Do temperature changes cause eczema flares? An English cohort study

Background It is unclear if ambient temperature changes affect eczema. It is also unclear if people with worse disease are more susceptible to weather-related flares, or specific types of emollient offer protection. Objectives To investigate the effect of short-term temperature variations on eczema symptoms in children. Methods Data from a UK cohort of 519 children with eczema were combined with data from the Hadley Centre's Integrated Surface Database. Hot and cold weeks were defined by average regional temperature > 75th or < 25th percentile, January 2018 to February 2020. Eczema flares were defined as & GE; 3-point change in Patient-Oriented Eczema Measure (POEM). Random-effects logistic regression models were used to estimate the odds ratios of flares in hot and cold weeks (reference group: temperate weeks). Results The baseline mean age was 4.9 years (SD 3.2) and the POEM score was 9.2 (SD 5.5). From the 519 participants, there were 6796 consecutively paired POEMs and 1082 flares. Seasonal variation in POEM scores was observed, suggesting symptoms worsening in winter and improving in summer. Odds ratios of flares were: 1.15 [95% confidence interval (CI) 0.96-1.39, P = 0.14] in cold weeks and 0.85 (95% CI 0.72-1.00, P = 0.05) in hot weeks. The likelihood ratio test showed no evidence of this differing by disease severity (P = 0.53) or emollient type used (P = 0.55). Conclusions Our findings are consistent with previous studies demonstrating either improvements in eczema symptoms or reduced flares in hot weather. Worse disease and different emollient types did not increase susceptibility or provide protection against temperature changes. Further work should investigate the role of sunlight, humidity, pollution and other environmental factors. This cohort study of 519 children with eczema, examined the effect of short-term temperature changes on eczema symptoms. The seasonal variation in symptom scores was observed, suggesting worsening with colder weather in winter and improvements with warmer weather in summer. We provide evidence to show temperature changes may play a role, specifically that hot weather is protective against flares. Switching emollients in different weather states to try and prevent a flare is unlikely to be helpful.

Automated summary

This study investigated the effect of short-term temperature changes on eczema symptoms in children. The findings suggest that eczema symptoms worsen in winter and improve in summer. Furthermore, the severity of the disease and the type of emollient used do not significantly affect the impact of temperature changes.