After my eczema flared up after years of being dormant, I found myself down the rabbit hole that is the Internet, searching for what could have brought back my skin condition. While my derm and I have some theories on my particular case, the one trigger I found most interesting? Stress.
For those that are unfamiliar with the problem, eczema is known in the medical community as atopic dermatitis and seems to have a genetic tie. “It forms when the skin barrier is compromised in predisposed individuals, causing microscopic skin fissures in the skin that lead to nerve excitation, inflammation, itch, and skin rash,” explains Dr. Melanie Palm, board-certified dermatologist and cosmetic surgeon and director of Art of Skin MD. "Eczema is considered as one-third of the 'atopic triad,' a constellation of conditions that seem to run through ‘atopic' families. These three conditions are eczema, allergic rhinitis (allergies), and asthma."
How long it lasts and the severity of it can vary from person to person, but usually, Dr. Palm says it shows up first during childhood and then improves in adulthood, though some may experience outbreaks later on. The outbreaks can be brought on by several factors. Of them, Dr Joshua Zeichner, Director of Cosmetic and Clinical Research in the Department of Dermatology at Mount Sinai Hospital, lists irritating skincare products, allergies, dry, cold weather, and like I had read, even stress. Dr. Melanie Palm also confirmed the parallel.
As someone who probably needs to meditate a little more and sweats the small stuff far too often, I have a tendency to describe myself as "stressed-out." That fun personal anxiety anecdote, along with the fact I’m already prone to the condition, made me super curious as to how stress can lead to flare-ups in individuals with atopic dermatitis.
"It is true that there is a well-established relationship between increased times of stress and eczema flares," says Dr. Palm. "The exact mechanism is not known, but it is likely that stress creates a pro-inflammatory response to the entire body (think very complicated release of hormones and stress proteins), that are like gasoline on the eczema fire. Eczema is a condition where the immune system is already in a pro-inflammatory state, so it is not surprising that life stressors would increase the severity of eczema." Basically, stress can make your rash far worse than it already is. Interestingly enough, stress can also exacerbate acne, hair loss, and psoriasis.
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So what can be done? For starters, if you find your skin freaks out during times of anxiety, Dr. Palm says decreasing your level of stress is important, and can be done with meditation, mindfulness, exercise, and seeking professional help. The next step is treating the skin to control the condition, as it can’t be totally cured.
"For soothing more typical eczema flares, foundational treatment starts with repairing skin barrier functions with skin cleansers and moisturizers that contain key ingredients such as ceramides, free fatty acids, or hyaluronic acids and do not contain things like harsh detergents and fragrances or preservatives," says Dr. Palm. She also mentions that decreasing inflammation is typically done with topical products like corticosteroids, and itching is controlled with anti-histamines.
To further soothe and treat the condition, Dr. Zeichner recommends switching to short showers (think 10 minutes or less) in lukewarm water, patting dry rather than rubbing, and moisturizing within five minutes of getting out of the shower, keeping the door closed with doing so, to hydrate the skin and draw in humidity from the air. You can also sleep with a cooling humidier to ensure moisture is in the air.
As for products, Dr. Zeichner recommends Neutrogena Ultra Gentle Hydrating Cleanser For Sensitive Skin ($9; target.com) and Vaseline Intensive Care Fragrance Free Advanced Repair Lotion ($2; target.com), as it seals in cracks and repairs your barrier. "It also has the seal from the national eczema association," he adds.
As for me, I'm going to stay diligent on fixing up my skin with super gentle and hydrating formulas and maybe add in an extra meditation session after my morning run.