Why is atopic eczema/dermatitis itchier at night?

No, it isn’t your imagination that your, or your child’s, eczema is itchier at night. Keep reading to find out more and to get some tips on how to alleviate this occurrence: 

Cortisol, the body's natural anti-inflammatory. Levels of our hormones go up and down throughout the day for a variety of reasons, depending on their purpose. One of our main hormones, cortisol is high in the early morning to help wake us up and then lowers as the day progresses until it reaches its lowest level at bedtime, allowing us to become sleepy and have a good night’s rest.  Cortisol also has anti-inflammatory effects, which helps naturally dampen eczema’s itchiness and flare. When cortisol levels are naturally low, inflammation will rise, and eczema’s affects will be more readily felt. Hence the night-time itch. 

The aim for all eczema support is lowering inflammation, often with medication such as hydrocortisone. However, identifying triggers for eczema flares whether environmental, stress or nutrition is ideal for keeping eczema flares and inflammation down. However, they can be tricky to pinpoint, and you should get support from a health or nutrition professional. 
 
Some foods are known for their anti-inflammatory properties such as oily fish (sardines, mackerel, salmon), nuts and seeds and green leafy vegetables. Other foods such as ultra-processed foods and drinks can have a more inflammatory effect on the body and so it may be wise to limit those, especially in the evening. 
 
Keep cool. For many, temperature differences can be a flare trigger. Too cold and the skin dries and becomes chapped and too hot and the blood vessels nearest the skin barrier, expand, triggering inflammatory cells, raising inflammation, and causing an itch.  
 
Consider introducing lighter bed clothes or a weighted blanket with a lower tog if you prefer the feeling of being tucked in.  Putting towels in the freezer and then applying them to the itchier parts of the body can be soothing. 
 
Natural versus man-made material sheets. Man-made sheets including polyester or nylon are less breathable and can result in more sweating which releases natural body salts which can irritate the skin. 
 
Consider investing in cotton or linen sheets which are more soothing to the skin. The only exception to that rule is a wool blanket, the natural lanolin it contains can be extremely triggering for eczema and should, therefore, be replaced with a thin fleece blanket or tucked-in, in a way that so that none of the wool touches the skin. 
 
Keep dust at bay. Most eczema sufferers have issues with dust mites and simply dusting the bedroom daily and regularly hoovering under the bed may already lessen a nocturnal flare. 
 
Rehydrate. We tend to lose a lot of moisture during the night and so we need to think of hydration both from the inside, by ensuring that we drink plenty of water during the day, but also the outside by moisturising before bedtime to help maintain the skin barrier. 
 
 
If you want to know more about what I do and how I can help, please visit my website: www.jessicafonteneaunutrition.com