It's been one year since NEA, in collaboration with four peer patient advocacy organizations, hosted the landmark patient-focused drug development (PFDD) meeting dedicated to eczema.
Published On: Jun 9, 2014
Last Updated On: Jun 9, 2014
The challenge of enjoying exercise without making your eczema worse can be a delicate balancing act. How do you avoid overheating, irritation and flare-ups when you’re just trying to work up a sweat?
The regulation of body temperature is important for people with eczema. For many of us, being subjected to quick changes in temperature such as through exercise can bring about the dreaded skin flare and itch.
Taking part in exercise — whether it’s a walk on a Saturday morning, a dance class, or an evening bicycle ride home from work — gives the body a workout, and we all sweat to moderate our temperature. As sweat evaporates, it cools the surface of the skin.
Perspiration is largely made up of water together with urea, lactate and minerals such as sodium. For people with eczema, exercise can dry out the skin through the loss of fluids, and the sodium in sweat can further dehydrate the skin as well as sting and irritate it.
For many people with eczema, exercise can trigger frenzied scratching as the skin surface temperature soars. But it doesn’t have to be this way. Being prepared can counteract many problems early.
No one needs to glug gallons of water before setting off, but drinking fluids regularly will replace the water lost when sweating. Anyone with eczema has inherently dry skin and is susceptible to weaker skin barrier function. Therefore, drinking water (especially around exercise) to keep the body and skin hydrated is recommended.
It’s important to choose the right clothing to minimize skin irritation as the body heats up. Synthetic moisture “wicking” clothing options draw sweat into the garments, but they may feel rough and irritate eczema. Loose-fitting 100 percent cotton clothing might buck the trend for body-hugging sports clothing, but they are likely to more comfortable. Mind the edges, too. Synthetics like polyester and Spandex around the waistline, neckline or cuffs is best avoided. Ultimately, of course, it comes down to personal choice. Look for light, breathable fabrics that don’t rub or scratch the skin during exercise.
Taking regular breaks during exercise isn’t cheating; it’s an opportunity to rest, rehydrate and cool down if you’re sensing the start of a flare with your eczema. Being realistic around the state of your eczema when you want to exercise means choosing a level of intensity to match.
Cold compression wraps (using either re-freezable ice or gel) are most often used to treat soft-tissue swelling or injuries but make excellent aids for cooling the skin and calming the itch in eczema. There are also a variety of cooling towels available today. Don’t wait until the escalation of a flare to use them; build their use into a rest period or a water break.
Given the potential to overheat, bear in mind both surroundings and other ways to slow the rise in temperature. Keep a towel nearby to wipe off sweat during exercise and exercise in indoor facilities that are well ventilated.
In much the same way that taking on water counteracts water lost while exercising, applying emollients will protect your skin in advance of and following exercise. A heavier ointment might feel hot and counterproductive and actually trap in sweat, so a cream or lighter application of ointment an hour before exercise allows time for it to have absorbed fully.
There is nothing quite as satisfying as a hot bath or shower after exercise to relax the muscles — except, of course, if you have eczema. Washing off sweat rather than letting it dry on the skin is a good idea, but resist the temptation to sizzle under the shower after a workout. Start with a warm shower and gradually make it cooler over minutes and in stages.
Gyms, health clubs and fitness centers might supply their shower gels and products but use your own products instead. It’s not worth risking a reaction for the sake of convenience. You can always decant your products into a travel-size container or get smaller quantities from your physician.
The benefits of exercise on the body and mind — from controlling weight to maintaining fitness, reducing stress, and releasing endorphins — outweigh the time and care needed to prepare.
The message is clear: don’t stop exercising because of eczema, but you might have to adapt what you do or compromise on the frequency and intensity.
There are clear links between eczema and stress. Exercise can be used as a tool to release stress and improve mood, which in turn benefits the skin.
Given that exercise can take any form that ultimately maintains or improves our health, there is no ideal type for people with eczema, just as there is no single treatment.
If your preferred choice of exercise proves problematic for your skin, then why not see it as an opportunity to try something new?
Walking or gardening can provide a great workout, but usually don’t lead to the levels of sweating and overheating in the way that bicycling or running might.
Also, consider low-impact exercise such as tai chi, Pilates, or yoga, which improve mobility, muscle strength and reduce stress. If you find your usual go-to exercises do aggravate your eczema, think outside the gym.
Millions of Americans swim to stay fit. Given its popularity, let’s look at some practical considerations to take the worry out of swimming for people with eczema.
Chlorine is the most common chemical used as a disinfectant to clean swimming pools, while bromine-based agents, UV-radiation and ozone gas are all rarer treatments. Chlorine can be a potential irritant for those with eczema. But for others, swimming in a chlorinated pool has the same positive effect as taking a bleach bath.
If you do want to take up swimming, get in touch with the pool manager in advance to determine the type of disinfectant used and when it’s added to the water. Chlorine evaporates, so the concentration in the pool will vary depending on when it is added.
Apply a thicker application of emollient to act as a barrier before entering the water, and shower soon afterwards to wash off any traces of disinfectant left on the skin. (Be sure to check that the water in the showers is not recycled). Liberally re-apply emollient to ensures that any drying out from swimming and showering is addressed.
An alternative to swimming in heated, chlorinated pools is to head outdoors to swim in the ocean, rivers, or lakes. Admittedly, in the depths of winter, this might have less appeal, but there’s no denying the practicality for people who know that the heat of exercise triggers their eczema. For some people with eczema, the sea’s saltwater can be soothing, but for others, it can be painful. The same is true for other bodies of water. It’s important to rinse and moisturize before and after swimming in any natural body of water.
Exercise can sometimes prove a real stumbling block for those who have eczema, and it can be frustrating to want to get involved in something that could risk upsetting your skin.
It might mean adapting how you do a certain sport or activity or taking up something new—which is hopefully no less enjoyable—but there’s no reason why anyone has to limit or stop their exercise because of their eczema.
Adapted from an article written by John Fuller for the United Kingdom’s National Eczema Society magazine, Exchange.