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7 Products That Might Do More Harm Than Good for Atopic Dermatitis
By By Carmen Chai. Medically Reviewed by Susan Bard, MD,
6 days ago
Some detergents and sunscreens are a no-go for eczema-prone skin. Getty Images (2)
If you or a loved one has just been diagnosed with atopic dermatitis (eczema), you may be learning about what triggers to avoid so you don't experience a flare-up.
Certain things can trigger atopic dermatitis symptoms because people with the condition have a weakened skin barrier, says Theodora Karagounis, MD , a dermatologist and an assistant professor of dermatology at the New York University Grossman School of Medicine in New York City, where she studies gut health and its link to skin health, particularly in the context of eczema.
"A normal skin barrier keeps irritating stuff out," Dr. Karagounis says. "But when the skin barrier is broken, as it is in eczema, irritating substances can get beyond the first layer of the skin to directly activate immune cells, triggering a flare, or break down more sensitive cells deeper in the skin."
Triggers are numerous. They include some of the products you use every day, says Peter Lio, MD , a clinical assistant professor of dermatology and pediatrics at Northwestern University in Chicago and a spokesperson for the National Eczema Association.
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"Flare ups can be extremely unpredictable, and sometimes - no matter how hard folks try - they can still happen," says Dr. Lio. "That said, some things are within our sphere of control and are worth understanding."
Of course, products that trigger atopic dermatitis symptoms vary from person to person. An item that triggers symptoms in one person may have no effect on another. But, there are some common culprits for people with atopic dermatitis.
Here are seven potentially irritating products you may need to limit or avoid, and what to use instead.
1. Products Containing Fragrances
While they may smell great, fragrances found in any products that come into contact with your skin - such as face wash, moisturizers, body washes, or deodorant - usually aren't a good idea for people with atopic dermatitis, Karagounis and Lio say.
"Fragrances are one of the most common causes of allergic contact dermatitis," says Karagounis. Allergic contact dermatitis is an itchy rash caused by coming into contact with substances you're allergic to - and it's common among people with atopic dermatitis.
"Fragrances, themselves, can also be irritating, causing immune cell activation and triggering flares," Karagounis adds.
When selecting a product, look for "fragrance-free" on the label to ensure there's no fragrance in it. Note that "unscented" is not the same thing as fragrance-free - that means the product won't have a scent, but it could still contain fragrances to mask a scent in the product, Karagounis says.
This applies to laundry products like detergents and fabric softeners, too, she adds. She recommends staying away from fabric softeners entirely, as they almost always contain fragrances.
Baby oils and baby shampoo products are no exception either. Although baby products are often considered to be mild on the skin, they may still contain fragrances or chemicals that can trigger skin irritation, Lio says.
2. Essential Oils
Essential oils can irritate the skin in the same way fragrances can. "I often have to remind patients that fragrances are usually derived from natural products - like citrus fruit and fragrant plants - so essential oils are no different from fragrances. I also recommend avoiding them," Karagounis says.
While they may not be a synthetic fragrance, these naturally derived oils can still bother your skin, Lio adds. Take tea tree oil, for example - although it has anti-acne, antifungal, and antibacterial properties, products containing tea tree oil can worsen atopic dermatitis symptoms .
Instead, shop for products formulated specifically for eczema. "My personal favorites are oil-based cleansers that often seem to moisturize as they gently cleanse the skin," Lio says.
3. Retinol Products
If you're a skin-care enthusiast, you've likely heard of retinol and how powerful it can be for combating the effects of aging. Retinol is a derivative of vitamin A, which plays a key role in cell reproduction. But it's also very potent, and it can cause red, flaky skin and a burning sensation if used too frequently - even in people without eczema.
If you'd like to try it for aging skin or other skin concerns, be sure to loop in your doctor first. "It is worth seeking the help of a dermatologist, as there are some nuances to retinol application," Karagounis says.
If they give you the okay, use it sparingly, Karagounis and Lio say. Mix a small amount - the size of a pea - with moisturizer to lower its strength. You can start by using it about once a week and work your way up to a few times a week if your skin tolerates it.
If your skin doesn't react well, though, it's probably best to avoid retinol.
4. Wool, Cashmere, and Synthetic Fabrics Like Polyester and Nylon
Many with atopic dermatitis know firsthand that fabrics like wool, cashmere, and synthetic materials like polyester and nylon can lead to overheating, sweating, and itchiness. That's why Karagounis and Lio suggest staying away from them.
Instead, look for clothes in 100 percent organic cotton, the least irritating fabric for eczema-prone skin, Lio says. It's softer and less likely to have dyes and chemicals that can trigger an allergic reaction.
"We're looking for loose-fitting, cool clothing with soft natural fibers," Lio says. "Tight-fitting clothes can irritate the skin, and many modern synthetics, though they look sleek, can trap heat and sweat, which can also be irritating."
The same is true for your bedding, including sheets, pillowcases, and duvet covers. Stock your linen closet with cotton options instead of synthetic materials or other potentially irritating fabrics.
5. Chemical-Based Sunscreens
Sun protection is a must if you or your little ones are outdoors playing sports, swimming, or on vacation in a sunny destination. But people with atopic dermatitis should avoid chemical sunscreens and opt for mineral sunscreens instead, Lio says. (Chemical sunscreens absorb the sun's rays before they reach the skin, whereas mineral sunscreens sit on top of the skin and reflect the sun's rays away.)
You should avoid chemical sunscreens. They contain ingredients like avobenzone, oxybenzone, and octinoxate, while mineral-based ones include ingredients like titanium oxide, zinc oxide, and iron. Many people with eczema tend to find the ingredients in mineral sunscreens less irritating than those in chemical sunscreens, Lio says. Indeed, the National Eczema Association awards its National Seal of Acceptance only to mineral sunscreens.
6. Products Containing Lanolin or Propylene Glycol
Steer clear of products containing lanolin and propylene glycol, says Karagounis. Lanolin is a natural moisturizer derived from sheep's wool - and because it's organic, you might assume it's safe for eczema. But a subset of eczema patients develop an allergy to lanolin, which can trigger flares, says Karagounis.
Propylene glycol is an emulsifier that's used in a lot of drugstore moisturizers and creams . It's even in some anti-inflammatory medications for eczema. Some people with atopic dermatitis are allergic to this ingredient. (If you're unsure if you're allergic, you can find out through patch testing with your dermatologist.)
Reach for moisturizers that are hypoallergenic and petroleum-based instead. If you need help finding one, the National Eczema Association has a lengthy list of ingredients - called The Ecz-clusion List - that you should avoid when choosing skincare and laundry products.
7. Products Containing Ethanol
Ethanol - or alcohol - is a common ingredient in gels. They're lightweight, cooling, and quick to evaporate, which makes them convenient for skin-care and hair-care products. But for people with atopic dermatitis, this ingredient can sting, burn, and dry out the skin, Lio says - and dry skin is a common eczema trigger. Instead, look for products that don't contain ethanol.
It's also important for people with eczema - and parents of children with eczema - to be mindful of products outside their home that might contain ethanol. Although you may be armed with the right moisturizers, face washes, and detergents at home, you might come across ubiquitous ingredients like ethanol in products like hand soaps at work or school, while traveling, or at a relative's house, for instance.
"These seemingly innocuous exposures can result in irritation that can then trigger the itch-scratch cycle, leading to what can sometimes be a very large flare-up," Lio says.
How to Know Which Products Will Trigger Your Atopic Dermatitis
It might take some trial and error to figure out which products do or don't trigger your atopic dermatitis symptoms. As mentioned, a product that's fine for one person could be very irritating for another. "There is no one-size-fits-all answer," Lio says.
That's why it's important to pay attention to what you're using and how your skin is reacting to different products.
It could also help to avoid trying multiple new products at one time, especially when it comes to skin-care products, Karagounis adds. The reason: If you have a flare up, you won't know which product triggered it.
Instead, if you're trying new products, introduce only one into your routine per month. "A month is enough time to figure out if the product is going to cause a flare or not," Karagounis says.
The Takeaway
Avoiding particular products can help you manage atopic dermatitis flare-ups more effectively. Products containing fragrances, certain fabrics, or harsh chemicals can irritate your skin and worsen eczema symptoms. Consider using fragrance-free, hypoallergenic, and natural fiber alternatives to keep your skin calm and comfortable.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Sources
Atopic Dermatitis: Symptoms & Causes. Mayo Clinic . May 15, 2024.
Susan Bard, MD, is a clinical instructor in the department of dermatology at Weill Cornell Medicine and an adjunct clinical instructor in the department of dermatology at Mount Sinai in New York City. Her professional interests include Mohs micrographic surgery, cosmetic and laser procedures, and immunodermatology.
She is a procedural dermatologist with the American Board of Dermatology and a fellow of the American College of Mohs Surgery.
Dr. Bard has written numerous book chapters and articles for many prominent peer-reviewed journals, and authored the textbook The Laser Treatment of Vascular Lesions .
Carmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer's.
Chai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the Toronto Star , Vancouver Province, and the National Post . She received a bachelor's degree in journalism from Ryerson University in Toronto.
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