How Stress Can Trigger Eczema, and How to Avoid a Flare-Up

The symptoms of eczema — which can include very dry or itchy skin that may crack and ooze clear liquid when scratched — are not constant.

Rather, symptoms vacillate from worse to better to worse again, often thanks to specific triggers that activate inflammation.

“There are many potential triggers for eczema, and each individual may have specific triggers for their own symptoms,” says Peter Lio, MD, a dermatologist at Northwestern University’s Feinberg School of Medicine in Chicago.

• Overly dry skin
• Dry, cold climate, particularly during winter
• Sweat
• 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

  

Stress is another common trigger for eczema symptoms.

In a 2016 survey by the National Eczema Association, about one-half of the respondents said they were bothered by poor sleep and symptoms of mental health issues like depression and anxiety caused by eczema. The skin condition also affected their ability to effectively engage in self-improvement activities.

The link between psychological stress and eczema is multifaceted, though the connection appears to stem from stress hormones.

“Stress is a very common trigger for both children and adults,” Dr. Lio says. While there are many theories about how stress and eczema are connected, researchers have found that there is a network in the body that both directly and indirectly affects the immune system, the skin barrier, and behavioral aspects of eczema, he explains.

“One of the hardest parts is that there can be a vicious cycle: The skin and symptoms cause more stress, which then, in turn, worsens the skin,” Lio says.

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.

The body also experiences various other physiological changes that affect the skin.

Research suggests that mindful meditation — especially regimens like mindfulness-based stress reduction (MBSR) — can help alleviate psychological stress and improve emotional well-being.

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 rain forest to represent moist skin

  

• Acupuncture, a traditional Chinese medicine in which thin needles are inserted at specific points of the body
• Distraction activities, such as writing, painting, video games, and knitting
• Listening to soothing music or nature sounds

Lio says he typically introduces his patients to several of these techniques and asks which ones sound good to them. “Finding ways to relax and destress is critical,” he says. “Sometimes it takes a few tries to find the right fit for someone, but once found, it can make a tremendous impact.”

Alternatively, you could also meet your exercise requirement by getting 75 to 150 minutes of vigorous-intensity (or a combination of moderate- and vigorous-intensity) aerobic exercise each week. Vigorous-intensity exercise includes running, hiking, playing soccer, or playing tennis singles.

The itchy, uncomfortable skin associated with eczema can make sleeping difficult.

Lack of sleep can cause stress and worsen eczema symptoms, especially if sleeplessness occurs the night before an important activity or tiredness interferes with important activities during the day.

According to the National Eczema Association, these tips will help you get a better night’s sleep:

• Wake up and go to bed at the same time every day.
• Create a consistent, relaxing bedtime routine.
• Stop using electronics 30-60 minutes before bedtime.
• Limit caffeine intake after lunch.
• Keep your bedroom dark, cool, and comfortable. 
  

Positive social relationships are important for physical and mental well-being.

Additional reporting by Ashley Welch.