by Dr. Frank Lichtenberger, MD, PhD, practicing allergist
Indoor allergies such as dust mites and animal dander, as well as food allergies are well established as triggers of atopic dermatitis/eczema. However, there is a debate in the allergy community as to the impact of environmental allergies (pollen) as they play a role in the development of eczema. Several studies have been published in the last 2 years that suggest that people with eczema and seasonal allergies, may get worse during allergy season.
The studies to date have shown that patients with tree pollen allergies, have a more difficult time controlling eczema when they are exposed to specific tree pollens to which they are allergic. This may seem intuitive that an allergic condition gets worse when exposed to allergens, but until a few years ago there was not very good data to prove the connection.
One of the studies suggests that skin that is directly exposed to pollen (in this case grass pollen) is likely to erupt in the itching and skin inflammation associated with allergic eczema. The good news was that in this study, only the skin that was exposed to the pollen-dense air was affected, the skin that was covered was not affected.
The Take-Away: Encourage bathing immediately after long periods of outdoor exposure, to wash off potential pollens.
My personal opinion is that many patients that have eczema, tend to be allergic to multiple different allergens. Exposing them to allergens in anyway can send them into an eczema exacerbation. As with most conditions in medicine, prevention is 100 times easier than treatment, so knowing the allergic triggers is very important for anyone with an allergic condition.
Again, rinse off immediately after spending time outdoors is a very good practice. Also consider wearing eczema clothing when outdoors as tencel® fabric is sweat wicking and also can prevent flares.
Fölster-Holst R, et al. Birch pollen influence the severity of atopic eczema - prospective clinical cohort pilot study and ex vivo penetration study. Clin Cosmet Investig Dermatol. 2015 Oct 29;8:539-48.
Werfel T, et al. Exacerbation of atopic dermatitis on grass pollen exposure in an environmental challenge chamber. J Allergy Clin Immunol. 2015 Jul;136(1):96-103.e9