Why does the world around us impact atopic dermatitis?

For people living with atopic dermatitis, choosing the wrong piece of clothing, a change in the weather, or even stroking a fluffy dog can trigger painful symptom flare ups that can be frustrating and take time to get under control.^1-4

“So often in both children and adults, people can become preoccupied with what might be triggering their eczema or atopic dermatitis. They might spend months or even years trying to eliminate different food types from their diet. They might spend ages avoiding certain different soaps, different creams, believing that they might be contributing towards their disease. They might try natural remedies which, instead of helping their disease, might worsen it. So that can often preoccupy patients.”

 

PROF. FAISAL ALI, MA, PHD, BM BCH, MRCP, MRCS

CONSULTANT DERMATOLOGIST AND DERMATOLOGICAL SURGEON

UK*

While understanding potential triggers can help some people reduce the risk of flare-ups, avoiding them is not always straightforward. At its core, atopic dermatitis is a chronic inflammatory skin condition driven by neuroimmune disruption, so long-term treatment is often needed to properly control the disease. The complex neuroimmune changes ultimately weaken the skin’s protective barrier, making the skin more prone to dryness and irritation.⁵ Whilst flare-ups can occur without clear cause, environmental factors can trigger the underlying inflammation, causing symptoms to worsen.^1-4 In children, exposure to environmental irritants may also influence the development and severity of the condition.^1,3,6 

This means that many people live with a degree of uncertainty, balancing efforts to identify and avoid potential triggers while managing a disease that is not always within their control.^1,3,7 Greater awareness of these challenges can help improve understanding of the day-to-day realities of living with atopic dermatitis, and the burden that flare-ups can have on patients and their families.

What are the challenges of trigger management in atopic dermatitis?

Identifying which environmental factors might trigger or worsen symptoms for people living with atopic dermatitis is often difficult because triggers vary considerably between individuals.^1,3,7 For example, as Dr. Alpa Kanji, MBBS, PhD Consultant Dermatologist, St John’s Institute of Dermatology at Guy’s and St Thomas’ NHS Foundation Trust and University Hospital, UK, explains “for some people, the sun is very helpful and helps clear their eczema. For other patients, sun is terrible and makes eczema flare.”*

For many people, the unpredictable nature of atopic dermatitis can leave them feeling on high alert for potential triggers in an effort to avoid aggravating their chronically inflamed skin.^1,5,6 Despite these efforts, this is not always possible - many common triggers are unavoidable in everyday life, and the constant effort required to manage them can negatively affect quality of life and mental wellbeing.^6,7 

How can triggers and unpredictable flares affect daily life?

The ongoing balancing act of managing triggers can influence how people spend their time and interact with the world around them. Many report sacrificing exercise, avoiding outdoor activities, deciding against having pets, or cutting back on socialising as they believe this might help reduce the risk of a flare.^1,2,6,7 Whilst these changes may help protect their skin, they can come at a personal cost.^6,7

“There used to be a greenhouse here before, but I told my husband to take it out. I knew it would be good for planting but since I won’t be able to do it now, seeing the empty greenhouse would make me feel upset so I just told them to remove it so I wouldn't have to see it.” 

 

PATIENT LIVING WITH ATOPIC DERMATITIS

The uncertainty surrounding flares can also affect relationships and contribute to feelings of isolation.^1,6-8 One patient shared, “I eventually lost touch with one of my best friends because I had to keep cancelling our catch-ups due to my skin, which was naturally very difficult.”* Education and awareness can help to reduce the stigma of living with a chronic skin condition and foster greater understanding of the challenges people may face in their daily lives, encouraging patients to be more open about their experiences. 

For families of children with atopic dermatitis, the impact often extends beyond the patient. Parents may have to miss work to care for their child, cope with disrupted sleep, and navigate the uncertainty of flares when planning family activities and important events.^1,6-8

“They want to book a vacation. But what happens? Their child has a flare right before the vacation. They want to book big life moments: celebrating a birthday, celebrating a graduation. What happens? Flare of atopic dermatitis. And we can't predict it, and so it's almost like walking on eggshells constantly.” 

 

DR. MAXWELL SAUDER, MD, FRCPC

ASSISTANT PROFESSOR, UNIVERSITY OF TORONTO, DERMATOLOGIST

AVENUE DERMATOLOGY GROUP, CANADA*

Even when known triggers are avoided, symptoms may still worsen without an obvious cause simply due to the chronic nature of the disease. Reflecting on this, Dr. Benjamin Ungar, MD, Director of the Alopecia Center of Excellence and the Rosacea & Seborrheic Dermatitis Clinic and Assistant Professor of Dermatology at Icahn School of Medicine at Mount Sinai, United States, says: “It's not the fault of the patients for not avoiding triggers, or not identifying them. It's very important for us to keep in mind that although we may be able to identify some triggers, and patients may be able to factor that into their lives, in many cases there are no clear triggers.”* 

How can we better support people living with atopic dermatitis?

Whilst some triggers can be self-managed, avoiding triggers alone isn't enough to control the disease; most patients with moderate or severe disease need lifelong treatment that addresses the root-cause of their symptoms, giving patients relief from both their symptoms and the burden of constantly managing potential triggers.^1,6-8 Greater awareness of the visible and invisible impacts of atopic dermatitis can help improve understanding, challenge misconceptions, and support more informed and personalized care for people living with the condition.^1,5-8 

As we mark Eczema Awareness Month, Galderma remains committed to helping to raise awareness of the patient experience and championing a more holistic approach to atopic dermatitis care.

Disclaimers: Raising awareness of atopic dermatitis can help improve understanding and support for those living with this condition. If you’re struggling with the symptoms of atopic dermatitis or if the condition is impacting your daily life, consider speaking with a healthcare professional for advice and support. *The views expressed in this content are the personal opinions and experiences of the individual patients, caregivers, and clinicians. Clinicians and experts featured may serve as paid consultants to Galderma. This content is not intended to, and does not constitute, medical advice.

References

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2. Park M, et al. Climate conditions, weather changes, and air pollutants and atopic dermatitis: a meta-analysis. JAMA Dermatol. 2025;161(8):828‑839. doi:10.1001/jamadermatol.2025.1790
    
3. Nicole A. Impact of environmental factors on the development and management of eczema. J Dermatol Dermatol Dis. 2024;11(1):445. Doi: 10.37421/2684-4281.2024.11.445.
    
4. Lee W, Chaudhary F, Agrawal DK. Environmental influences on atopic eczema. J Environ Sci Public Health. 2024;8(2):101‑115. doi:10.26502/jesph.96120209
    
5. Yang G, et al. Skin Barrier Abnormalities and Immune Dysfunction in Atopic Dermatitis. Int J Mol Sci. 2020;21(8):2867. doi: 10.3390/ijms21082867
    
6. Laughter M R, et al. The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990-2017. Br J Dermatol. 2021;184(2):304‑309. doi: 10.1111/bjd.19580
    
7. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345‑360. doi:10.1016/S0140-6736(20)31286-1
    
8. Girolomoni G, Busà VM. Flare management in atopic dermatitis: from definition to treatment. Ther Adv Chronic Dis. 2022; 13:20406223211066728. doi:10.1177/20406223211066728.