Can Contact Dermatitis or Eczema Worsen in Cold Weather?
Yes, contact dermatitis and eczema can worsen in cold weather due to low relative humidity and environmental factors that damage the skin barrier and increase exposure to irritants.
Environmental Factors That Worsen Dermatitis in Cold Weather
Cold weather creates multiple conditions that exacerbate both irritant and allergic contact dermatitis:
- Low relative humidity is a recognized irritant that directly damages the skin barrier and worsens contact dermatitis 1
- Hot water used for handwashing (often used more frequently in cold weather to warm up) is a common irritant that exacerbates contact dermatitis 1
- Water temperature above 40°C affects the stratum corneum through lipid fluidization and disordered lipid structure, leading to increased skin permeability and irritation 2
Mechanism of Cold Weather Worsening
The pathophysiology involves direct barrier damage:
- Repeated exposure to irritants damages the skin barrier, changes skin flora, and results in more frequent colonization by staphylococci and gram-negative bacteria 1
- Soaps and detergents damage skin by causing denaturation of stratum corneum proteins, and changes in intercellular lipids lead to decreased corneocyte cohesion and water-binding capacity 1
- Cold or very cold water for handwashing is specifically listed as a risk factor for inducing or worsening hand contact dermatitis 2
Clinical Presentation in Cold Weather
Affected individuals typically experience:
- Complaints of dryness or burning sensation, skin that feels "rough," along with erythema, scaling, or fissures 1
- Chronic phase characteristics including dryness, lichenification, and fissuring—all worsened by low humidity environments 1, 3
Prevention and Management During Cold Weather
To mitigate cold weather exacerbation:
- Use cold or lukewarm water for handwashing rather than hot water, as water temperature does not affect microbe removal but does increase skin irritation 2
- Apply moisturizer after washing hands and before wearing gloves if needed 2
- Identify and avoid irritants, with awareness that wet work and exposure to surfactants and detergents are particularly damaging 2
- Apply mid- to high-potency topical corticosteroids such as triamcinolone 0.1% for acute flares, escalating to very high-potency agents for persistent dermatitis 4
Common Pitfalls in Cold Weather
- Washing hands with very hot water to combat cold temperatures significantly worsens dermatitis through barrier disruption 2, 1
- Increased indoor heating reduces humidity, creating an environment that perpetuates skin barrier dysfunction 1
- More frequent handwashing during cold/flu season compounds irritant exposure without adequate barrier restoration 2