in addition to irritants and allergens other factors -- such as emotional issues temperature and climate and skin infections -- can affect atopic dermatitis. although the disease itself is not caused by emotional factors or personality it can be exacerbated by stress anger and frustration. interpersonal problems or major life changes such as divorce job changes or the death of a loved one can also make the disease worse. often emotional stress seems to prompt a flare of the disease. bathing with harsh soaps without proper moisturizing afterward is a common factor that triggers a flare of atopic dermatitis. typical recommendations include using a very gentle soap-free cleanser or milder soap the "three-minute rule" of lubricating with a rich moisturizer within three minutes of drying off after a bath or shower is particularly helpful for many patients. the low humidity of winter or the dry year-round climate of some geographic areas can intensify the disease as can overheated indoor areas and long or hot baths and showers. sweating and chilling can also induce an attack in some people. bacterial infections can also prompt or increase the severity of atopic dermatitis. if a patient experiences a sudden onset of illness the doctor may check for a viral infection (such as herpes simplex) or fungal infection (such as ringworm or athlete's foot).
what other factors may play a role in atopic dermatitis?