If you’ve ever felt like an eczema flare-up might be linked to your stress levels, it’s not a coincidence. We sat down with Vhi Consultant Dermatologist Dr Rupert Barry to get a better understanding of eczema and its types, how stress can trigger your eczema, when to seek medical advice/talk to a healthcare provider, and why developing your own wellness practices is key.

What is eczema?

Dr Barry explains that two of the key functions of the skin are 1) to reduce the amount of water loss (known as evaporation) from the skin surface and 2) to act as a barrier to stop the entry of potentially harmful agents such as bacteria, fungi or viruses. Eczema is an inflammatory condition of the skin where the barrier function of the skin is impaired. This can lead to increased water loss from the skin, which can cause dehydration. Due to the damage to the barrier function of the skin, there is an increased chance that everyday agents such as bacteria or fungi could get into our skin tissue, and this would then cause inflammation in the skin—this is what someone with eczema experiences as redness, soreness and itch. Dr Barry says this is known as an ‘inflammatory flare’.

Similarly, everyday products often contain chemicals that can irritate our skin, especially if the person already has a damaged skin barrier. This is why people with eczema often find that everyday products such as soaps, detergents, perfumed products and even the moisture from some foods such as tomatoes or citrus fruits can irritate their skin and cause itchiness and discomfort when their skin is inflamed. An eczema ‘flare’ can result in dry, itchy, irritated, or painful skin. When someone with eczema experiences a flare-up, it can last anywhere from a few days to weeks, but there are plenty of ways to treat and manage your eczema.

What are the different types of eczema?

There are many types of eczema, including:

•  Atopic eczema –This is usually seen in the creases of the elbows and knees. People with this eczema have an increased tendency to also have asthma or hay fever at some stage in life.
• Contact allergic eczema – this eczema is brought on by contact with triggers that your immune system sees as a threat, such as chemicals in makeup, causing an allergic reaction.
•  Contact irritant eczema – this is an irritancy to your skin, such as contact with poison ivy, rather than an allergic reaction by your immune system.
• Asteatotic eczema – this is caused by overly dry skin (especially on the lower legs) and is more commonly found in elderly people. This dryness can be alleviated by moisturisers.
• Discoid eczema – this is a chronic type of eczema that tends to recur frequently. The skin lesions are round in shape (coin-shaped) and often start on the limbs but can spread to the torso too. It is important to see your healthcare provider for this eczema, and you will usually need a short course of topical steroids. You’ll then need to regularly use moisturiser.

The link between stress and eczema

We all have a built-in fight-or-flight response mechanism in our bodies that is triggered when we experience stress. This fight-or-flight response is linked to our nervous system, which is intertwined with our immune system. When we are stressed, our body releases chemicals and hormones such as cortisol, and these can have an impact on our skin. Dr Barry says ‘stress can lead to a cascade of events in our immune system, which then can disrupt the normal balance in our skin. This can then be a trigger for a flare-up in a person’s eczema.’

Dr Barry highlights that people with atopic eczema are one of the most likely dermatology patient groups to see the impact of stress on their condition. Learning how to alleviate your stress is an important part of the overall approach to the management of your eczema.

Ways to reduce your stress

Sometimes, when the discomfort of persistently itchy, sore skin dominates our thoughts, it can be hard to relax at all. It can cause sleep deprivation and agitation. Over time, it can make it tough to form relationships, go to the gym, take a dip in the sea, or can even effect intimacy.

When stress is identified as a potential factor in your flare-ups, Dr Barry indicates that it’s important to try and combat this. One useful way to do this is by building ‘me time’ into your week as much as possible.

Some activities that would be good ‘me time’ include:

1.  Going for a walk
2.  Reading a book
3.  Having a bath
4.  Exercising
5.   Practicing mindfulness or meditation

The point is to carve out time each week when you can unwind, stop multi-tasking, and let your mind rest or focus just on that activity, rather than racing over the list of things you need to do. Dr Barry highlights the need to be ‘ruthless’ in making sure we find this time in our busy schedules each week. Reducing our levels of stress is two-fold in its positive impact on eczema; if you do enter a flare-up period and you’re generally less stressed, it’s likely you’ll be better prepared to cope and won’t feel as overwhelmed by the flare-up.

Hopefully, these practical steps will give you a path forward and a better understanding of the link between stress and eczema flare-ups. It can be difficult to manage a bad flare-up by yourself, so make sure you are talking to your healthcare provider or a dermatologist to develop the right treatment for you.

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately. 

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