Eczema, or dermatitis, is an inflammation of the skin that has both physical and psychological consequences for those who suffer from it. Several factors can exacerbate this condition, among which stress. Learn more.

- Carnet
- Skin Concerns
- Are stress and eczema linked?
Are stress and eczema linked?
- Eczema flare-ups linked to stress
- How does stress trigger eczema flare-ups?
- Managing stress to live better with eczema
- Appliquer quotidiennement un émollient
- Des douches adaptées
- Éviter de se gratter
- Sources
Eczema flare-ups linked to stress.
The role of stress in eczema remains to this day somewhat poorly understood and, while several studies have confirmed the link between stress and eczema, work on this subject would benefit from being refined. Furthermore, let's remember that several forms of dermatitis coexist, and it's possible that stress plays a more significant role in some of them. Today, stress is not labelled as an "eczema trigger", but rather as an "aggravating factor".
A study was conducted following an earthquake in Hanshin, Japan. This disaster helped to highlight the role of stress in the progression of eczema in a population. 1,457 patients with atopic dermatitis were included. Three areas were defined: severe destruction (zone A), moderate destruction (zone B) and no destruction (zone C).
One month after the trauma, individuals were required to answer a series of questions and were examined by doctors. A flare-up of atopic dermatitis was noted in 38% of patients in zone A, 34% of patients in zone B and 7% of patients in zone C. Multiple logistic regression analysis showed that subjective distress was the most significant factor in the intensification of skin symptoms, more so than exposure to a dusty environment.
How does stress trigger eczema flare-ups?
When we delve into the biological mechanisms at play, we find that stress increases skin inflammation by triggering the degranulation of mast cells, immune cells involved in allergic reactions. This is mediated by neuropeptides released by cutaneous nerve fibres: CRH (Corticotropin Releasing Hormone), neurotensin, substance P and other tachykinins. The release of these hormones triggers a cascade of reactions leading to the release of mediators responsible for the itchiness of eczema and the dilation of blood vessels.
Furthermore, cortisol, the stress hormone, impacts the skin barrier by weakening it. It initially reduces the synthesis of lipids, molecules that constitute the stratum corneum and help maintain skin hydration. A decrease in the production of these lipids can lead to dry and easily irritable skin. Cortisol also increases the skin inflammation by stimulating the synthesis of pro-inflammatory cytokines, molecules involved in various inflammatory phenomena and implicated in eczema.
Managing stress to live better with eczema.
Stress is a common and multifactorial element of our lives: professional interviews, medical appointments, bereavement... Unfortunately, it is not possible to alter any potential genetic susceptibility to stress or to change one's life when suffering from eczema. However, several methods can help to better respond to stress.
Ahealthy lifestyle notably allows for a better response to stress: regular practice of a sport, pleasant surroundings, avoidance of addictive substances, regular sleep... Although there are few studies due to significant methodological difficulties and the unique nature of each patient, psychotherapies appear to have a role in the treatment of inflammatory skin conditions.
Furthermore, in general terms, psychosocial interventions have proven effects on immunity. To better manage stress, cognitive-behavioural therapies such as relaxation or Schultz's autogenic training can be beneficial. Yoga and meditation can also be helpful, as can techniques for self-assertion, cognitive restructuring, or non-violent conflict resolution. The aim is to develop a better ability to cope with stressful situations. However, it should be noted that the benefits of all these techniques for atopic dermatitis itself have not been proven.
Finally, while stress can promote the onset of eczema flare-ups, it is likely that this disease itself is a cause of stress, creating a vicious cycle. By focusing on alleviating the symptoms of dermatitis, we probably also reduce stress, thereby improving the prognosis of the disease. This theory remains to be proven, but it seems worthwhile to keep it in mind.
Appliquer quotidiennement un émollient.
En plus d'une meilleure gestion du stress, les personnes sujettes à l'eczéma émotionnel sont invitées à suivre les mêmes recommandations que celles souffrant d'eczéma atopique ou de contact. Le premier geste à adopter est l'application quotidienne d'un émollient. Ce soin permet de restaurer la barrière cutanée en contribuant à combler le manque de lipides. Cela permet de limiter l'évaporation de l'eau de la peau et le passage des allergènes à l'origine de la réaction inflammatoire. Les baumes émollients sont des soins formulés pour nourrir, assouplir et adoucir la peau. Ils procurent une sensation d'hydratation et de confort et permettent de limiter l'intensité et la fréquence d'apparition des crises.
Des douches adaptées.
Pour éviter les démangeaisons et les poussées d'eczéma, il est conseillé de privilégier des soins lavants doux et non-irritants, ne renfermant de préférence ni parfum ni allergène. Il existe des formules cosmétiques apaisantes et non-délipidantes, formulées spécifiquement pour les personnes ayant une peau atopique ou sensible. En cas de doute, demandez conseil à votre dermatologue qui pourra vous orienter vers un produit approprié.
Lorsque vous vous lavez, privilégiez les douches à l'eau tiède aux bains, afin de raccourcir le temps de contact de l'eau avec la peau. L'eau, en particulier l'eau chaude, est en effet asséchante pour l'épiderme. On conseille également aux personnes souffrant d'eczéma de sécher doucement leur peau à la sortie de la douche à l'aide d'une serviette douce et moelleuse. Les frottements pouvant provoquer des irritations et des démangeaisons, effectuez plutôt de légers tapotements.
Éviter de se gratter.
Une règle primordiale et pourtant compliquée à respecter est d'éviter au maximum de se gratter, au risque d'écorcher sa peau et d'aggraver les lésions d'eczéma. Pour réduire les sensations de démangeaison, vous pouvez utiliser de l'eau thermale ou certaines huiles essentielles, dont les propriétés anti-inflammatoires aident à calmer le prurit. Elles peuvent s'appliquer directement sur la peau par massage ou vaporisées si elles se présentent sous forme de spray.
Un autre conseil pour diminuer les sensations de démangeaison est d'appliquer du froid sur les zones de prurit. Il s'agit en effet d'un excellent calmant. Pour profiter de ses bienfaits, appliquez une compresse froide, placée préalablement au réfrigérateur, sur les zones de démangeaison pendant une trentaine de minutes. Vous pouvez également utiliser des glaçons, à condition que ceux-ci soient enveloppés dans un tissu propre. N'appliquez pas de glaçons directement sur votre peau, cela pourrait la brûler.
Sources
ROGUEDAS A. M. et MISERY L. Atopie et stress. Annales de dermatologie et de vénéréologie (2004).
GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).
YEUNG J. & al. Diagnosis and treatment of pruritus. The College of Family Physicians of Canada (2017).
Diagnostic
Understand your skin
and its complex needs.