Eczema, also known as atopic dermatitis, is a common skin condition characterized by itchy, inflamed, and irritated skin. While the exact causes of eczema are not fully understood, it is believed that a combination of genetic and environmental factors contribute to its development. An emerging area of research is examining the role of emotions and stress in triggering or exacerbating eczema symptoms.
The Link Between Emotions and Eczema
There is growing evidence from scientific studies that our emotions and stress levels can influence the occurrence and severity of eczema flare-ups. This is because emotions and stress affect important physiological activities in our body that are relevant to eczema:
- Our immune system function – Chronic stress and negative emotions like sadness, anxiety, and depression may suppress immune system activity. This makes the body more vulnerable to inflammation and allergic reactions that drive eczema.
- Inflammatory response – Stress leads to increased levels of inflammatory markers like cytokines in the body. This heightened inflammatory response can aggravate eczema.
- Skin barrier function – Psychological stress can impair the skin’s protective barrier function, making it more permeable to irritants, allergens, and microbes that worsen eczema.
Let’s look at the key emotions that are linked to eczema flare-ups:
Anxiety involves feelings of fear, worry, and unease about future events. Studies show that anxiety is strongly associated with increased eczema severity. One reason is that anxiety activates the body’s ‘fight or flight’ stress response. This leads to the release of stress hormones like cortisol that suppress the immune system and skin barrier function. Additionally, people with anxiety tend to have more obsessive scratching behaviors that further damage the skin.
Depression is characterized by persistent sadness and loss of interest in normal activities. Research indicates that adults and children with eczema often suffer from depression. This is likely because living with a visible skin condition can negatively impact self-esteem. Furthermore, depression harms immune function and promotes inflammation, which can worsen eczema.
Feelings of anger and frustration are common in people with chronic eczema, especially due to uncontrolled itching and discomfort. Anger leads to surges in stress hormones like adrenaline and cortisol, which impair immune defenses. Additionally, feelings of anger are linked to more vigorous scratching and skin picking behaviors that exacerbate eczema lesions.
Many people with eczema experience embarrassment about their appearance from visible red, inflamed skin lesions. Fears over social stigmatization and comments from others can heighten anxiety and depression. Such negative emotions indirectly promote inflammatory pathways that aggravate eczema.
How Stress Impacts Eczema
Stress is the body’s response to challenging or threatening situations. Acute stress from isolated incidents is a normal part of life. However, chronic, unmanaged stress from factors like work pressure, financial issues, or relationship conflicts can have detrimental effects on eczema.
When we experience stress, our body produces higher levels of stress hormones like cortisol and adrenaline. Although these hormones help us respond to dangers in the short-term, prolonged elevated levels from chronic stress have harmful effects:
- Suppression of the immune system’s functions, thereby increasing susceptibility to eczema triggers
- Imbalances in inflammatory signaling molecules like cytokines, leading to greater inflammation
- Disruption of skin barrier proteins, making the skin more permeable to irritants and microbes
- Altered epidermal nerve fiber density and neuropeptide production, making the skin more sensitive and itchy
Furthermore, psychological stress promotes emotional distress – especially anxiety, depression, and frustration. As discussed earlier, such negative feelings can directly impact physiological processes involved in eczema.
Strategies to Manage Emotional Triggers for Eczema
Given the influence of emotions and stress on eczema flare-ups, it is important to develop healthy coping mechanisms. Here are some evidence-based tips:
Cognitive-behavioral therapy (CBT)
CBT is a structured psychotherapy that helps identify and change negative thought patterns. CBT teaches techniques like Cognitive Restructuring to challenge pessimistic thoughts and employ more realistic, positive thinking. This can alleviate emotional distress from eczema.
Methods like meditation, deep breathing, and progressive muscle relaxation activate the body’s relaxation response. This lowers stress hormone levels and controls inflammation. Regular practice of these techniques helps manage stress and anxiety.
Joining eczema support groups allows people to share their experiences and advice. The social support and sense of community can provide emotional relief and prevent feelings of isolation.
Light therapy with blue or ultraviolet light helps reset the body’s circadian rhythm, improve sleep, and balance hormone levels. This enhances emotional well-being and alleviates stress.
Healthy lifestyle habits
Adjusting daily routines to include a balanced diet, regular exercise, and good sleep hygiene reduces stress and improves coping abilities for people with eczema.
The Gut-Brain-Skin Connection
An emerging concept in dermatology is the ‘gut-brain-skin’ axis which explores how the gastrointestinal system, nervous system, and skin interact and influence one another. Studies show that chronic stress can disrupt the microorganisms in our gut microbiome. This can cause increased intestinal inflammation and permeability, allowing bacteria and molecules to enter the bloodstream. These substances may then negatively affect emotional processing in the brain as well as skin inflammation.
Additionally, stress leads to elevated levels of neuropeptides, inflammatory messengers produced in the brain, that can directly stimulate skin inflammation. Targeting this gut-brain-skin connection through stress management, dietary changes, and probiotics may help alleviate eczema.
Emotional health is deeply interconnected with skin health. Scientific research demonstrates that chronic stress, anxiety, depression, and other negative emotions can exacerbate eczema through their effects on immune function, inflammation, and the skin barrier. Learning to manage emotional triggers through cognitive-behavioral techniques, relaxation methods, light therapy, and lifestyle changes may help prevent or reduce eczema flares.