EczemaNet Article
Heat, Humidity, and Emotions: Possible Triggers for Atopic Dermatitis

Excessive heat, high humidity, excessively dry air and emotional stress are mild annoyances for most people, but for a person with atopic dermatitis (AD) they may be triggers that worsen symptoms. Persons with AD are more sensitive to irritants than are people without AD. The list of potential irritants is long, including soaps and detergents, scratchy clothing, many chemicals, extremes of heat and humidity, and emotional stress. The effect of irritants in AD is to initiate reactions in the skin that worsen the itch-scratch cycle. No single factor is an irritant for all people with AD, but most people are sensitive to one or more of the long list of irritants.

Atopic dermatitis patients who are sensitive to heat and humidity may have to reduce exposure to outdoor extremes of both. They also may have to take measures to control indoor heat and humidity. A case-control study by McNally et al (see references) found a statistically significant association between AD symptoms in children and excessive humidity in the home as well as excessive heat and dryness when a radiator was used to heat the patient’s bedroom.

The relationship between emotional stress and triggering of symptoms is not clear. While some female patients have felt that AD symptoms may worsen before or during menstruation, there is no evidence that hormones are a trigger for AD. Frustration, embarrassment and anger have been identified by patients as emotional events that can worsen the itch-scratch cycle. A study by Ginsburg et al (see references) of emotional factors in 34 adults with AD found that they felt anger more readily but were less effective in expressing anger than were persons without atopic dermatitis. Links between emotional stress and regulation of immune reactions in skin are not well understood and require more investigation.

References:
Ginsburg IH, Prystowsky JH, Kornfeld DS, Wolland H. Role of emotional factors in adults with atopic dermatitis. Int J Dermatol 1993; 32:656-660.

McNally NJ, Williams HC, Phillips DR. Atopic eczema and the home environment. Br J Dermatol 2001; 145:730-736.

Nassif A, Chan SC, Storrs FJ, Hanifin JM. Abnormal skin irritancy in atopic dermatitis and in atopy without dermatitis. Arch Dermatol 1994; 130:1402-1407.

Ohmen JD, Hanifin JM, Nickloff BJ et al. Overexpression of IL-10 in atopic dermatitis. Contrasting cytokine patterns with delayed-type hypersensitivity reactions. J Immunol 1995; 154:1956-1963.

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