions made in eczema treatments, not much research on how to prevent it has been done, however, it seems to be clear that it is not down to one single thing.1,2,3 

When (young) children have eczema, in some cases, it is seen that eczema improves significantly, or even clears up completely when they get older. Although eczema is more common in (young) children, it can also develop in adults for the first time.1
A study done in 2017 has shown that the incidence of atopic dermatitis has increased 2- to 3-fold in industrialised nations, affecting roughly 15% to 20% of children and 1% to 3% of adults worldwide!4

Symptoms of eczema

A diagnosis is typically made based on the symptoms of itchy, dry, cracked, inflamed and sore skin. 

Where some people only experience tiny itchy patches of dry skin, others suffer from widespread itchy, inflamed skin all over their bodies.

Your skin tone usually determines what colour the inflamed patches take on. It typically will be red on lighter skin and darker brown, grey or even purple on darker skin. 

The eczema patches will also generally have a preference to affect the skin of the hands, the insides of the elbows and knees and the face and scalp. 

People suffering from this condition will have periods where it is not that bad and the symptoms are not affecting their daily lives much, as well as periods where the symptoms are more severe; the so-called flare-ups.1

Risk factors

Next, we will list a number of risk factors to discuss how they trigger your eczema and cause a flare-up. 

Atopic dermatitis (or atopic eczema) tends to occur more often in people who have allergies.1 The word ‘atopic’ stems from the Greek word atopia or atopos describing “unusualness, strangeness, odd or out of place” as the reaction is classed as a hypersensitivity or overreaction to allergens.5

These allergens can play a part in food allergies, especially seen in young children with terrible eczema.1 


Since your diet can trigger flare-ups, what should you potentially avoid? Foods that are known to cause an allergic reaction are: peanuts, tree nuts, chicken eggs, shellfish, fish, dairy products, wheat, soy, spices and some fruit and vegetables. If you suspect your diet is involved in triggering your eczema, you can start keeping a food diary to try and determine whether a specific food is making your eczema worse. When you have an idea, avoid these foods for a couple of weeks and then re-introduce them, one at a time, into your diet to confirm. When all this fails, you can always see your doctor for some allergy tests.1,4,6,7


Itching is possibly the first all-important trait required for a diagnosis of atopic dermatitis, as it is the leading symptom. Itching can be triggered by emotional stress in 81% of the patients studied by Beltrani et al. in 2003.8 People suffering from eczema experience itching; all day, every day and it interferes with their sleep, which comes with its own problems. For some, it is that bad they also suffer from mental distress and increased risk of suicidal ideation.4 Once the itching begins, the surrounding skin will be very sensitive and can involuntarily react to other stimuli like being touched by clothing to start the vicious circle of itching, scratching, damaging the skin, inflamed, red, dry and cracked skin that itches, sleep disturbance, emotional stress, etc.9

Extreme climate/temperature variations

Extremes of hot and cold weather are not tolerated by people suffering with eczema, basically because it can lead to sweating and dry skin respectively, initiating itching. When braving cold weather, please do not dress your child in wool, as it has been found to be a trigger.4,7 Same for central heating, reducing the humidity indoors and dries the skin. Additionally, moving between indoor warmth and outdoor cold can also be a trigger!7

Skin irritants

Several skin irritants also need mentioning, like house dust mites, animal dander, saliva and fur, pollens and moulds can all irritate the skin; as can handling irritant foods like citrus fruits, raw onions, raw potatoes, garlic, tomatoes, peppers, and chilies.10 

Chemicals (cleaning detergents, laundry detergents)

It is believed that non-biological cleaning and laundry detergents are safest for eczema sufferers to use and that fabric conditioners irritate eczema. You may experience this differently. Although, there is no scientific proof that states that the enzymes in biological detergents make eczema worse since some people with eczema find that they have no problems with unperfumed detergents and fabric conditioners.10 

Cosmetics and make-up

The same would apply to cosmetics and make-up. Seek out the hypoallergenic brands and determine which ones suit you best.10

Family history

Typically you will find that people suffering from eczema have family members with atopic diseases as well, like food allergies, bronchial asthma or allergic rhinoconjunctivitis. When looking at the genetic makeup, it was found that there is also a mutation or defect of the FLG gene.4,11,12 


Unfortunately, there is no cure for eczema yet, but it can be treated to help relieve the symptoms and usually help improve it over time. Severe eczema can take a toll on someone's quality of life where  great difficulty in coping physically and mentally.4 To minimise the additional risk of getting a skin infection, you can use emollients to keep your skin moist and supple and anti-inflammatory topical steroids and calcineurin inhibitors (tacrolimus and pimecrolimus) to help reduce the itching, swelling and redness.1,2  Oral medications can also be explored, like taking a low-dose antihistamine to help with the itching or more recently the biologicals IL-4R-blocker dupilumab, and different Janus kinase (JAK) inhibitors. 2,8,13,14 


Eczema is a chronic skin disease where you have an itchy rash, inflamed, and typically red, cracked, and dry. The cause of eczema remains unclear, although if you have family members with atopic diseases, you will have a higher risk. Unfortunately, there is no cure for eczema yet, but it is possible to treat the symptoms to help improve your quality of life. Please see your doctor or dermatologist for help.


  1. Atopic eczema. [Internet]. 2017 [cited 2022 Sep 5]. Available from:
  2. Wollenberg A, Christen-Zäch S, Taieb A, Paul C, Thyssen JP, Bruin-Weller M de, et al. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020; 34(12):2717–44.
  3. Williams HC, Chalmers J. Prevention of atopic dermatitis. Acta Derm Venereol. 2020; 100(12):adv00166.
  4. Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care. 2017; 23(8 Suppl):S115–23.
  5. atopic | Etymology, origin and meaning of atopic by etymonline [Internet]. [cited 2022 Sep 6]. Available from:
  6. Food allergy. [Internet]. 2017 [cited 2022 Sep 6]. Available from:
  7. blue_admin. National Eczema Society [Internet]. 2020. Triggers for eczema; [cited 2022 Sep 6]. Available from:
  8. Beltrani VS, Boguneiwicz M. Atopic dermatitis. Dermatology Online Journal [Internet]. 2003 [cited 2022 Sep 6]; 9(2). Available from:
  9. Lambert A. National Eczema Society [Internet]. 2021. Stress and eczema; [cited 2022 Sep 6]. Available from:
  10. blue_admin. National Eczema Society [Internet]. 2020. Household irritants and eczema; [cited 2022 Sep 6]. Available from:
  11. Hu C, Duijts L, Erler NS, Elbert NJ, Piketty C, Bourdès V, et al. Most associations of early-life environmental exposures and genetic risk factors poorly differentiate between eczema phenotypes: the Generation R Study. Br J Dermatol. 2019; 181(6):1190–7.
  12. Pullerits T, Rönmark EP, Ekerljung L, Palmqvist MA, Arvidsson M, Mincheva R, et al. The triad of current asthma, rhinitis and eczema is uncommon among adults: Prevalence, sensitization profiles, and risk factors. Respir Med. 2021; 176:106250.
  13. Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017; 13(1):15–26.
  14. Bordon Y. JAK in the itch. Nat Rev Immunol [Internet]. 2017 [cited 2022 Sep 6]; 17(10):591–591. Available from:

IIona Kosten

Master of Science - (MS), Immunology and Infectious diseases, Vrije Universiteit Amsterdam (VU Amsterdam), Netherlands

Ilona has a BSc and MSc in Biomedical Sciences and a PhD in Immunology with a sweet spot for “all things allergy”.
She’s published a number of articles in peer reviewed journals ranging from skin and mucosa tissue engineering, immunoassays, DCs, LCs and T cells." presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
Klarity / Managed Self Ltd
Alum House
5 Alum Chine Road
Westbourne Bournemouth BH4 8DT
VAT Number: 362 5758 74
Company Number: 10696687

Phone Number:

 +44 20 3239 9818