Board-certified allergist Dr. Michael Pistiner shares what he wishes more of his patients knew about the association of eczema and allergies.
Published On: May 3, 2021
Last Updated On: Jun 10, 2021
With spring finally here, many of us are dusting off those old running shoes and gearing up to get back into shape. Gyms, exercise classes, tracks and race registrations are all opening up again. Whether it’s that daunting marathon you’ve always wanted to run or just a quick walk around the park, it’s always the right time to start moving your body again.
The challenge is that excessive sweating and exercise can lead to flaring skin if you live with eczema. According to the International Journal of Dermatology perspiration and physical activity are two of the most commonly reported triggers of eczema itch. Poorly fitting gear, clothing and temperature fluctuations can also irritate skin symptoms and get in the way of your fitness goals.
We asked two expert dermatologists and an exercise physiologist for their tips on working out flare-free.
The first question to ask yourself before lacing up those shoes is: have I consumed enough water today? “Hydration impacts everything,” said Dana Schuman, an exercise physiologist, personal trainer and conditioning coach outside of San Francisco. Schuman has experienced the importance of hydration for her skin personally: she has lived with eczema for many years. “I get rashier if I can’t cool off and I need hydration for that.”
Anyone who lives with eczema will tell you that sweating affects their skin and without proper hydration, cooling down can take much, much longer. Dr. Heidi Gold is a dermatologist and fellow of the American Academy of Dermatology. She practices in Florida and echoed Schuman’s emphasis on hydration. “Staying hydrated is important for everyone while exercising,” Dr. Gold said. “And those with eczema should be extra cautious to avoid becoming dehydrated with excessive exercise.” For the average adult, according to the Mayo Clinic, that means drinking on average 3.7 liters of water a day for men and 2.7 liters of water a day for women. So listen to your body, Schuman said, and come up with a hydration regimen that works well for you.
Dr. David Pariser is a professor of dermatology at Eastern Virginia Medical School and former President of the American Academy of Dermatology. “Prepare for workouts,” he said, “by preparing your skin.” To combat dryness and itch (which can be exacerbated by sweating), moisturize thoroughly before exercise. “Anyone with eczema,” he said, “should be moisturizing as frequently as possible. When your skin is hydrated, it seals in water.”
The next step is to choose your clothing wisely. Dr. Pariser explained that “tight fitting clothing and fabrics like spandex can rub on your skin at the seams, and any friction to the skin may cause irritation to eczema. Choose loose fitting, cotton garments that won’t rub or irritate.”
Dana Schuman’s gym bag includes her own yoga mat, towels, moisturizers, hand sanitizer, cleaning spray, soap and shampoo (if she’s planning on showering at the gym), and a change of clothes and socks. “Everyone brings their own gear to their workout,” she said. “Your eczema ‘kit’ is just part of your workout stuff.” She knows the products that work for her skin and brings them with her so she doesn’t need to use the communal gym products that might irritate her. “I have my own disinfecting wipes that aren’t as harsh as what the gym is using,” she said. “I wipe the dumbbells, for instance, before I use them, because if I touch the dumbbell and then my face. I don’t want to flare up.”
Schuman also keeps her moisturizer in her back pocket and applies it as needed throughout her workout, especially to trouble spots.
For people with eczema, swimming may be the perfect solution for working out. Dr. Pariser pointed out that “chlorine can actually be helpful to eczema.” But it’s still important to do your research and ask a few questions before you jump into the pool. “Chlorinated water can be similar to a bleach bath and regular chlorine in a pool is usually not harmful. Some pools, however, use other chemicals to keep water clean that may not be as helpful and may cause a flare,” said Dr. Pariser. “So find out what they’re using at your pool, wash off after your swim, and moisturize, moisturize, moisturize.”
For eczema warriors who prefer to swim in open water, salt water can complicate things. “Salt water can go either way, depending on your skin,” according to Dr. Pariser. “Do a short swim to see if salt helps or hurts you.” Regardless of the type of water, if you are in a serious flare and your skin’s normal barrier function is compromised, give it the chance to heal before diving into the water. And, as always, after you dry off don’t forget to moisturize.
Whether you’re swimming, running, or cycling outdoors, the sun is something to think about, even on a cloudy day. Dr. Gold explained that “some sunlight exposure can actually be good for patients with eczema as the UV rays decrease inflammation in the skin.” But you don’t want to expose yourself to levels of sun that can cause skin damage or overheating (which in itself can exacerbate eczema); so choosing the time of day to exercise outdoors without sunscreen (such as in the morning) is important.
If you’re working out later in the day and you have to wear sunscreen to stay safe, Dr. Gold said: “I love mineral sunscreens, i.e. those containing zinc or titanium as active ingredients. Not only are they less irritating to the skin than the chemical alternatives but they are actually a lot more effective at protecting us from harmful UV radiation.” Dr. Pariser agreed and said that if you’re “not in a flaring stage (with red, inflamed skin), a mild to moderate amount of sun exposure may be helpful.” If you’re flaring, on the other hand, you should protect yourself with either clothing or sunblock. When choosing your sunscreen, don’t use gels, sprays, liquids or anything containing alcohol. Look for double-duty sunscreen creams that help provide moisture, as well.
Whether you’re running with a friend, or getting to know the people at your new gym, there are tremendous social benefits to working out in a community. Schuman, in relation to her own workouts, described how “fitness has a way to bring people together and many of us build our community and friends from that common bond. I love it and see it all the time in the gym: new friendships, couples, business ventures, everything! I’ve met some of my favorite people in a group class that I never would’ve met otherwise.”
Dr. Pariser added that “exercise is a great way for people to feel good about themselves. You get to feel good about yourself and accept who you are.” Dr. Gold mentioned the importance of managing stress, too: “Exercise is such an important element in managing stress,” she said, “and we know that stress can cause this condition to flare so that alone is a good reason for people with eczema to exercise.”
Schuman encouraged resilience for those still trying to figure out how to start working out. “Don’t give up,” she said. “You’re so not alone. There’s this dance those of us with eczema have to do, but what you are doing for yourself through exercise is so important and beneficial, it outweighs the eczema.”