To Flake or Not to Flake: How to Cope When Eczema Threatens Your Plans

It’s Friday. You have plans but your eczema is flaring. What should you do? You don’t want to miss out, but suffering through an uncomfortable evening just isn’t worth it.

We spoke with three adults with eczema and Dr. Lisa Lombard, a licensed clinical psychologist in Oak Park, Illinois, to discover the best practices for navigating this tricky terrain. 

Stay home or socialize during a flare?

It’s not an easy decision. Up to one-half of adults with atopic dermatitis, a type of eczema, avoid social interactions due to their appearance. Many others with eczema may also be in too much pain or physical discomfort to go out. But spending time with friends and family provides you with a vital social network, which can help boost your mental health. 

So, what should a person with eczema do? Ultimately, it’s a personal decision that comes down to how you prioritize self-care.

When tackling this problem, 34-year-old Elise Loubatières, who lives in London, England, first considers the severity of the flare and whether going out would impact her healing. “The second consideration is how much I would feel left out if I didn’t attend the event. It’s a balancing act between looking after my skin health and mental health,” she said.

Ar Ducao, 43, based in New York City, considers a variety of criteria before they decide if they should go out. “If it’s planned far in advance, easy to do, for example, in my neighborhood, and/or a very special, infrequent occurrence with a very special person, I’ll do it,” Ducao said. “Otherwise, maybe not.”

Your innate temperament can also impact which way you’ll lean when it comes to socializing with a flare. “It may also depend on the continuum between extrovert and introvert,” said Dr. Lombard, who specializes in therapy for people with allergies, eczema and asthma. “Some people really get their energy from being socially interactive.” However, introverted people who feel drained by social events are more likely to stay home. 

Patricia Cervini, 59, who lives in Washington, D.C., didn’t let flares stop her from attending social engagements when her eczema was at its worst. “Being with my friends was like really good medicine,” Cervini said. “I could laugh, I could go to a happy hour and actually focus more on that than what was going on with my body. But I understand not everyone can do that.”

How to choose between staying home and going out

For those sitting on the fence, Dr. Lombard advised making a pros and cons list. “Sometimes it’s just easier to see it when it’s written down,” she said.  

Another approach Dr. Lombard recommends is keeping the engagement, but “having an exit strategy with time limits.” In this scenario, you attend the event but check in with yourself after 30 minutes (or another predetermined time limit). If you are having a good time at that point, you may decide to stay. If you feel uncomfortable, you go home. She advised continual check-ins with yourself throughout an event. 

Saying no when you have a flare

Deciding to cancel plans can be tough, and so can breaking the news to others. “Try to reframe it to let the person know that although you wish to be able to do it, right now isn’t a good time,” Dr. Lombard said. For example, “It’s just not going to work for me this week, but I really like getting together with you.”

When opting to stay home, people with eczema frequently experience pressure to change their minds. “Often people insist that I go out, as they believe that being out would be a good distraction,” said Loubatières. “However, what they don’t realize is that the whole process to leave the house when I’m in a flare is incredibly strenuous both physically and mentally.” 

Although friends and family can be well-meaning, too much peer pressure is ultimately a red flag. Dr. Lombard said, “If someone isn’t understanding or sensitive, they’re probably not a really valuable friend.”

Deciding to stay home can also trigger strong emotions. Dr. Lombard explained people may feel a sense of loss that “can also be accompanied by a feeling of anger or unfairness, that they need to modify what they do or decline an invitation because of their skin therapy.” 

To soothe these feelings, she suggested spending time at home with a favorite activity or talking to a close friend or family member. Reaching out to others with eczema can also help. “As awful as it is to have this condition, one thing I am grateful for is the incredibly supportive community of others who hold each other up in their shared experiences,” said Loubatières. “It truly makes what would usually be such a lonely, isolating situation so much easier.” 

What to share about your eczema

Whatever you decide to do, the question of privacy arises. Is it better to let people know exactly what’s going on or keep the details to yourself? 

Loubatières and Cervini expressed concern over their eczema taking too much focus during a gathering. “We are constantly aware of our skin with the pain we go through. Personally, I would rather it just not be addressed at all,” said Loubatières.

It also depends on the nature of the relationship. Acquaintances or colleagues may not require as much information. Dr. Lombard advised, “We can just say, I’m not really up for it, or I’m not feeling well, without explaining the actual sensation or description of what’s going on in the body or mind.”

There are also ways of explaining the severity of the situation without giving too many details. “When dealing with work-related acquaintances, emphasizing that I’m disabled and have a chronic illness (which is arguably true, given how severe and frequent my flares can be) helps me to navigate these types of unfamiliar spaces,” Ducao said.

However, there can be benefits to disclosing some personal information when appropriate. Cervini shared that once she explained her condition to close friends, they began making accommodations for her without being asked. For example, her friends would suggest meeting at a place with air conditioning. She said her newfound openness also helped increase her comfort level in setting boundaries and communicating her needs. She also sees sharing her story as a way to raise eczema awareness.

Since many people in the general population are unaware of the severity of eczema, those with it are often met with a lack of understanding when they talk about their flares. 

“People who don’t quite understand the full impact that a flare can have both physically and mentally will often try to offer reassurance by saying, ‘Oh, it doesn’t look that bad,’” Loubatières said. “But to me, this undermines my experience and everything I go through with my eczema.”

Loubatières has found that sharing social media videos documenting her flares often helps people understand her condition better. 

Ducao takes another approach to explain why they can’t attend a social event. “Usually, a flare is triggered by allergies, so I often mention that first. More people understand allergies than eczema,” they said. 

Feel confident in your decisions

Whether you are more introverted or extroverted, however you decide to handle social engagements when you have an eczema flare is up to you. You don’t have to feel guilty or pressured to go out or stay in. Try to weigh the pros and cons overall and decide based on what you think will make you feel the most comfortable. 

And remember, as frustrating as it is to cancel or change plans because of a flare, the situation is temporary. “It doesn’t stay horrible forever,” said Dr. Lombard. “The impact of a flare can change because the flare itself changes.”