Clothing, pajamas, sheets, towels, underwear and even the elastic in a waistband can all come into contact with our skin for hours at a time. And for some people, those textiles can be a source of itching, redness or irritation.

The tricky part is that when we talk about a "fabric allergy," the fabric itself isn't always the problem.

You could be reacting to a fiber, but you could also be sensitive to a dye, chemical finish, elastic, latex or another substance used to manufacture the textile. Heat, sweat and friction can make things even worse, particularly if you already have eczema or very sensitive skin.

Beyond the material itself, you could also be reacting to the detergent you use to wash the items. Did you know that detergents can remain in clothing after rinsing with water up to 10x?

As the founder of The Eczema Company, and as a mom whose son struggled with severe eczema, I've spent years learning how much our everyday environment can affect sensitive skin. Textiles are one of those areas that are easy to overlook.

So let's break down what a textile allergy or sensitivity actually is, what may be triggering your skin, and which fabrics may be worth trying instead.

What Is a Textile Allergy?

"Textile allergy" is a broad term people often use to describe a skin reaction that happens after contact with clothing or another fabric.

In some cases, the reaction may be allergic contact dermatitis. This happens when your immune system reacts to a particular allergen.

In other cases, it may be irritant contact dermatitis. Your skin isn't technically allergic to the material, but something about the textile is irritating your skin. Friction, sweat, heat and rough fabric can all contribute.

What Can Cause a Reaction to Clothing or Fabric?

There are a surprising number of things in and on textiles that can bother sensitive skin.

Synthetic Fibers Like Polyester and Nylon

Polyester and nylon are synthetic fibers that are extremely common in clothing, activewear, underwear and bedding. Even if your items are not made from these materials, it is quite common for items to be sewn using polyester or nylon thread on seams.

A true allergy to the fiber itself isn't necessarily what's happening when someone says they're "allergic to polyester." The skin reaction may instead be related to dyes, finishing chemicals or other substances used in manufacturing.

Synthetic fabrics can also be uncomfortable for some people with eczema or sensitive skin because heat, perspiration and friction may aggravate already-irritated skin.

I've always found it more helpful to focus on what your individual skin tolerates rather than labeling an entire fabric as "good" or "bad."

If you consistently get itchy in polyester workout clothes, but feel comfortable in cotton or lyocell, that's useful information.

Listen to your skin.

Latex, Spandex and Elastane

Latex, spandex and elastane often get lumped together because they're all associated with stretchy clothing, but they're not the same thing.

Spandex and elastane are two names for the same synthetic fiber. You'll find it in leggings, workout clothes, bras, underwear, socks and other fitted clothing, usually blended with cotton, polyester or nylon to add stretch and help clothing hold its shape.

Latex is different. Natural latex is a rubber material derived from rubber trees, while spandex and elastane are synthetic fibers made primarily from polyurethane. Polyester and nylon are different synthetic fibers as well. None of these fibers automatically contain natural latex.

Where it gets confusing is that a garment made with spandex, polyester or nylon can still contain latex or rubber in other components, such as elastic waistbands, grips or trims.

If you have a diagnosed latex allergy, don't assume that avoiding spandex or other synthetic fibers means you're avoiding latex. Look for products specifically identified as latex-free and, when necessary, check with the manufacturer about the entire garment.

And remember that an uncomfortable reaction to stretchy clothing doesn't necessarily mean you have a latex allergy. Tight-fitting fabrics can also trap heat and sweat or create friction, all of which can aggravate sensitive or eczema-prone skin.

This is an important distinction when you're trying to figure out a textile reaction. An allergy and skin irritation aren't necessarily the same thing.

Fabric Dyes

Sometimes it's not the fabric at all. It's the color.

Textile dyes can be a source of allergic contact dermatitis, particularly in people who are sensitive to certain chemicals used in dyes.

This is one reason I pay attention not only to what a textile is made from, but also to how it's dyed.

A beautifully soft cotton fabric can still have a lot done to it between the cotton field and your skin.

Chemical Finishes and Treatments

"Wrinkle resistant." "Stain resistant." "Easy care."

These features may sound convenient, but they also tell you that something has likely been done to the fabric to create that performance.

Textiles can be treated with finishing agents, resins and other chemicals during manufacturing. For people with very reactive skin, simplifying what comes into contact with the skin can sometimes make a big difference.

This is one reason I personally gravitate toward textiles that are transparent about both their fiber and how they're processed.

Metals, Fasteners and Other Materials

Sometimes the reaction isn't coming from the fabric at all.

Nickel in snaps, buttons or zippers can cause allergic contact dermatitis in people with nickel allergies. Adhesives, rubber components, elastic and other materials incorporated into a garment can also be potential triggers.

Look at where your rash actually appears. That can provide important clues.

Signs Your Clothing May Be Irritating Your Skin

Textile reactions can look different from person to person, but you may notice:

• itching or burning after getting dressed
• redness or a rash where fabric touches your skin
• irritation around waistbands, cuffs, seams or elastic
• itching that gets worse when you sweat
• irritation under tight-fitting clothing
• skin that feels better after changing into softer, looser clothing

Areas where clothing fits tightly or where we tend to sweat, such as the underarms, waist, chest and groin, can be particularly vulnerable.

If you're noticing the same reaction every time you wear a certain pair of pants, pajamas or workout clothes, don't ignore the pattern.

Which Fabrics Are Better for Sensitive Skin?

There isn't one perfect fabric for everyone.

That's important.

Eczema and sensitive skin are incredibly individual, and what works beautifully for one person may not work for another. But there are a few materials I tend to look at first when someone is trying to simplify their textiles.

Organic Cotton

Cotton is familiar, breathable and generally comfortable against the skin. For sensitive skin, I prefer organic cotton when possible, particularly when the manufacturer is also thoughtful about dyes and processing.

And don't stop at clothing.

Think about everything that spends hours against your skin.

For example, AIZOME makes bedding, pajamas and towels using organic cotton and plant dyes. I appreciate this approach because it looks beyond the fiber itself and considers how the finished textile is made.

For someone trying to reduce potential textile triggers, that kind of transparency can be very helpful.

TENCEL™ Lyocell

Lyocell is another fabric I really like for eczema-prone and sensitive skin.

It feels incredibly soft and smooth, and that matters when irritated skin is already uncomfortable. Reducing rubbing and friction can make clothing much easier to tolerate.

At The Eczema Company, we carry Remedywear™, which combines TENCEL™ Lyocell with zinc oxide embedded directly into the fibers, plus recycled elastane for a form fitting stretch. It's one of my favorite textile options for eczema-prone skin, particularly when itching and friction from regular clothing are a problem.

Silk

Silk can also feel wonderful against sensitive skin because of its smooth surface and low friction.

Again, I would still look beyond the fiber itself. Dye, processing, seams and the construction of the finished garment all matter.

What About "Natural" Fabrics?

Here's where I think we need to be careful.

Natural doesn't automatically mean allergy-free. And synthetic doesn't automatically mean irritating.

Even a natural fiber can be heavily dyed, chemically treated or processed in ways that may not agree with your skin. On the other hand, some people tolerate certain synthetic textiles perfectly well.

Rather than relying only on labels like "natural," I look at the bigger picture:

• What is the fiber?
• How was it processed?
• How was it dyed?
• Does it contain elastic or latex?
• Does it trap heat?
• Is it soft?
• Does it rub?
• And most importantly, how does your skin actually respond to it?

How to Figure Out What Your Skin Is Reacting To

If you suspect a textile is bothering your skin, simplify things before replacing your entire wardrobe.

Start by paying attention to patterns.

• Did the rash appear after wearing a new garment?
• Does it happen with dark clothing but not lighter clothing?
• Only around elastic?
• Only when you exercise or sweat?
• Do certain pajamas make you itch at night?
• Does your skin improve when you switch to cotton or lyocell?

When Should You See a Dermatologist?

If your reaction is severe, persistent or keeps coming back and you can't figure out why, talk with a dermatologist or allergist.

Patch testing can sometimes help identify specific allergens responsible for allergic contact dermatitis, including substances associated with textiles.

That's particularly important if you suspect latex, textile dyes, formaldehyde-related chemicals, nickel or another contact allergen.

And if you ever experience symptoms of a serious allergic reaction, such as difficulty breathing or swelling of the face, lips or throat, seek emergency medical care immediately.

The Bottom Line on Textile Allergies

When your skin reacts to clothing, it's tempting to blame the fabric listed on the tag.

Sometimes that's part of the story. But often, it's more complicated.

The fiber, dye, chemical treatments, elastic, latex, heat, sweat and friction can all play a role.

If you have eczema or sensitive skin, I think the best approach is to simplify wherever you can. Choose soft, breathable textiles. Look for companies that are transparent about materials, dyes and processing. Wash new textiles before they touch your skin. And pay attention to what your own skin is telling you.

Because when your skin is already struggling, what touches it all day matters.