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There’s no doubt that if you live with atopic dermatitis or eczema, it takes a toll on your mental health. Relentless itching, sleepless nights. An ugly, red rash. If you live with this, it’s challenging for your emotional well-being.

To add fuel to the fire, anxiety and stress are common triggers for atopic dermatitis (AD) flares. This in turn creates even more anxiety and stress, which leads to even more atopic dermatitis.

Here’s why this happens and how to break this vicious cycle.

The Link Between Atopic Dermatitis and Mental Health

When you go through a stressful situation, your body goes into fight-or-flight mode. It increases stress hormones such as adrenaline and cortisol. But while this can be helpful if you’re facing an attacker, it can cause damage. In fact, if your body makes too much cortisol, it suppresses your immune system and causes an inflammatory response in your skin. People who live with atopic dermatitis are already quite susceptible to this inflammatory response.

This doesn’t mean that if you get rid of stress, you’ll get rid of your atopic dermatitis. But it may help improve some of your symptoms.

More than 30% of people with atopic dermatitis have also been diagnosed with depression or anxiety, according to the National Eczema Association. That’s much higher than the general population, which hovers at around 7.6% It makes sense that if you have atopic dermatitis, it could make you feel sad or anxious. But atopic dermatitis is also associated with skin inflammation, which may be then communicated to your brain. This may leave you feeling anxious, depressed, tired, and with foggy thinking.

What to Look For

If you have atopic dermatitis, it’s important that you watch for the following symptoms:

  • Feeling sad, empty, or anxious
  • Feeling hopeless
  • Loss of interest in activities you once enjoyed
  • Less energy
  • Trouble concentrating
  • Restlessness
  • Insomnia
  • Oversleeping
  • Weight change
  • Thoughts of death or suicide

It’s important to realize that everyone experiences these symptoms occasionally. But if yours happen most of the day, nearly every day for at least 2 weeks, you may have depression. It’s very important to speak to your doctor right away. They can refer you to talk therapy, and, if necessary, prescribe medication.

Some people with atopic dermatitis take the medication montelukast (Singulair) to treat underlying allergies and asthma. It’s been linked to serious behavior and mood-related changes, including suicide. If you take this drug and notice these symptoms, tell your doctor immediately.

How to Feel Better

There are lifestyle changes you can make to help improve your mental health, which may make it easier to live with atopic dermatitis. These include:

Practice mindfulness. It may both help improve anxiety and relieve some of the itching associated with atopic dermatitis. Both atopic dermatitis and chronic itch appear to activate areas of the brain related to chronic stress and pain. These parts of the brain stay overactive, which leads to the release of stress hormones and other inflammatory chemicals. Research has shown that meditation itself deactivates these parts of the brain, which may in turn relieve itching and lower inflammatory and stress hormones. One study found that people with atopic dermatitis who practiced meditation for 8 weeks reported improved quality of life and less itching. There are many ways to practice mindfulness, which include:

  • Deep breathing
  • Using a guided meditation app
  • Yoga or tai chi
  • Nature walks

You may have to do a little trial and error to find a technique that works best for you.

Get enough sleep. If you have atopic dermatitis, you may find it harder to get a good night’s rest, which can make symptoms of anxiety or depression worse.  Some ways to make nodding off easier are:

  • Sleep in silk. Try using specially treated silk-like Dermasilk, which is coated with antimicrobial agents such as triclosan. It can help relieve atopic dermatitis symptoms. 
  • Keep a constant sleep schedule.
  • Avoid daytime naps.
  • Avoid afternoon caffeine.
  • Keep the temperature down. Lower skin temperature leads to constriction of your blood vessels, which can decrease inflammation and itching. In addition to turning down the heat (or cranking up the AC), you can try cooling pillows and mattress covers.
  • Try a mini massage. It can help relieve insomnia as it relaxes muscles and reduces anxiety. You can also rub coconut oil on areas of skin that have atopic dermatitis, as it has anti-inflammatory properties.

Join a support group. It can be helpful to connect with others who also live with atopic dermatitis. You can connect with the National Eczema Association or Eczema Wise, an online support group for people with atopic dermatitis.

Stay active. Regular exercise releases endorphins, which are hormones that help you feel calm and happy. But it’s a delicate balance. Dehydration from exercise can dry out your skin, and sweat can sting and irritate it. This can all make your atopic dermatitis worse. Ways to avoid this include:

  • Drink plenty of water during your workout.
  • Wear loose-fitting, 100% cotton clothes. Avoid moisture “wicking” clothing: since they draw sweat into them, they can irritate atopic dermatitis.
  • Ice, ice baby. Cold compression wraps or ice packs can cool the skin and calm itch during a workout. Use them halfway through your exercise routine, during a water break.
  • Don’t sizzle under the shower. Take a quick, lukewarm rinse to wash off sweat, then follow up with your usual moisturizer once you’re done. This will help keep moisture in your skin and replenish what you’ve lost.

© 2022 WebMD, LLC. All rights reserved.

Show Sources

Photo Credit: wagnerokasaki / Getty Images

SOURCES:

Cleveland Clinic: “The Connection Between Stress and Eczema.”

National Eczema Association: “Eczema and Exercise,” “Nearly One-Third of People with Atopic Dermatitis Report Depression/Anxiety,” “The Science Behind Feeling Lousy,” “Meditation and Eczema.”

Acta Dermato-Venereologica: “Psychoneuroimmunology of Psychological Stress and Atopic Dermatitis: Pathophysiologic and Therapeutic Updates.”

National Institute of Mental Health: “Depression.”

Dermatitis: “Clinical Pearls on Sleep Management on Atopic Dermatitis.”