Eczema is a complex skin condition and it’s often difficult to identify the underlying cause. However, one trigger that seems to persistently recur is stress, with many sufferers recognising emotional stress as a major instigator. In today’s blog, I explore this connection and discuss how stress can affect your eczema symptoms, as well as what you can do to minimise its impact!
This is often a source of confusion as stress has become so interwoven with eczema that some actually believe that it could be an underlying cause. Eczema is even sometimes known as a psychodermatologic disorder, which is a fancy way of saying that it is a physical disorder that is tied to your emotional health.1
However, this doesn’t mean that stress is the actual cause of eczema; it simply means that stress can inspire a flare-up of a pre-existing skin condition. It won’t cause eczema to manifest if you have never suffered from the disorder before, but, if you do suffer from eczema, you may notice that your symptoms seem to get increasingly worse during times of emotional stress.
How does stress affect eczema?
So, stress might not cause eczema but how exactly does it affect your symptoms? In order to answer this question, you first have to understand how stress can affect your body as a whole. When you experience stress, your primordial flight-or-fight reflexes will kick in as your body will instinctively believe that you are in a life-or-death situation.
When this happens, your sympathetic nervous system will prioritise short-term survival over long-term survival and nutrients will be redirected to other areas of your body, such as your muscles. Stress hormones such as cortisol and adrenaline will be released to prepare you for a fight or flight scenario. During this period, certain biological functions will be suppressed such as digestion and your reproductive system.
Your parasympathetic nervous system, sometimes known as the ‘rest and digest’ system is slower to respond but it can help to calm your body down, shifting focus from short-term survival back to long-term survival.
If episodes of stress are infrequent, there shouldn’t be any lasting consequences; however, if you find yourself under emotional stress on a regular basis, this process will keep happening, placing a lot of pressure on your sympathetic nervous system and affecting your immune function, digestive health and more.
So, what does this all have to do with eczema? Well, one study concluded that stress was a “significant contributor to AD disease course through its direct and indirect effects on immune response, cutaneous neuropeptide expression and skin barrier function.”2 In other words, stress affects eczema due to its impact on other parts of the body.
So, how does stress affect the immune system and why does this have an impact on eczema? Eczema is considered to be an autoimmune disease, which is why immunosuppressant medicines such as steroids are often prescribed by doctors. However, ideally you don’t want your immune function too low either, as this can make you more vulnerable to pathogens that may irritate your skin.
In cases of chronic stress, your immune system will eventually become weakened, as our mental wellbeing adviser, Marianna Kilburn, explores in her blog ‘Why stress is the enemy of your immune system.’ Repeated exposure to stress hormones such as cortisol can start to affect how your immune cells respond to threats, making you more exposed to pathogens and viruses.
The immune system can also instigate an inflammatory reaction, which it may continue to do when you experience stress. Inflammation, as you may be aware, is not good news for your eczema symptoms! Interestingly, one study also revealed that the immune system also helps to regulate what microbes inhabit your skin, and, if your immune system is weak, sometimes unhealthy microbes can make a home for themselves there too.
You also have to consider the affect that cortisol can have. This stress hormone has a lot to answer for – under normal circumstances, it can be very useful, helping to regulate your metabolism and reduce inflammation. However, when chronic stress occurs, over time your immune system will become more insensitive to cortisol’s effect on inflammation, not to mention cortisol can also work to supress your immune function.
The result of all this stress is that you are left with a fatigued immune system that’s unable to fight off invasive pathogens and keeps releasing inflammatory chemicals that may upset your skin.
Gut health is something that I often mention in relation to skin conditions like acne, however, it’s also applicable to eczema too! It’s estimated that over 70% of our immune cells are located in our gut, so what happens in this area of the body can be surprisingly relevant for your skin.
As I remarked earlier, when you experience stress, it’s not unusual to also experience a bout of constipation or diarrhoea. This is because your sympathetic nervous system does not prioritise breaking down your food, so it will either attempt to evacuate your bowels or cause you to retain waste products.
I’m sure you can imagine the effect this will have on your gut if it is a regular occurrence. Frequent bouts of diarrhoea can cause your body to lose fluids while constipation means that all those toxins are trapped in your body, which can cause further instances of inflammation. For more information, please take a look at our stress advisor Marianna’s blog, ‘How does stress impact our digestive system?’
All of this can have implications for your gut flora too, which feeds into the idea of the gut-brain-skin axis. Gut dysbiosis, also known as an imbalance with your gut flora, can occur as a result of chronic stress which again, can stimulate inflammation. Not to mention, gut dysbiosis can also cause toxic by-products to be released within the body and sometimes, these impurities are eliminated through the skin, causing further irritation.
My Self-Care Tip: The impact of diet and stress on eczema
In this video, I discuss the association between stress, diet, and eczema.
Read on to find out more about the connection between stress and eczema.
Finally, stress can have a direct effect on your skin barrier. In one study it was found that stress can inhibit your skin’s ability to retain moisture, causing it to lose valuable fluids, making you more inclined to bouts of dry skin.
In addition to this unfortunate issue, stress can even impact your skin’s ability to repair itself, making it more vulnerable to irritation by invasive pathogens, stimulating symptoms such as itchiness. Stress can also affect your mood which may make you more predisposed to destructive behaviours, such as scratching or overeating.
What can you do to eliminate stress?
It’s all very well telling you that stress is bad, not only for your skin, but your entire body as a whole, but eliminating stress is a lot easier said than done. There could be multiple factors affecting your stress levels – financial issues, sleep deprivation, illness, or relationship worries – and none of them are going to disappear overnight.
Even if you can’t eliminate the source of your stress, you may still be able to help yourself cope better with the ordeal. That’s why I’d recommend starting with your diet.
As I mentioned earlier, food intolerances can play a role in eczema, not to mentioned that certain food products such as refined sugar, can impact the overall health of your skin – please check out my blog ‘The bitter truth about sugar and your skin,’ if you want to learn more.
Your diet can also play a role in affecting your stress levels too, so instead of bingeing on processed foods and caffeine, focus first on getting plenty of fresh fruit and veg into your meals.
Not only will these types of food be rich in skin-boosting antioxidants, they may also contain magnesium and other nutrients that can help to benefit your mood. You could try Biotta’s Carrot Juice, which is a great source of vitamin A, a really important nutrient for your skin!
It may even help to consider a prebiotic and probiotic combination to help support healthy gut flora. Molkosan is our gentle prebiotic which can help to create a healthy environment for your gut flora to flourish in.
Once you have your diet under control, you could look at your lifestyle. If your day-to-day routine is busy and hectic, it’s important that you try and set aside some time for yourself every day, at least 30 minutes. It’s also essential that you get plenty of good-quality sleep as this can have a huge impact on your overall happiness and wellbeing, as our sleep advisor Marianna details in her blog, ‘Is a good night’s sleep the key to happiness?’
Getting plenty of exercise can also help to lower your stress levels. If you are new to working out, I would recommend starting with a low-impact form of exercise such as yoga, which can teach you deep breathing techniques, enabling you to cope with stress better. If you are more used to exercise, though, you could try running or cycling, which can be great for getting you outdoors and exposing you to more vitamin D!
Finally, if you feel that stress is really starting to take over your life, you could try our natural, gentle stress remedy, AvenaCalm, which works gradually to ease the symptoms of mild stress and anxiety, restoring a sense of balance and calm. Prepared using extracts of organic oat herb, this remedy is very popular with our customers and can also be used to help you drift off into a natural sleep.
Originally written 6 October 2017 (updated 12 May 2020).