Why Is My Eczema Suddenly Getting Worse In The Autumn?

As summer comes to an end and the weather begins to change, many people notice that previously manageable eczema suddenly becomes drier, itchier, redder or much more difficult to control.

In clinic, we often hear from people whose skin has been relatively settled throughout the warmer months, only to flare again as autumn arrives. Old patches may return, itching can intensify and skin can become increasingly dry, cracked or inflamed.

Here's the thing, it's likely not just one thing. Autumn brings several changes at once. Temperatures and humidity fall, central heating goes on, we spend more time indoors, respiratory infections become more common and our exposure to sunlight decreases. For somebody already prone to eczema, these seasonal changes can combine to create the perfect conditions for a flare.

Colder weather and the skin barrier

One of the most obvious reasons eczema can get worse in autumn is the change in temperature and humidity.

Our skin acts as a physical barrier, helping us retain moisture while protecting us from allergens, irritants and microorganisms. In atopic eczema, this barrier is already more vulnerable. Some people have changes in proteins involved in maintaining the skin barrier, including filaggrin, while inflammation itself can further disrupt normal barrier function.

As temperatures and humidity fall, the skin can lose more moisture. Cold winds can add to dryness and irritation, while repeatedly moving between cold outdoor temperatures and warm indoor environments places additional stress on already sensitive skin.

Once the skin barrier becomes compromised, irritants and allergens can penetrate more easily, potentially triggering further immune activity. Dryness leads to itching, itching leads to scratching, and scratching causes further damage to the skin barrier. This itch-scratch cycle is one reason eczema can suddenly become much harder to control as autumn progresses.

Central heating and autumn eczema

The start of autumn also usually means the return of central heating. Warm indoor air can be particularly drying for the skin, especially when humidity is low.

At the same time, people may start having hotter baths and showers as the weather becomes colder. For someone with an already vulnerable skin barrier, the combination of cold weather outside, heated air inside and hotter water can significantly increase dryness.

If your eczema tends to worsen around the same time that the heating goes on each year, this seasonal change may be an important part of the picture. Supporting the skin barrier and avoiding excessively hot baths and showers can become particularly important during the colder months.

Spending more time indoors can increase allergen exposure

Autumn doesn't only change the weather. It changes our environment and our routines.

As the evenings become darker and the weather becomes colder and wetter, we naturally spend more time indoors. This can mean greater exposure to dust mites, pet dander and other indoor allergens.

Sensitisation to environmental allergens is common in people with atopic conditions, particularly when eczema occurs alongside asthma, hay fever or allergic rhinitis. This doesn't mean that allergy is responsible for everyone's eczema, but if worsening skin is accompanied by nasal congestion, sneezing, itchy eyes, wheezing or other allergic symptoms, increased indoor allergen exposure may be relevant.

Histamine and mast cells

Histamine can also be part of the eczema picture. Mast cells are immune cells found throughout the body, including within the skin. When activated, they release histamine alongside many other inflammatory mediators.

Histamine can contribute to itching, redness and swelling. Some people with eczema also experience other histamine-type symptoms, such as flushing, hives, headaches, nasal congestion, digestive symptoms, palpitations or reactions to certain foods, alcohol, heat, fragrances or medications.

This doesn't necessarily mean somebody has Mast Cell Activation Syndrome (MCAS). MCAS has specific diagnostic criteria, and experiencing itching or responding to an antihistamine is not enough to diagnose it. However, histamine and mast cell activity can still be relevant to eczema without somebody having MCAS.

For some people, the increase in indoor allergens, infections and other inflammatory triggers that occurs during autumn may coincide with an increase in both eczema and histamine-type symptoms.

Damp and mould during autumn

Another environmental change that becomes particularly relevant during autumn is damp.

Colder temperatures, wetter weather, closed windows and increased condensation can create conditions that encourage mould growth. Damp may become more noticeable around windows, bathrooms, bedrooms and colder external walls, particularly where ventilation is poor or there has been previous water damage.

Mould exposure affects people differently. For some, it causes few obvious symptoms. In others, mould spores and components of damp indoor environments can act as allergens or respiratory irritants.

Not everybody whose eczema worsens around mould has Chronic Inflammatory Response Syndrome (CIRS), and eczema itself is not evidence of CIRS. However, the timing and pattern of symptoms can sometimes provide useful information. We become more interested in the environment when eczema consistently improves away from a particular building, worsens in a particular room or home, or deteriorates following a leak, water damage or an increase in visible damp or mould.

The presence of other symptoms, such as nasal congestion, headaches, fatigue or respiratory problems, may also provide further context.

Autumn infections and the immune system

Autumn also marks the beginning of the respiratory virus season. Children return to school, people spend more time together indoors and infections become increasingly common.

Viruses stimulate a significant immune response. In somebody who already has an inflammatory or atopic tendency, this additional immune activation may coincide with worsening eczema.

This doesn't necessarily mean that the infection directly caused the eczema. Instead, infection may act as another stressor that temporarily changes the person's inflammatory threshold. We sometimes see people whose eczema becomes considerably more reactive following COVID-19, flu or another significant infection, particularly when other symptoms such as fatigue, digestive changes or increased histamine-type reactions appear at the same time.

Less sunlight and vitamin D

Another significant seasonal change is the reduction in sunlight exposure. During autumn and winter in the UK, sunlight is insufficient for reliable vitamin D production through the skin.

Vitamin D plays a role in immune regulation and skin barrier function, and low vitamin D status has been associated with atopic dermatitis. This doesn't mean that vitamin D deficiency is responsible for every autumn eczema flare or that taking high doses of vitamin D will resolve eczema.

However, nutrient status can be worth considering, particularly when worsening eczema occurs alongside fatigue, dietary restriction or digestive problems. Other nutrients involved in skin and immune health may also become relevant depending on the person's diet, symptoms and medical history.

Where a deficiency is suspected, testing and correcting it appropriately is generally more useful than simply adding increasing numbers of supplements.

Stress, sleep and the change of season

The relationship between the nervous system, immune system and skin is another important part of eczema.

Autumn often brings changes in routine. Children return to school, workloads increase after the summer, daylight hours become shorter and people may spend less time outdoors. Sleep, mood and energy can also change as the seasons shift.

Psychological and physical stress can influence immune signalling and skin barrier function, while eczema itself can significantly disrupt sleep and increase physiological stress. It can become a difficult cycle in which itching interferes with sleep, poor sleep increases physiological stress, and increased stress makes inflammatory symptoms and itching harder to regulate.

This doesn't mean that eczema is caused by stress or that symptoms are psychological. It reflects the constant communication between the nervous system, immune system and skin.

The inflammatory threshold

One of the most useful ways of understanding why eczema can get worse in autumn is to think about the body's inflammatory threshold.

Someone may already be dealing with an impaired skin barrier, poor sleep, psychological stress or underlying inflammation. As autumn arrives, the skin becomes drier, the central heating goes on, time spent around indoor allergens increases, a respiratory infection occurs and exposure to sunlight decreases.

Any one of these factors might be manageable on its own. Together, they may be enough to push the skin and immune system beyond the point at which symptoms become much more noticeable.

This can explain why eczema sometimes seems to become dramatically worse without one obvious new trigger. Rather than there being one problematic food, allergen or environmental exposure, several smaller factors may have accumulated at the same time.

Looking at what changed before your eczema flare

When somebody comes to us with worsening eczema, the timeline is often one of the most useful places to start.

We look at when the skin changed and what was happening during the weeks or months beforehand. A flare may have coincided with colder weather and central heating, but there may also have been an infection, increasing allergies, digestive symptoms, worsening sleep, hormonal changes, a change in diet or medication, or a change within the home environment.

Looking at these factors together can be more useful than becoming overly focused on finding one single trigger.

A functional medicine approach to eczema

At The Autoimmune Clinic, when somebody comes to us because their eczema has become worse, we start with their history and timeline.

We look at the skin, but we also consider the wider picture, including digestive health, allergies and histamine, infections, hormones, sleep and stress, nutrient status and environmental exposures such as damp and mould. We may also consider whether eczema is occurring alongside other inflammatory or autoimmune symptoms.

From there, we can decide whether further investigation is appropriate rather than ordering every available test or assuming that everybody with eczema needs the same protocol.

If your eczema gets worse every autumn, the seasonal pattern itself can provide useful information. Colder weather, reduced humidity, central heating, indoor allergens, damp and mould, respiratory infections, reduced sunlight and changes in sleep and stress can all potentially contribute.

For some people, one factor will stand out. For others, it is the cumulative effect of several changes happening at the same time.

We use functional medicine and nutritional therapy to support adults and children with persistent or complex eczema, particularly when eczema occurs alongside digestive problems, histamine intolerance or mast cell activation, autoimmune disease, post-viral illness or mould-related illness.

Understanding your individual pattern can help us identify the factors that may be contributing to ongoing inflammation and skin reactivity, rather than treating each autumn eczema flare in isolation.