Laundry tips when someone in the house has eczema

When a child, a partner or a parent has eczema, the laundry room becomes a place where you feel you can actually do something. The good news is that a handful of simple habits cover almost everything that matters. The honest news is that some of the advice you will hear, like banning enzymes or buying silk, is not backed by the evidence people assume.

Why laundry matters more when skin has eczema

Eczema, also called atopic dermatitis, is a chronic inflammatory skin condition with dry, red, intensely itchy patches. The Eczema Society of Canada estimates it affects about 15 percent of Canadian children and 4 percent of adults, most of them mildly to moderately.

Eczema skin has a weakened barrier, the outer layer of cells and fats that keeps moisture in and irritants out. That is why triggers that healthy skin shrugs off, such as certain soaps, clothing fabrics, overheating, sweating and dry air, can start a flare. The Eczema Society of Canada lists certain soaps, clothing fabrics, overheating, sweating and low humidity among common triggers. The goal of eczema-friendly laundry is to leave as little as possible in the fabric and to keep the fabric itself soft.

Choose a fragrance-free, dye-free detergent

Fragrance is one of the most common causes of contact allergy, and it serves no cleaning purpose. Dyes only colour the detergent. Removing both takes two variables off the table for a skin that already has enough to deal with.

A few label notes:

• “Fragrance-free” means the product is free of all fragrances, even ones you cannot smell. “Unscented” means a fragrance has been masked so you cannot smell it. The American Academy of Dermatology tells parents of children with eczema to use only detergent that is fragrance-free and dye-free.
• Liquids dissolve more readily than powders, which may mean less undissolved residue in a cool wash, but this is a practical observation rather than a proven skin benefit.

Curious what a fragrance-free formula looks like on a label? Browse the laundry products the panel has reviewed.

Use the right dose and rinse well

More detergent does not mean cleaner clothes. It means more surfactant, the cleaning molecule that lifts grease, left in the fibres after the rinse. The American Academy of Dermatology’s self-care advice for atopic dermatitis is specific: use only the recommended amount and make sure there is enough water for rinsing.

In practice:

• Measure. The cap lines on a bottle are easy to overshoot, and concentrated formulas need far less than they look like they do.
• Do not overload the drum. Clothes need room to move through water, and a packed load rinses poorly.
• Use the extra-rinse option if your machine has one, especially for the eczema sufferer’s clothes and bedding.

Is there a trial proving an extra rinse prevents flares? No. It is a low-cost, no-downside step that reduces what stays in the fabric, and that is the honest reason to do it.

Skip softener and dryer sheets, and wash new clothes first

Softeners and dryer sheets work by coating fibres with a thin layer of conditioning agents, usually carrying fragrance. Coating fibres is the opposite of what you want against eczema skin, and the fragrance is the ingredient most likely to cause a reaction. The American Academy of Dermatology names scented softeners and dryer sheets as possible contributors to irritation.

If stiff towels bother you, tumble drying alone softens them, and wool or rubber dryer balls reduce static without adding anything to the fabric.

New garments carry dyes that are not fully set, plus finishing chemicals applied in manufacturing to keep fabric crisp or wrinkle-free. The American Academy of Dermatology recommends washing new clothes before wearing them to remove those excess dyes and finishes. One wash with your usual fragrance-free detergent is enough.

While you are at it, cut out scratchy labels or buy tag-free clothing. Tags rub, and rubbing is a flare trigger.

What about enzymes, “biological” detergents and hot water?

Here the evidence gets interesting. Many eczema guides tell you to avoid enzyme-containing detergents (sometimes called biological detergents). Enzymes are proteins that break down protein, starch and fat stains, and in their raw form they can irritate. But in a randomized, double-blind crossover study, 25 people with atopic dermatitis used a trial detergent with enzymes for a month and the same detergent without enzymes for a month. There was no difference in steroid cream use, eczema scores or symptoms. The authors concluded enzyme detergents did not aggravate atopic dermatitis over that period. It is one small, older study, but it is the best direct test available, and it does not support the ban.

On temperature: no trial shows that hot washing helps eczema. For everyday clothing, the dose and the rinse matter more than heat, so wash at the temperature your detergent is designed for.

Fabric choice: cotton, wool and silk

Cotton is the standard advice because it is smooth, breathable and cheap. The American Academy of Dermatology suggests loose-fitting, 100 percent cotton clothing and advises avoiding wool and synthetics like polyester. That is a good default. But two trials complicate the picture:

• A randomized crossover study of 39 children aged 4 weeks to 3 years compared superfine merino wool garments with cotton. After 6 weeks, eczema severity scores were lower with the wool, quality of life improved and steroid use fell. Superfine wool is not the itchy wool of old sweaters, and the study was funded by a wool industry group, so treat the result as promising rather than settled.
• The CLOTHES trial in the UK randomized 300 children with moderate to severe eczema to standard care with or without silk garments for six months. Silk added no measurable benefit.

The practical lesson: smooth, soft, loose and breathable matters more than the fibre’s name. Avoid rough, tight or non-breathable clothing that traps heat and sweat, both of which the Eczema Society of Canada lists as flare triggers. Canadian winters add a wrinkle: layers of scratchy wool against skin, plus overheated indoor air, are a common seasonal combination worth watching.

When to see someone

Laundry is a supporting player. As the Eczema Society of Canada puts it, keeping your skin moist is your first line of defence, so a daily moisturizer matters more than any detergent. If a flare is spreading, weeping, crusting or not settling after two weeks of your usual care, see your doctor or pharmacist. Do not stop any prescribed treatment because a laundry change seems to be helping.

What to remember: fragrance-free and dye-free detergent, the labelled dose, a thorough rinse, no scented softener or dryer sheets, and new clothes washed first. Choose soft, smooth, breathable fabrics, and do not stress about enzymes. If the eczema does not improve after these changes, the laundry probably was not the cause, and that is useful to know too.