Managing Stress from Eczema

How are stress and eczema related?

When people think about the side effects of eczema, likely the first thing that comes to mind is dry, red and itchy skin. But some of the most serious consequences of eczema are invisible, specifically the toll the disease can take on mental health.

To make that even more complicated, stress and eczema can be a vicious cycle. Anxiety and stress are common triggers and are known to cause flares, which in turn can create even more stress. So how can we stop this cycle?

The first step is understanding the link between eczema and stress, which is still under research. When a stressful situation arises, our body naturally reacts by going into a fight-or-flight mode and producing more stress hormones like adrenaline and cortisol. Stress can also cause the release of various inflammatory cytokines leading to increase in inflammation in the skin and worsening of eczema. Recent studies have shown that stress can also activate itch nerve fibers in the skin leading to more scratching and itching. These physiologic responses to stress all contribute to worsening eczema during stressful situations.

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If you have eczema, are you more prone to depression and other mental health issues?

Adults with atopic dermatitis (the most common type of eczema) have up to a three-fold higher risk for anxiety or depression that increases with disease severity.¹ Children and teens with atopic dermatitis are also more likely to have depression, anxiety or attention deficit/hyperactivity disorder (ADHD). It is not just patients themselves that struggle with their mental health — parents of children with atopic dermatitis suffer as well.

Additionally, people with atopic dermatitis are up to 44% more likely to exhibit suicidal ideation, and 36% more likely to attempt suicide.²

Though more research needs to be done on the link between eczema and mental health issues, it is believed that people with inflammatory skin diseases such as eczema are more prone to mental health issues because of the way their bodies communicate with their brains during an inflammatory response.

Though there is no cure for eczema, by reducing stress levels it can help relieve some symptoms of the disease.

How do you know if you are depressed?

According to the National Institute of Mental Health, if a someone has experienced some of these symptoms for two weeks or longer, they may have depression and should see a healthcare provider:

• • • Feeling sad, empty and/or anxious
    • Feeling hopeless
    • Lost of interest in hobbies or other activities
    • Decreased energy, feeling tired more often
    • Difficulty concentrating

• Restlessness, unable to sit still
• Problems sleeping
• Weight change
• Thoughts of death or suicide

If this applies to you, talk to a mental health specialist and/or dermatologist if you are experiencing these symptoms and eczema. Stress and depression can be eczema triggers, which can make some eczema symptoms, such as itchiness and dry skin, worse. A mental health provider or doctor can help you come up with a stress management program or treatment plan for depression to complement your eczema treatment so that everything works in tandem to improve both your mental and physical health.

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What Did Your Mental Health Journey Look Like?

Four young adults talk about how their mental health was impacted by their eczema. They share openly and honestly about their firsthand experience.

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Follow these strategies to slash stress and anxiety to live better with eczema.

Learn relaxation techniques

Relaxation techniques are a crucial component of self-care and can help reduce stress and anxiety. However, it is not a one-size-fits-all solution, so try a few options to see what works best for you.

These methods will help you get started:

• Mindful meditation
• Practice deep breathing while listening to nature sounds
• Download a guided meditation app
• Journal daily
• Go to a sound therapy class
• Enroll in a yoga or tai chi class
• Allot a certain amount of time each day to reading a book
• Cuddle with your pet
• Make it a daily habit to stroll along a nature trail
• Distract your mind from negative thinking with creative activities to do with your hands, such as painting, knitting, baking or chess

Get sleep under control

Sound sleep is even more important when you have eczema. But getting a good night’s rest can be tough when your skin is itchy and uncomfortable. If your eczema is keeping you awake at night, consult your doctor to see how you can get your symptoms under control.

To calm your body before bed, you can take a bath to get into a relaxed state and follow it up with moisturizer to help prevent itch.

To calm your mind, it is also important to practice good sleep hygiene by avoiding the use of electronics one to two hours before bedtime — including TV and your phone. Try turning your bedroom into a sleep sanctuary by keeping the room dark, cool and clean.

Join an eczema support group

Although eczema is very common, with more than 31 million Americans affected by it, managing eczema can feel very isolating. It’s normal to be embarrassed by eczema and to do things like wear long-sleeved shirts to hide rashes.

By joining an eczema support group, you will be surrounded by people who understand what you are going through and have faced many of the same challenges. Talk with your dermatologist to see if they can refer you to a local support group.

Another way to find others in the eczema community is by following the National Eczema Association (NEA) on social media (@NationalEczema). In addition, once a year, NEA hosts Eczema Expo where people living with or affected by eczema can come together in-person for a four-day conference of learning and support. There are various support groups held during Expo.

Talk to a therapist

Sometimes talking to a family member or friend about eczema isn’t enough. That’s where a mental health professional comes in. It’s best to seek a therapist who has experience with eczema patients; those who are trained in holistic care can help eczema patients learn problem-solving skills, relaxation strategies, acceptance and/or ways to change their thinking patterns to cope with the psychosocial burden of eczema. They can also give you coping mechanisms to help improve sleep.

Exercise regularly

Anyone who has ever gone for a good jog or taken a Pilates class after a tough day and instantly felt a mood boost knows the power of physical activity for mental health benefits. Research has shown that exercise is one of the most effective ways to mitigate stress, anxiety, depression and other negative emotions.

Find a workout you like, it could be anything — walking, running, swimming, boxing or playing tennis, to name a few. Exercise releases certain neurotransmitters and hormones that can dramatically improve your mood, such as endorphins, which are nature’s mood booster and responsible for a runner’s high.

In addition to muscle-strengthening activities, the Department of Health and Human Services recommends that adults get a minimum of 150 minutes of moderate-intensity physical activity each week. If sweat can trigger your eczema, be sure to take a cool or lukewarm shower after you exercise and put on fresh, clean clothes.

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De-stressing Yoga Nidra and Meditation Routine

Yoga instructor Eunice Yu explains how yoga nidra can help people with eczema. She takes you through this meditation practice to help you de-stress.