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The Eczema and Stress Connection
Mindfulness meditation, exercise, and support groups can all help reduce stress and flare-ups if you have eczema.
The symptoms of eczema — which include very dry, itchy skin that may crack and ooze clear liquid when scratched — are not constant at all times.
Rather, symptoms sway from being worse to better to worse again, often thanks to specific "triggers" that activate inflammation. These triggers (1) include things like:
- Overly dry skin
- Dry, cold climate, particularly during winter
- Irritants such as metals, cigarette smoke, fragrances, and fabrics like wool and polyester
- Allergens such as mold, pollen, dust mites, and pet dander
- Various foods that cause allergic reactions, such as eggs, soy, shellfish, tree nuts, peanuts, fish, wheat, and milk
- Bacterial, viral, and fungal infections
- Hormonal changes, particularly during pregnancy or in the days before menstruation (2)
Another common trigger for eczema symptoms is stress.
For some people, various external factors, such as school or work, can cause stress, resulting in worsening eczema symptoms. For others, flare-ups result from the stress of knowing they have eczema.
Eczema and Other Mental Health Issues
The psychological stress of having eczema can often lead to more significant problems.
In a , about half of the respondents said they were bothered by poor sleep and symptoms of mental health issues like depression and anxiety due to eczema. The skin condition also affected their ability to effectively engage in self-improvement activities.
During inflammatory eczema responses, the body — particularly the skin, the body's largest organ — communicates with the brain through various sensations, such as pain, heat, itch, and discomfort.
These sensations can ultimately result in feelings of anxiety and depression, and can cause tired and foggy thinking.
Controlling eczema flares induced by psychological stress may relieve symptoms of anxiety and depression and improve emotional well-being. (3,4)
How Does Stress Worsen Eczema Symptoms?
The link between psychological stress and eczema is multifaceted, though it appears to all stem from stress hormones.
When we experience stress, the body induces a "flight or fight response," also known simply as the "stress response." Part of this response is the activation of the so-called HPA axis, a network involving the hypothalamus, pituitary gland, and adrenal glands, which produce hormones.
The HPA axis increases the amount of cortisol — a "stress hormone" — circulating in the body.
Cortisol is an immune system regulator and ultimately causes an imbalance in the body's different types of immune responses, resulting in the increase of cell signaling molecules that promote inflammation.
Part of this cascading response from the immune system imbalance is an increase in the production of immunoglobulin E (IgE) antibodies, which cause allergic reactions.
The body also experiences various other physiological changes that affect the skin.
For example, the production of mast cells increases — these white blood cells release histamine, a compound that causes itchiness. Stress also causes our blood vessels to dilate, which leads to a further release in histamine. Additionally, sensory nerves release molecules that can disrupt the normal functions of the outermost layer of the skin (the skin barrier).
These and other responses work in concert during stressful events and drive up eczema symptoms. (5,6,7,8)
Mindful Meditation and Relaxation Practices for Stress
Research suggests that mindful meditation — especially regimens like mindfulness-based stress reduction (MBSR) — can help alleviate psychological stress and improve emotional well-being.
In a review published in March 2014 in the journal JAMA Internal Medicine, researchers found that mindfulness meditation programs can help reduce anxiety, depression, and pain. (9)
More recently, an article published in January 2019 in the journal Psychiatry Research shows that MBSR reduces stress hormones and inflammatory molecules in people with generalized anxiety disorder, suggesting the practice helped people better deal with stress and may reduce inflammation. (10)
Mindfulness meditation involves sitting comfortably; focusing on deep, steady breathing; and paying close attention to the present moment, particularly your own thoughts, emotions, and sensations. (11)
Other complementary relaxation techniques include:
- Light, graceful exercises, such as yoga, tai chi, or ballet
- Positive imagery or visualization, in which you focus your thoughts on an image associated with your desired change, such as a tropical rainforest to represent moist skin (12)
- Distraction activities, such as writing, painting, video games, and knitting
- Listening to soothing music or nature sounds
The Importance of Exercise for Stress Relief
Physical exercise is well known to help relieve stress, and is also a great way to reduce anxiety, depression, and other negative emotions. (4,13)
The U.S. Department of Health and Human Services recommends you get a minimum of 150 minutes of moderate to intense physical activity a week, whether you prefer to engage in walking briskly, running, playing tennis or other sports, or swimming. These activities can also deepen breathing and relieve muscle tension. (8)
If sweat is a flare-up trigger for you, make sure to take a shower after exercising and change your clothes. Alternatively, sticking to swimming may help reduce those flares. (4)
Sleeping Well When You Have Eczema
The itchy, uncomfortable skin associated with eczema can make sleeping difficult.
Lack of sleep can cause stress and worsen eczema symptoms, especially if occurs the night before an important activity or tiredness interferes with important activities during the day.
What's more, research shows that sleep loss, even if it occurs for just one night, can increase inflammation. (14)
To get a better night's sleep:
Better Support to Cope With the Stress of Eczema
Positive social relationships are important for physical and mental well-being.
A study published in January 2019 in the journal PNAS suggests that social networks are just as important as diet and exercise throughout your whole life. Social isolation in adolescence, for instance, increases the risk of inflammation.
Video: What is the Connection Between Eczema and Stress | How Stress Can Worsen Your Eczema
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