Can dust mites cause eczema?

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Dust mites are microscopic insect-like creatures that live in house dust and household items such as furniture and bedding. Dust mites feed on:

• dead skin cells
• fungi
• yeasts
• bacteria

Most households contain some species of dust mites, and they are present in approximately 84% of homes in the U.S.

Dust mites thrive in warm, moist environments, ideally those with around 70% humidity, and typically live on items that dead skin cells collect on, such as:

• bedding
• furniture that contains fabric
• curtains
• carpets or rugs
• mattresses
• pillows
• cloths
• toys with fabric

Dust mites do not attach to the skin, or pierce it. Their droppings may trigger eczema, but only in people prone to eczema.

People can have an allergic reaction to numerous mite allergens. The name of allergens in dust mites comes from the first three letters of the mite’s genus, Dermatophagoides pteronyssinus, followed by the first letter in the species and then the group number. The formal name for the most common allergen in dust mites is Der p1.

Currently, researchers have identified 24 potential allergens associated with dust mites, of which five other than Der p1 are considered major allergens. Experts associate the allergens Der p11 and Der p18, in particular, with atopic dermatitis, a form of eczema. The most common major allergen associated with the American house mite, Dermatophagoides farinae, is Der f1.

Many people experience a reaction to dust mites when their skin comes into contact with a dust mite allergen. These allergens destroy tight junctions and deteriorate the skin barrier function. Because they are so tiny, dust mites can also be inhaled. Many people inhale dust mite allergens, which can cause an immune response and inflammation or irritation in the nose, throat, or lungs.

Skin barrier damage from dust mites’ allergens can reach lower levels of cells that can spark an immune cascade, resulting in inflammation that can trigger or worsen eczema symptoms in people prone to it. If dust mite allergens damage the skin barrier, it is also less capable of preventing exposure to other allergens.

Dust mite allergy is an IgE mediated Type 1 hypersensitivity reaction.

Many people who do not have eczema, or are not prone to it, have a house dust allergy and are allergic to dust mite allergens.

Some 20 million people in the U.S. alone are sensitive or allergic to dust mite allergens. By some estimates, 97% of people with house dust allergies are sensitive to Der p1, and 70% are also sensitive to Der p23.

Symptoms of dust mite allergies tend to occur year-round, and worsen while sleeping because of exposure to allergens in bedding, pillows, and mattresses.

Common symptoms of a dust mite allergy include:

• nasal congestion, sneezing, sinus inflammation, and a postnasal drip
• itchy skin
• cough
• unexplained exhaustion
• trouble sleeping because of wheezing, coughing, or difficulty breathing

The allergens in dust mites can also trigger other allergic conditions, such as:

• allergic asthma
• allergic rhinitis with only nose symptoms
• allergic rhinoconjunctivitis with nose and eye symptoms
• sinusitis
• increased sensitivity to other allergens and irritants such as pollution, dry air, smoke, and pollen

People with eczema can manage exposure to triggers such as dust mites, but they must still seek medical treatment for eczema and use other methods to help prevent it from worsening.

Typical medical treatment options for eczema include:

• prescription moisturizers
• topical corticosteroids
• over-the-counter topical corticosteroids
• sedating antihistamines for nighttime use
• topical calcineurin inhibitors such as pimecrolimus or the ointment tacrolimus
• phototherapy
• oral steroid medications
• immune-suppressing medications
• biologic medications
• wet wrap treatments
• oral medications that reduce itching
• topical anesthetics
• acupuncture

At-home or lifestyle remedies for eczema include:

• identifying triggers and taking steps to limit or reduce exposure
• bathing daily in lukewarm water and applying moisturizers with ceramides immediately afterward
• getting enough sleep and exercise
• bathing with soothing ingredients such as oatmeal, diluted apple cider vinegar, and baking soda, or creating a paste with these ingredients and applying it to the skin
• keeping nails trimmed or wearing cotton gloves, especially to bed
• using cleansers with a low pH
• applying cool compresses to the skin
• avoiding itching or scratching the skin
• wearing soft, breathable clothes such as those made of loose-fitting cotton
• avoiding sitting with bare legs on rough carpet, grass, plastic chairs, or other potentially irritating surfaces

While there is no way to completely get rid of dust mites, there are several strategies for reducing exposure to them. Tips for reducing dust mites include:

• dusting household surfaces as often as possible with a wet mop or damp dusting cloth
• vacuuming carpets and rugs several times each week
• cleaning furniture, toys, and other household items weekly, paying particular attention to vacuuming the seams where dust mites tend to accumulate
• washing bed linens at least twice each week and pillows and duvets every 4–6 weeks in water that is 140°F, and drying items using a tumbling, hot setting in a dryer
• using an air purifier that contains a high-efficiency particulate air (HEPA) filter, especially in bedrooms
• vacuuming mattresses thoroughly every few weeks
• washing or dry-cleaning cushion covers, curtains, and fabric-containing toys regularly in water that is at least 140°F
• choosing furniture in materials that are easier to fully clean, such as leather, vinyl, or wood
• switching fabric curtains for plastic roller blinds
• changing carpeted flooring to materials that can be easily cleaned, such as wood, linoleum, vinyl, or laminate
• allowing good airflow in the home to reduce humidity, or using a dehumidifier to keep humidity levels below 50%
• replacing mattresses and pillows when they become old or too hard to clean, and buying washable pillows
• using anti-dust mite covers to protect mattresses, pillows, and duvets
• keeping items that sit on open shelves such as books inside a cupboard, and keeping toys in a closet or toy box

• putting non-washable toys in a plastic bag in the freezer for at least 24 hours, then brushing off potential dust mites
• reducing excess items in the home
• brushing pets frequently, ideally outdoors
• wearing rubber gloves and a face mask while cleaning
• if considering new or additional pets, looking into breeds or species that shed less fur and dander
• using acaricides short term, which are chemicals that can kill house dust mites
• cleaning vacuum filters frequently and using a low-dust exhaust vacuum cleaner
• using cotton bed linens

People should talk with a doctor, or a doctor that specializes in skin care called a dermatologist, if they experience unexplained skin symptoms, such as:

• itchiness
• rash
• inflammation
• discoloration
• oozing or weeping
• crusting
• redness
• roughness
• scaling

People with skin conditions such as eczema should also speak with a doctor if their symptoms worsen or do not ease with treatment.

Dust mite allergens or contact may trigger allergic conditions such as eczema.

Most people can reduce symptoms of eczema linked with dust mite exposure by following an eczema treatment plan and taking steps to reduce the number of dust mites and dust mite allergens in their homes and household items.