What to Wear When You Have Eczema
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When you have atopic dermatitis, the most common form of eczema, your skin can be so sensitive that wearing a scratchy sweater or a garment with a tag or rough seam can lead to a flare-up.
“One of the hallmarks of atopic dermatitis is intolerance to certain clothing,” says Bruce Brod, MD, clinical professor of dermatology and co-director of the occupational and contact dermatitis program at Penn Medicine in Philadelphia.
Atopic dermatitis is marked by symptoms such as itchiness, dryness, rashes, scales, oozing patches, blisters, and infections — and clothing that is rough on skin, or that causes overheating, sweating, and irritation, only makes these issues worse.
Here are some tips on how to make the best clothing choices to help avoid atopic dermatitis triggers that intensify symptoms, in order to protect hypersensitive skin.
Dress in Soft, Breathable Fabrics
The National Eczema Society provides this list of materials that are gentle on skin:
- Cotton It’s soft, durable, and breathable. Although 100 percent cotton is optimal, cotton blends can be okay too; just check the label to make sure there isn’t a high percentage of polyester, which can aggravate eczema.
- Bamboo This plant grows in hard stalks, yet somehow it produces soft textiles. Some apparel and textile companies tout bamboo as being as soft or even softer than cotton, silk, or cashmere — and more breathable as well. Research confirms that bamboo fiber is highly absorbent and naturally hypoallergenic (meaning it does not cause allergic reactions). One issue with bamboo: The National Eczema Society warns that the processing needed to make bamboo fiber can be chemical-intensive. While these chemicals may not directly irritate skin, they can be detrimental to the environment, which can indirectly create issues for people with atopic dermatitis.
- Silk This is another soft, breathable fabric. Unfortunately, it stains easily (a particular problem if you use a lot of moisturizers or topical eczema treatments) and can be expensive to buy and care for. Still, while it’s common practice to dry-clean silk, the Martha Stewart website says it’s possible to gently hand-wash many silk garments.
Although conventional wool is notoriously itchy, a study published in 2019 in Dermatitis found that merino wool, which is thinner and softer than most wool, not only improved eczema symptoms (compared with standard clothing) but also boosted patient quality of life.
Organic textiles are not treated with harsh chemicals or pesticides and are often particularly soft and breathable, making them especially eczema-friendly.
Layer Up in All Types of Weather
Cold weather can often mean wearing wool for warmth. Because many types of wool can be a bit scratchy, layering is often a good strategy for the eczema crowd. For instance, wearing a cotton shirt underneath a wool sweater can reduce friction and irritation.
In general, layering is a useful tactic for people with atopic dermatitis, no matter the weather. “It gives a person more control over their environment,” Dr. Brod says. “A person can sense when they are feeling uncomfortable and adjust accordingly, whether that’s putting on more layers in the winter or shedding layers in the summer.”
It’s important not to overheat in warm weather, because sweat contains salts and other minerals that can trigger flare-ups, according to the National Eczema Association.
“Some patients with atopic dermatitis are aggravated by perspiration — it makes them feel really itchy,” says Brod. “Some say they actually feel like they’re allergic to their own sweat.”
Be Cautious About Certain Textile Colors and Dyes
Jenny Murase, MD, a dermatologist at the Palo Alto Medical Foundation in Mountain View, California, warns that certain fabric colors and dyes can trigger flares in people with atopic dermatitis. She advises against wearing dark clothes in the summer, for instance, because they absorb sunlight and may contribute to overheating.
Plus, she says, “Different textile dyes like blue, black, orange, and red can trigger an allergic skin reaction.”
The American Contact Dermatitis Society offers specific information on allergens in textile dyes and clothing. People with atopic dermatitis may want to ask their dermatologist about allergy testing.
Aim for a Loose and Airy Fit
Close-fitting clothing that rubs against skin can aggravate atopic dermatitis. Tight workout wear can be especially troublesome because physical exertion produces both friction and sweat.
People with atopic dermatitis tend to do better when their skin gets more air, so loose-fitting garments are best.
But even loose-fitting clothing can rub against skin. Dr. Murase urges patients to be aware of problem areas, such as the fronts of the shoulders, the armpit areas, and along the waistline where a shirt may be tucked in against the belly.
The National Eczema Society encourages consumers to check clothing for features that may cause irritation, such as tags, rough seams, fasteners, and loose threads.
Launder Away Irritants
Washing clothes soon after buying them can help eliminate problematic chemicals, but people with atopic dermatitis need to be careful with their cleaning products.
The National Eczema Association encourages the use of hypoallergenic detergents and fabric softeners that are free of dyes and fragrances and formulated for sensitive skin. Liquid cleaning products are recommended over powders, as powders tend to leave a residue.
People who are extra sensitive may consider giving their garments a double rinse after washing.
You will also want to avoid fabric dryer sheets if you have eczema, as these often contain fragrance (which can trigger a flare) and can leave an irritating residue on clothes.
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