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How Stress Can Trigger Eczema and How to Avoid a Flare-Up
It’s been a hectic week at work, and you’ve noticed that your eczema outbreak is worse than ever. Your skin is dry and itchy, with rashes and rawness, and maybe some oozing bumps and skin crusting. If you presumed that the stress of your job and life and everything in between had triggered this eczema flare-up, you would be absolutely right!
Stress is a proven and common trigger for eczema flare-ups. Before you get more stressed reading this, let us assure you that this article will provide a detailed explanation of stress-induced eczema and the many ways to keep it under control. This way you can understand how to take care of your body, manage your stress and keep eczema flare-ups under control.
There is scientific evidence to prove that stress acts through multiple different mechanisms, affecting the way our body works. It affects everything from the time taken to heal from an illness, wound, or surgery, the functioning of our immune systems, and specifically in terms of eczema – the maintenance of our skin barrier.
When you are stressed, the body automatically goes into adrenaline i.e., flight or fight mode. This triggers the activation of three glands namely, the adrenal gland, pituitary gland, and hypothalamus which in turn provoke hormone production (these three together are called the HPA axis).
During this phase, endorphin levels are reduced, whereas the hormone cortisol is produced in response to this heightened nervous tension. Cortisol hormones generated in response to any recurring psychological stress about work, school, and family, can start accumulating in your body.
As higher amounts are generated as a consequence of chronic stress, somatic responses i.e., physiological responses like abnormal oiliness which in turn trigger eczema outbreaks.
Cortisol is the hormone that regulates the immune system- its excess production causes an imbalance, which in turn triggers increased cell signaling for inflammation and increased immunoglobulin E (IgE) antibody production which triggers allergic reactions.
Furthermore, excess cortisol disrupts the function of sensory nerves which in turn produce molecules that impair the skin barrier making outbreaks more likely. The white blood cells called mast cells also rise in number when cortisol is produced, generating histamine – the hormone responsible for allergy symptoms like itching, rashes, dryness, and redness.
If the stress continues it can exacerbate the severity of eczema outbreaks and also prolong the time taken for it to heal. The biggest problem with eczema is this stress-eczema cycle wherein the longer eczema lasts and the greater the severity, the greater stress you are under.
Eczema itself is stress-inducing with about 14% of people in the United States who suffer from eczema developing depression and 12% developing anxiety.
Psychological stressors like depression and anxiety make eczema worse; one of the somatic expressions of anxiety is eczema. Extended periods of healing skin damage, the stigma associated with skin disease, and poor sleep due to the itching sensation can all contribute to heightened stress/anxiety.
If you have an underlying phycological disorder, get these under control before you target eczema, because 30% of people with eczema i.e., atopic dermatitis has psychological/mental illnesses as well. As stress rises, our blood vessels also tend to dilate which causes the body to produce more histamine, creating an endless cycle.
How To Stop the Stress-Eczema Cycle?
Stress is only a trigger and not the underlying cause of eczema which could be genetics, a reactive immune system i.e., a tendency to have allergies or other environmental factors.
To minimize the impact stress has on your eczema try out the following techniques −
Talk therapy with a licensed therapist can help your control some behavioral aspects of eczema such as compulsive itching, and scratching out of habit through strategies like biofeedback or behavior modification.
You can also talk through your fears about the skin disease with the therapist, particularly fears of others’ perception which plagues sufferers of eczema. If you have underlying issues of anxiety, depression, or any other mental health challenge, your psychiatrist /therapist may also recommend some medications for relaxation. (Only take these with a prescription)
Ensure you have supportive family members, friends, colleagues, and other people who have combatted this issue either through peer, family, or eczema support groups. They will help you feel comfortable with the condition, providing emotional strength and encouragement, a sympathetic ear to listen to, and advice when needed.
Social isolation for adolescents suffering from eczema has been shown to make the inflammation worse, whereas a thriving social network will reduce self-esteem issues and emotional difficulty greatly.
All these techniques are useful in addition to some medication be they over-the-counter or prescription. Drugs like cyclosporine, azathioprine, or prednisone may be used to control severe eczema, but are only to be used short.
Dupilumab or tralokinumab are monoclonal antibodies or biologics which can be injected for people for whom moderate to severe eczema hasn’t responded to other treatments. Ointments, creams, or gels with corticosteroids or topical calcineurin inhibitors may also be prescribed as may wet dressings in which ointments are sealed in with wet gauze and then covered with dry gauze.
Phototherapy/light therapy can help by exposing your skin to UV light of a specific wavelength that suppresses overactive inflammation-inducing cells.
Exercise or Relaxing/Diverting Activities
Find an activity or form of exercise that you enjoy. It relieves muscle tension and makes your breathing deeper thus calming the nerves as well. Take a shower or change your clothes after a workout to make sure that sweat or chlorine doesn't trigger eczema again.
Try out other activities like reading, painting, listening to soothing music or meditation sounds, yoga, or tai chi which all destress your body and deflect attention from eczema symptoms. Mindful meditation may also be useful in this context.
If you identify your stressor, you can tackle it. There are many ways to do so – you just have to find the combination that works best for you.
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