If you’ve ever spent a night clawing at your ankles while the rest of the world sleeps, you know eczema isn't just "dry skin." It’s an ordeal. But here is the weird thing: if you ask ten people with atopic dermatitis when their skin feels the worst, you’ll get two completely different, equally passionate answers. Some people swear the cold is their nemesis. Others feel like the sun is literally trying to melt their moisture barrier.
So, is eczema worse in summer or winter? Honestly, it’s a tie, but for totally different reasons. Your skin is basically a temperamental ecosystem. It hates change. It hates extremes. Whether you’re dealing with the "Winter Itch" (pruritus hiemalis) or a "Summer Flare," the underlying cause is usually a breakdown in the skin's ability to keep the outside world out and the hydration in.
The Winter Wreckage: Why the Cold Bites Back
Winter is the classic villain for most eczema sufferers. Why? Physics. Cold air holds significantly less moisture than warm air. When the humidity drops outside, and you crank up the forced-air heating inside, your skin becomes a sacrificial lamb to the laws of evaporation.
This process is called Transepidermal Water Loss (TEWL).
In people with healthy skin, the "bricks and mortar" of the skin barrier—ceramides, fatty acids, and cholesterol—hold steady. But if you have eczema, your "mortar" is already crumbly. The dry air sucks the water right out of your cells. This leads to that familiar, tight, "about to crack" feeling. It’s not just uncomfortable; it’s a physical breach. Once that barrier cracks, irritants like wool sweaters or even laundry detergent fragrance get deep into the dermis. Then, the immune system panics.
The "Hot Shower" Trap
We’ve all done it. You come in from a freezing January afternoon, and the only thing that sounds good is a steaming hot shower. It feels amazing for exactly four minutes.
But heat is a vasodilator. It brings blood to the surface, which triggers the itch-scratch cycle. More importantly, scalding water strips away the natural oils you desperately need. Dr. Peter Lio, a clinical assistant professor of dermatology at Northwestern University, often points out that over-washing and high temperatures are major triggers. You’re essentially degreasing your skin like a dirty frying pan.
When you step out of that hot shower into a cold bathroom, the rapid evaporation causes a massive spike in dryness. That’s why winter flares often look like "crazy paving"—red, cracked, and weeping.
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The Summer Struggle: It’s Not Just the Heat
If winter is about lack of moisture, summer is about the presence of irritants. For a huge segment of the population, summer is actually the harder season to manage.
The primary culprit here is sweat.
Sweat contains trace amounts of minerals like sodium, chloride, and potassium. When the water in your sweat evaporates, these minerals stay behind on the skin. For someone with eczema, these salts act like sandpaper. They irritate the already sensitive surface, leading to a prickly, intense itch, especially in the "crook" of the elbows and behind the knees. This is often referred to as miliaria rubra or heat rash, but for an eczema patient, it can trigger a full-blown flare-up of atopic dermatitis.
Chlorine, Salt, and Sunscreen
Summer also brings the lifestyle triggers.
- Chlorine: While a "bleach bath" is a recognized medical treatment for some eczema patients to reduce Staphylococcus aureus bacteria, the high concentrations of chlorine in public pools can be incredibly drying.
- Sunscreen: Many chemical filters (like oxybenzone) are notorious for causing contact dermatitis.
- Pollen: If you have the "Atopic March"—the trifecta of eczema, asthma, and hay fever—the high pollen counts in early summer can trigger an internal immune response that manifests on your skin.
Basically, you’re trapped between wanting to enjoy the outdoors and knowing that the humidity might make you feel like you’re wearing a suit of itchy wool.
Does Humidity Help or Hurt?
This is where it gets nuanced.
Moderate humidity (around 50%) is the "Goldilocks zone" for skin. It keeps the stratum corneum (the top layer) supple. However, once you hit "tropical" levels of 80% or 90% humidity, things get messy. High humidity prevents sweat from evaporating. If sweat can't evaporate, it sits on the skin. If it sits on the skin, it breeds bacteria.
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Staphylococcus aureus loves a warm, damp environment. Research shows that over 90% of eczema patients are colonized with this bacteria, compared to only 5-30% of healthy individuals. In the summer, this bacterial load can skyrocket, leading to infected eczema, which is a whole different level of pain involving crusting and pustules.
The Role of Vitamin D: A Summer Silver Lining
There is one reason why some people find their eczema actually improves in the summer: Narrowband Ultraviolet B (UVB) light.
Doctors actually use phototherapy to treat severe eczema. The sun provides a natural (though unregulated) version of this. UVB light has an immunosuppressive effect on the skin, calming down the overactive T-cells that cause inflammation. Plus, sun exposure boosts Vitamin D levels. There’s a growing body of evidence suggesting that Vitamin D deficiency is linked to increased eczema severity.
So, if you’re one of those people whose skin clears up at the beach, you’re likely benefiting from that combination of UV-induced immune suppression and a boost in your "sunshine vitamin" levels. But it’s a fine line. Too much sun leads to a burn, and a sunburn is just another word for massive skin barrier damage.
Real World Examples: The Two Types of Sufferers
Take "Sarah." Sarah lives in Chicago. In February, her hands get so dry they bleed. She has to wear cotton gloves to bed. For her, is eczema worse in summer or winter? Definitely winter. The central heating is her enemy.
Then take "Mark." Mark lives in Florida. He’s fine in the winter because the air never gets truly dry. But in July, the humidity and the sweat make his neck and inner arms look like raw steak. For Mark, summer is the danger zone.
The "worst" season is entirely dependent on your specific triggers and your local climate.
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How to Fight Back (No Matter the Month)
You can’t change the weather, but you can change how your skin interacts with it.
Winter Survival Tactics
- The 3-Minute Rule: You have to apply a thick, bland emollient within three minutes of getting out of the shower. This "locks in" the hydration before the air can steal it.
- Ointments over Creams: Creams have more water; ointments (like Vaseline or Aquaphor) have more oil. In winter, you need the grease.
- Humidify: Run a cool-mist humidifier in your bedroom. Aim for 45-50% humidity. Any higher and you risk dust mites, which are another major eczema trigger.
Summer Mitigation
- Rinse Immediately: After swimming in a pool or the ocean, or even after a heavy workout, rinse off with lukewarm water. Get the salt and chlorine off your skin now.
- Mineral Sunscreen: Look for zinc oxide or titanium dioxide. These sit on top of the skin rather than absorbing into it, making them much less likely to cause a flare.
- Cotton is King: Synthetic fabrics like polyester trap heat and sweat. Stick to loose-fitting organic cotton or silk.
What Research Says About Seasonality
A study published in the Journal of the American Academy of Dermatology analyzed thousands of patients and found that flares do indeed peak in the winter for the majority of people in temperate climates. However, a significant subset—particularly children—showed a secondary peak in late summer.
This suggests that we shouldn't be looking for a "one size fits all" answer. The "worst" season is simply the one where your environment most aggressively attacks your specific barrier weaknesses.
Actionable Next Steps
If you’re currently struggling, don't just wait for the season to change.
First, track your flares. Use a simple note on your phone to record the temperature, humidity, and what you ate or wore when a flare started. You might find that your "summer eczema" is actually a reaction to a specific grass pollen, or your "winter eczema" is actually a reaction to the dander from your cat who is spending more time indoors.
Second, audit your moisturizer. If you’re using the same light lotion in January that you use in July, you’re doing it wrong. Switch to a heavy-duty, ceramide-rich balm the moment the leaves start to fall.
Third, see a specialist. If you’re stuck in a cycle of scratching and bleeding, you might need more than over-the-counter help. Prescription topical calcineurin inhibitors (like Tacrolimus) or newer biologics (like Dupixent) can change the game regardless of what the thermometer says.
Eczema is a marathon, not a sprint. Whether you’re battling the frost or the humidity, the goal is the same: protect the barrier at all costs.
Keep your showers short and lukewarm. Use fragrance-free everything. And remember that your skin is just trying to protect you—it’s just a little bit confused about how to do its job.