The symptoms of atopic dermatitis can vary between people. The most common symptom is itching, which can be mild or moderate. In some people, the itching can be quite severe and cause inflamed skin. The itching can sometimes lead to bleeding and worsening of the eczema, also known as the "itch-scratch cycle".³

Other common symptoms of atopic dermatitis include:³

• Dry, sensitive skin

• Inflamed skin

• Itching (pruritus)

• Red or darker colored patches of skin

• Rough, leathery, or scaly patches of skin

• Oozing or crusting

• Areas of swelling

There are many known triggers for atopic dermatitis and some of the common ones include:⁴

• Irritants

• Allergens

• Dry skin

• Stress

• Infections

• Sweat

• Hormones

• Weather

Irritants

Atopic dermatitis compromises the skin barrier, which causes increased sensitivity to a range of irritants.² There are common skin irritants that can aggravate or trigger the condition. These include harsh soaps, detergents, fabric softeners, chemicals, wool or nylon clothing, abnormal temperature/humidity, dust, and sand.^4,5

Allergens

Not everyone with atopic dermatitis will find allergens to be a trigger. However, it has been found that up to one-third of people with atopic dermatitis experience having an immunoglobulin E-mediated food allergy, which includes food such as wheat, milk, eggs, peanut, and soy.⁵ Other allergens can include dust mites, molds, pollens, and pet dander.^4,5

Dry skin

Skin that becomes too dry can become rough and itchy, which can lead to a flare-up and the beginning of an itch-scratch cycle.^4,6,7

Stress

Emotional stress can be a trigger for atopic dermatitis, although the reason for this is not yet understood. However, it is likely that flare-ups caused by stress are associated with the immune response in the body, which impairs the skin barrier function and increases the risk of infection and aggravation of the skin.⁷

Infections

Infections are a common trigger of atopic dermatitis. The most common infection triggers are caused by Staphylococcus aureus and herpes simplex virus (HSV).⁴

Staphylococcus aureus: more than 90% of skin lesions in people with atopic dermatitis have been found to have the presence of Staphylococcus aureus bacteria. This bacterium has the ability to produce toxins, which affect the way the body fights off this bacterium and worsens skin lesions.⁸

HSV: an infection with HSV can occur due to the impaired skin barrier caused by atopic dermatitis. This can cause lesions to appear all over the body, which occasionally results in a secondary Staphylococcus aureus infection.^8,9

Sweat

Sweating causes the body to lose fluids, and, as a result, dry out the skin.¹⁰ This dry skin can then become rough and itchy, which can lead to a flare-up.⁴ However, the risk of a flare-up can be reduced by drinking plenty of water before, during, and after exercise to replenish lost fluids as well as by ensuring that skin is moisturized before and after activity.¹⁰

Hormones

Hormone changes can be an atopic dermatitis trigger for many women. 30% of women experience flare-ups before their menstrual cycle and 50% find that their symptoms worsen during pregnancy.¹¹

Weather

The weather can affect people with atopic dermatitis in different ways. Some people find their condition worsens in the winter, and others worsen in the summer. However, it is also common that flare-ups can occur as seasons change.¹² The cold winter months can dry out the skin causing cracks or bleeds.¹³ The warmer months cause perspiration, which can dry out the skin and cause flare-ups.^10,12