Tips for Safe Swimming With Atopic Dermatitis

From the risks posed by chlorine and other chemicals to the sun exposure and sweat, you may wonder if swimming is off-limits for people with atopic dermatitis (AD). It doesn’t have to be.

Water can affect eczema-prone skin in different ways, depending on the environment, your skin’s sensitivity, and how long you’re exposed. But with a few simple precautions, it’s possible to protect your skin barrier and reduce the risk of irritation or flares.

How Water Affects Atopic Dermatitis

Temperature matters, too. “Extreme hot or cold water temperatures can affect sensitive skin,” says Joseph Lam, MD, a pediatric dermatologist at the BC Children’s Hospital in Vancouver, British Columbia, who is a spokesperson for the Society for Pediatric Dermatology.

How to Prep Your Skin Before You Swim

• Apply a thick layer of moisturizer before entering the water. “If you’re planning a day at the pool, it’s a good idea to apply a generous amount of a heavy emollient cream or ointment before jumping in,” Block says. But don’t overdo it on the palms of your hands or the soles of your feet, because you’ll need to be able to hold onto things to avoid slips and falls. And if you’re going to be outdoors, keep in mind that sunscreen can’t be applied over ointment.

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• Choose the right sunscreen for sensitive, eczema-prone skin. If you’re spending time outdoors, sunscreen is nonnegotiable, says Block. People with AD should choose mineral sunscreens, made with ingredients like zinc oxide or titanium dioxide, she says. Use a sunscreen with a sun protection factor (SPF) of at least 30.

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   And always choose sunscreens that are fragrance-free and hypoallergenic, Van Onselen says.
• Time your skin-care routine for maximum protection. If you’re swimming indoors, aim to moisturize about an hour to 30 minutes before getting into the water to protect and soften the skin, Van Onselen says.

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   But if you plan on being in the sun, factor in some extra time: Moisturizer should always be applied first, wait 30 minutes, then apply sunscreen, she says.

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   “Don’t forget to reapply [sunscreen] every two hours or after swimming or sweating even if it’s labeled water-resistant,” Block says.

How to Keep Your Skin Safe While Swimming

Once you’re in the water, paying attention to your skin can help you avoid irritation. You should:

• Limit time in the water to prevent over-drying. “If you are at a new pool, it’s always good to start slow, which means spending only a short time in the pool,” Block says. While research doesn’t provide guidance on what a “short” time looks like, one review does note that staying in the pool for two hours increases transepidermal water loss (TEWL), a marker of skin barrier disruption.

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• Monitor skin for early signs of irritation. “Everyone's skin is different and if someone feels signs of redness, itching, stinging, or tightness during and after swimming, then it makes sense to exit the water,” Dr. Lam says. He recommends that you rinse off, pat dry, then moisturize.
• Wear comfortable swimwear. If you’ve had a reaction to a swimsuit in the past, check the label for the fabric composition. Spandex and polyester can irritate the skin, while materials like cotton, hemp, or bamboo tend to be more eczema-friendly.

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   Fit is important, too, Van Onselen says. Comfortable, nonrestrictive swimwear is best for people with eczema, since tight-fitting suits can increase friction and irritation.

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   “Sometimes swimsuits with longer arms and legs are quite useful for people with eczema, particularly children,” she says. She suggests UV-protective clothing for added sun protection if you’re swimming outdoors.
• Avoid swimming during a severe flare. Because inflamed skin is more vulnerable to irritation, get out of the water if stinging, itching, or tightness worsens. Van Onselen says you should avoid swimming altogether if eczema is infected or severely flared.

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Have a Post-Swim Skin-Care Routine

Post-swim care is essential for restoring your skin barrier.

Block recommends a “rinse and repair” approach. As soon as possible after leaving the water, rinse your skin with fresh, lukewarm water to remove chlorine, salt, or other residues.

How to Manage Atopic Dermatitis Flares After Swimming

Even with the best precautions, atopic dermatitis flares can still happen. The key is recognizing and treating them early.

Common signs of a flare include redness, itching, dryness, and irritation that look like your usual eczema symptoms, Lam says. “If symptoms resemble a typical eczema flare, people should use moisturizers or prescription medications to calm it down,” he says.

Because irritation can appear up to 48 hours after exposure, tracking your symptoms can help identify triggers, Block says. She recommends documenting your skin’s response using tools like the EczemaWise app to log details like timeline, symptoms, and severity to show your dermatologist.

If your eczema consistently flares after swimming, it may be worth trying a different pool, as variations in chemical balance can play a role, Van Onselen says.

If symptoms worsen, persist, or feel different from your usual flares, consult your dermatologist for guidance, Block says. “Don't wait, because eczema may become more severe if not managed immediately,” Block says.