Winter exposes how closely eczema, asthma and allergies are linked

Atopic dermatitis (AD), or eczema, is one of the most common chronic skin conditions in children, and for many families it becomes harder to manage as colder weather sets in.

During the winter months, children tend to spend more time indoors, which increases exposure to dust mites, pet dander, mold and other indoor irritants. Combined with cold, dry air and indoor heating, these factors can heighten itching, redness and dry, cracked skin, adding daily stress for both children and caregivers.

Beyond the visible skin symptoms, eczema is usually part of a larger allergic picture. According to Dareen D. Siri, M.D., a board-certified allergist and immunologist at Midwest Allergy Sinus Asthma, SC, many parents are surprised to learn that AD frequently occurs alongside other conditions such as asthma and allergies.

Siri said this pattern is so common that clinicians refer to it as the “atopic march,” a progression in which allergic diseases develop over time.

This connection exists in part because the skin barrier in children with AD doesn’t function properly. For instance, when the barrier is impaired, allergens and irritants can more easily penetrate the skin, triggering inflammation and early immune responses, Siri explained.

Over time, this immune activation could increase the risk of developing food allergies or asthma, particularly in children with more severe eczema. Siri encourages parents to watch for warning signs beyond the skin, including reactions to foods, persistent itching that worsens with triggers or breathing symptoms such as wheezing or shortness of breath.

As winter approaches, practical steps at home can help reduce flare-ups and improve comfort. Siri stressed that consistency is key when it comes to skincare routines and encouraged several steps to take, including regular moisturizing and using fragrance-free cleansers and detergents to reduce irritation in sensitive skin. Clothing choices also matter, with soft, natural fibers such as cotton preferred over wool, which can further irritate eczema-prone skin.

Bathing habits are another area where misunderstandings are common. Some families limit baths, fearing that water will dry out the skin even more. Siri shared that this approach could actually worsen symptoms.

“Infrequent bathing is not recommended for most children with AD, as sweat, allergens, and bacteria can accumulate on the skin and worsen irritation and flares,” she said.

Short, warm baths followed immediately by moisturizer can help remove triggers while locking in hydration and supporting the skin barrier.

While daily management strategies are essential, treatment options have also expanded in recent years, offering new possibilities for children who have eczema along with asthma or allergies.

New data presented at the American College of Allergy, Asthma & Immunology (ACAAI) meeting showed promising results for Vtama (tapinarof) cream 1%, a once-daily, steroid-free topical treatment approved for adults and children ages 2 years and older with AD. In clinical trials, children experienced improvements in skin clearance, itch and sleep by week eight, regardless of whether they also had asthma, allergic rhinitis or food allergies.

“These findings are important because early relief of symptoms like itch can have a meaningful impact on patients and overall disease management,” Siri said. She added that having effective topical options with favorable safety profiles can help clinicians tailor care plans to individual patients, particularly those managing multiple conditions.

Due to eczema, asthma and allergies being so closely connected, coordinated care plays a critical role in long-term outcomes. Allergists are uniquely trained to manage these conditions together rather than in isolation, working alongside pediatricians and other specialists.

“As a board-certified allergist and immunologist, my role is to manage all atopic diseases together, not in isolation,” Siri said. “By addressing underlying allergic inflammation early, we can reduce flares, improve asthma control, and sometimes alter disease progression.”

Additionally, Siri pushed on the importance of clearing up common myths that can add to family stress. First, she noted eczema is not contagious, nor is it caused by something parents did wrong. While it is a chronic condition, it is highly manageable with the right education, support and treatment plan.

By reassuring families, addressing triggers early and coordinating care across conditions, Siri advised that clinicians can help children with AD achieve better control and a higher quality of life year-round.