November 28, 2023

How Lifestyle Changes and Self-Care Can Improve Your Atopic Dermatitis

Changing your wardrobe or environment won’t eliminate eczema, but it can help reduce flares

person scratching neck that has eczema

If you or somebody you love struggles with eczema, you know all too well how much it can impact your daily life. The itching keeps you awake at night and distracted at work, and the angry red rash is a particularly annoying third wheel on date night. It may prevent you from doing activities you love, or even mess with your mood.

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For people whose eczema (the most common form of which is called atopic dermatitis) isn’t well-managed, the impact can truly be all-consuming. But there’s good news: Your skin condition might not be curable, but it can be improved.

We talked with dermatologist Anthony Fernandez, MD, PhD, to learn how lifestyle changes and self-care practices can impact eczema. He shares some strategies for calming your skin and improving your daily lives.

How self-care can help with severe atopic dermatitis

Self-care means different things to different people, but when we’re talking about self-care for eczema management, the definition’s a bit easier to wrap your arms around.

“It’s all about prioritizing your physical and emotional well-being,” Dr. Fernandez says. In this context, that means intentionally taking time out of your day to care of yourself in ways that support your skin’s health.

For people living with eczema, the standard self-care bubble bath is a bad idea. But there are plenty of activities you can do that aren’t just OK for your skin, but good for it. It could be anything from taking a short nap or a walk to devoting five minutes to mindfulness every morning.

Right about now, you might be wondering, “How are naps, walks and mindfulness good for your skin?” The answer might surprise you.

Mindfulness

When you’re living with eczema, stress shows up on your skin. That, itself, can be pretty stressful. But that vicious cycle isn’t the only reason you need to attend to your insides as much as your outsides.

Dr. Fernandez explains that people with atopic dermatitis actually perceive itchiness differently than typical people do because their neural pathways are overreactive. Put another way, people living with eczema don’t just have sensitive skin; they also have sensitive nervous systems. When you take care of your mental and emotional well-being, you are treating your skin condition.

But let’s, for a moment, pretend there wasn’t a neuro or psychological component to eczema. It’s still a chronic illness. While some people are lucky enough to outgrow it, many individuals have work to manage the symptoms for the rest of their lives. As is true for most chronic illnesses — the mental and emotional health impact of dealing with eczema can be just as difficult to handle as the physical symptoms. That’s one reason Dr. Fernandez is a strong believer in the importance of mindfulness practices for atopic dermatitis treatment.

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“Your eczema probably won’t cause you to develop a mental or emotional health issue, but it can definitely make one worse — and vice versa,” he explains. “Mindfulness can help everybody, but especially people who are experiencing severe symptoms.”

The research backs Dr. Fernandez up. A 2023 study found that adults with eczema who did online mindfulness and self-compassion training for 13 weeks saw a decline in the severity of their symptoms and an overall improvement in their quality of life. When we say, “quality of life,” we mean that they were in less discomfort, reported being in a better state of mind and were able to do their day-to-day tasks more effectively.

Here are a few ways you can work (preferably with the help of a trained mental health professional) to harness the power of the brain-body connection:

  • Therapy. Maybe living with a skin condition has got you struggling with body image issues. Maybe all that itching makes you irritable or keeps you from getting anything done. These are just a few great reasons to consider seeing a mental health professional for eczema-related concerns. They can help you understand what’s happening in your brain and body when your symptoms are acting up. And the coping skills they teach you may help reduce the frequency or severity of your flares.
  • Support groups. You don’t have to have a life-threatening illness to benefit from support groups. For conditions like atopic dermatitis, these in-person and online meetings aren’t just spaces to vent, but they’re also great places to stay updated on current research, get product recommendations and learn life hacks that you may have never thought of on your own. In addition to organizations like the National Eczema Association (NEA) and the Asthma & Allergy Foundation of America (AAFA), you can find eczema support groups through social media.
  • Mindfulness. We mentioned earlier that mindfulness has been shown to improve eczema symptoms, but what exactly is mindfulness? It’s an activity — or several — that helps us get tuned into the present moment. It helps us connect more deeply to our body, our environment and our thoughts. Examples include:
  • Self-soothing. If you have eczema, you know that there are moments when the itch becomes unbearable. But scratching is never a good call. It’s a gateway to further irritation and, potentially, infection. Self-soothing is sort of like hitting ctrl + alt + del on your brain. There are lots of different ways to self-soothe. Here are a few techniques Dr. Fernandez likes:
    • Get up and move. Even a little light stretching can do wonders.
    • Change your scenery. Go sit in the backyard for a moment, take the dog on a walk or grab a coffee across the street. A new environment means new things to see, hear, touch, smell and taste.
    • Activate your other senses. It’s all about making the itching sensation compete for your attention. Hold an ice cube in the palm of your hand. Take a few big whiffs of a scented candle, or — your skin permitting — dab a bit of essential oil on your wrist. Listen to some music you really love or turn on a guided meditation. Pop a hard candy in your mouth. Squeeze a stress ball or pet your furry friend. There’s lots of ways to engage your senses: Find the method that works best for you!
    • Rocking. There’s a reason we instinctively rock our children when they cry: It’s soothing! If you’re comfortable rocking yourself back and forth, go for it. Alternatively, consider getting yourself a rocking chair, glider or hammock that you can retreat to when you need a little extra comfort.

Lifestyle changes for dealing with severe eczema

Making time for mindfulness is just one lifestyle change that can positively impact your day-to-day symptoms. If you feel less like you’re managing your eczema and more like it’s managing you, Dr. Fernandez suggests considering changes in these five areas:

  1. Your medications.
  2. Your exercise regimen.
  3. Your eating habits and nutrition.
  4. Your bathing and skin care routine.
  5. Your environment.

Medications

Atopic dermatitis treatment has come a long way in a short time, so if you haven’t seen a dermatologist recently, Dr. Fernandez suggests making an appointment.

“There are new prescription medications — some pills, some injections and some creams — that are making a big difference for people with eczema,” he says.

Also keep in mind that if you have other allergic conditions like a histamine intolerance, certain kinds of asthma, or mast cell activation syndrome (MCAS), treating those conditions might also improve your skin. Finally, a positive side effect!

Exercise

Dr. Fernandez has seen it happen far too often: People with severe eczema stop being physically active. Why? Because raising the surface temperature of your skin and sweating can make eczema itch worse.

“The benefits of exercise far outweigh the impact on your skin,” he says. “Instead of giving up on your fitness routine, choose activities that are less likely irritate your eczema and take precautions before, during and after your workout.”

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Here are a few recommendations:

  • Stay hydrated. Everybody should make sure to drink plenty of water while they’re working out, but that goes double for people with dry skin.
  • Focus on activities that won’t make you sweat as much. You don’t have to complete an Iron Man to feel the burn and reap the benefits of exercise. Activities like Pilates can get your blood pumping and burn calories without leaving you drenched.
  • Wear loose cotton clothes. Tight, moisture-wicking fabrics can be irritating for sensitive skin.
  • Exercise indoors. If your eczema is flaring up, ditch the trail and run on a treadmill instead. You’ll still work up a sweat, but the climate control will help cool you down faster.
  • Get the sweat off your body fast. According to Dr. Fernandez, all that salt sitting on your skin can dry it out. Have a towel handy to (gently) dab sweat away while you exercise. If you feel like your skin is overheating or your eczema’s getting angry, take a break and use a cold compress to cool down the affected skin.
  • Consider swimming. For some people living with atopic dermatitis, chlorine does more harm than good. But for others, a swim in the pool can be like soaking in a really, really big bleach bath. And bonus: You don’t have to worry about being sweaty at the end of your workout!
  • Moisturize before and after your workout. Put your moisturizer or eczema cream on an hour before being physically active and immediately after getting out of the shower. Just be sure to use something lightweight, Dr. Fernandez urges, so you aren’t trapping any extra heat on your skin.
  • Avoid hot showers and skip the sauna. You don’t have to take a polar plunge or anything, but you also don’t want your post-workout routine to make your skin hotter. It feels great, but the warm water will dry your skin. Shower in lukewarm or cool water and, if you’re at a fancy gym, resist the temptation to sit in a steam bath. PS: If you plan on showering at a gym, be sure to bring your own soap, shampoo and lotion to avoid allergic reactions.

Diet

There’s no one way people who have eczema should eat because everybody has different triggers. That’s why it’s important to take the time — and it does take time — to figure out if anything you’re eating is making your eczema worse.

One way to do that is to go on an elimination diet. An elimination diet is exactly what it sounds like: An experiment to see what happens if you completely stop eating a certain type of food like gluten, dairy, or red meat for an extended period of time, usually about a month.

It’s important to do elimination diets under medical supervision. Your provider can help you ensure your nutritional needs are being met. They can also they monitor your symptoms and give you advice on what to cut out of your diet and when.

If you find your symptoms improve while you’re on an elimination diet, that’s valuable information that can help you decide what an eczema-friendly diet looks like for you.

Bathing and skin care routine

People living with eczema have to be very intentional about their personal hygiene. It’s important to keep showers short and temperatures lukewarm to cool. You also need to use bath products that are mild and, where possible, fragrance-free. Gently pat yourself dry with your towel to avoid irritating your skin and slather on the lotion afterward to lock in the moisture. And If you tend to scratch in your sleep, it’s time to embrace the short-nail lifestyle (or sleep with gloves on).

Environmental changes

Like any other allergic condition, the severity of your eczema has a lot to do with your surroundings. If your symptoms are giving you trouble, Dr. Fernandez says you may want to evaluate your space. You might need to put an air purifier in your bedroom or switch your cleaning products and laundry detergents. It could be time to swap out your yoga pants for something that’s less restrictive. If your furry friends shed a lot, you may need to vacuum several times a week to keep the dander levels in check. It may even be necessary to limit your time outside— or, if that’s a no-go, take steps to reduce your sun exposure. Small changes like these can make a big difference to your quality of life.

Final thoughts

There’s no cure for eczema, but that doesn’t mean you need to resign yourself to a lifetime of itching and discomfort. Instead, look at your lifestyle and see what changes you can make. From managing stress to making different fashion choices, there are lots of ways to reduce the frequency and severity of your flare-ups. Take what works, leave the rest — and when in doubt, talk to your dermatologist.

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