How the 4-7-8 Breathing Technique Can Help Reduce Stress

When you undergo excess stress, your body may respond with rapid heartbeat, sweaty palms — and an eczema flare. That’s why Dr. Olivia Hsu Friedman, a doctor of acupuncture, traditional Chinese medicine and herbal medicine at Amethyst Holistic Skin Solutions, advocates that people with eczema practice breathwork to stop stress in its tracks.

When stress or anxiety rises, “Many eczema patients can find themselves flaring or feeling anxious about possible ‘what ifs?’ that happened before or that could happen again,” Dr. Friedman said. The 4-7-8 breathing technique offers a simple method for helping people with eczema reduce stress and the likelihood of a flare, while helping to regulate the nervous system. 

What is the 4-7-8 breathing technique?

The 4-7-8 breathing technique is based in pranayama yoga, an ancient yoga practice that incorporates breath control for relaxation. This breathing exercise involves breathing in for the count of four, holding your breath for the count of seven and then exhaling for the count of eight.

This controlled breathing technique was developed and popularized by Dr. Andrew Weil, founder and director of the Andrew Weil Center for Integrative Medicine at the University of Arizona. This breathing technique doesn’t require any equipment. You can do it anywhere to help calm your stress and anxiety.

How does the 4-7-8 breathing exercise work?

“The 4-7-8 breathing technique allows you to relax the sympathetic nervous system, which is responsible for the ‘fight or flight response,’ while it activates your parasympathetic nervous system to bring you back to a normal heartbeat, deeper breathing and a calmer mind,” Dr. Friedman explained.

Your sympathetic nervous system boosts your energy and increases your heart rate when your body senses danger. Your parasympathetic system slows your breathing and heart rate when the threat passes. Both must work together to keep your body’s nervous system in balance. But when your sympathetic nervous system remains activated too long, it can worsen eczema symptoms or trigger a flare.

Dr. Friedman has seen firsthand how breathwork can help people with eczema relax. She led a group of eczema patients through the 4-7-8 breathing exercise. Afterwards, she said, “Every single person felt a calmness come over them and agreed it would be useful during stressful moments, but also daily to maintain equanimity.” 

In Dr. Friedman’s work, she assesses each of her eczema patients using traditional Chinese medicine, which considers how someone’s emotional and psychological states may contribute to a condition and vice versa. Traditional Chinese medicine views internal states like stress and external conditions, including an eczema flare, as mutually impactful.

“During intake, I ask patients how much stress they’re experiencing and what they are doing to manage the stress,” explained Dr. Friedman. “Depending on their answers, it tells me a lot about their eczema and if we should discuss implementing the 4-7-8 technique.”

How do you do the 4-7-8 breathing exercise?

1. To begin, find a comfortable position and make sure you’re sitting up straight. 
2. Rest your tongue against the back of your teeth and breathe all the way out through your mouth. 
3. Close your mouth and inhale through your nose for four counts. 
4. Hold your breath for seven counts. 
5. Breathe through your mouth for eight counts, and make a whooshing sound as you exhale completely. 

Try to complete a few cycles the first time and gradually increase with practice. Some people report becoming light-headed, but the sensation will pass.

When should you practice 4-7-8 breathing for eczema?

“This technique can be a great tool for nights when sleeping is difficult, whether because of itching, feeling hot or having a racing mind,” Dr. Friedman said. “Instead of looking at the clock and wondering when you’re gonna fall asleep, this technique reduces your heart rate and blood pressure, which makes your body better able to fall asleep.”

For people with eczema, the 4-7-8 breathing technique may be beneficial during flares, when you worry that the next flare is about to happen or any time stress increases. This breathwork practice can also help you focus on being more present and aware of your body, a core tenet of traditional Chinese medicine. 

Dr. Friedman also emphasized that you do not need to have eczema to practice this breathing technique. In fact, it’s a great option for eczema caregivers. Eczema caregivers, for example, take on large amounts of stress, supporting and advocating for their loved ones. Deep breathing practices like this can help improve their well-being too.

“Stress is unavoidable in life whether or not you have eczema,” Dr. Friedman shared. “But the best lessons I’ve learned to manage my life came from having to live with eczema. It forced me to turn my stress into good habits, which set me up well for the rest of my life.”