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
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 patientís 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.
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;
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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