Coping with the mental stress of eczema
As research for National Eczema Week reveals the condition’s psychological effects, an expert advises LISA SALMON how to deal with them
ECZEMA is so much more than just dry skin – and new research has found the skin condition significantly reduces quality of life for 89% of adults who have it, impacting everything from their education to their careers and relationships.
The National Eczema Society‘s Eczema Unmasked research, published in National Eczema Week (September 12-19), found the skin condition, which affects one in five children and one in 12 adults, takes a huge psychological toll on sufferers, with 74% of the 530 adults surveyed saying it had left them feeling depressed, anxious, helpless and socially isolated.
And eczma has a significant impact on children too, with a quarter of the 524 young eczema sufferers surveyed admitting to low self-esteem. Many parents say the condition affects their child’s ability to make and maintain friendships.
Yet less than half of those surveyed had been offered emotional or psychological support to help manage their feelings about the condition, which can vary in severity from dry, scaly, red and itchy skin to weeping, crusting and bleeding areas. Constant scratching can also make the skin split and bleed and leave it open to infection.
“Eczema is a complex medical condition and its impact goes way beyond the relentless itch and painful skin,” says Andrew Proctor, chief executive of the National Eczema Society (NES).
“The psychological effects of living with eczema often go unacknowledged, but people are suffering. Eczema can affect how you feel about yourself, your self-esteem and body image, and how others treat you, and it’s important to address the mental impact of the condition alongside the physical symptoms.”
He says that while psychological treatments like cognitive behavioural therapy and habit reversal therapy can be effective, there’s much patients can do to support their own mental wellbeing.
Here the NES outlines the best ways to cope with the psychological problems caused by eczema…
1
REDUCE STRESS
MORE than half (51%) of adults with eczema say stress is the biggest trigger of a flare-up, so finding ways to reduce stress is crucial.
“Otherwise, you end up in a vicious cycle where you get stressed because your skin’s so bad, the stress encourages flare-ups causing your skin to worsen, you then get even more stressed and upset and the cycle is perpetuated,” explains Andrew.
The NES recommends relaxation techniques such as deep breathing, meditation, yoga, mindfulness, and anything that promotes calm and time to unwind.
2
ITCH DISTRACTION
“THE itch is so often cited as the most torturous aspect of the condition, like the worst mosquito bite you can ever imagine,” says
Andrew. “It’s almost impossible not to scratch, even though that makes eczema worse, as well as leaving you more vulnerable to infection. It’s a real mental battle to stop yourself from just clawing at your skin.”
Distraction is a method many patients use to prevent scratching, so try squeezing a ball/other object to keep your hands busy.
Alternatively, try mentally training yourself so as soon as an itch starts, you do something else – changing your environment or position, or doing a task, anything to distract you from the itch.
3
PRIORITISE SLEEP
THE physical discomfort of the itchy, painful skin caused by eczema means it goes hand-in-hand with poor sleep – 29% of adults in the
NES research said they had disturbed sleep most nights.
“It’s important to do everything you can to create a good sleep routine, ie. practice sleep hygiene,” stresses Andrew.
Having a calming and healthy bedroom environment is especially important for people with eczema, as changes in temperature (getting too hot or cold in bed) can quickly lead to itching.
Choose bed linens carefully – soft, 100% cotton is the optimum choice – and use hypoallergenic duvets and pillows. Dust can be a major trigger for eczema, so the room should also be vacuumed and dusted regularly.
Have a routine, with a fixed bedtime and getting-up time, and a set of things you do just before bed. Follow a relaxing pre-bed routine, perhaps allowing 30 minutes to wind down with some light stretching, reading or relaxation exercises, and dim the lights.
Unplug electronics at least an hour before bed, and cut down on caffeine in the afternoon and evening.
4
TALK ABOUT IT
THE NES survey found many people with eczema feel selfconscious, lonely and socially isolated, with 21% of adults saying they try to keep their eczema hidden from their partner, 40% from family, 29% from friends and 25% from colleagues.
“It’s therefore really important that people talk to those closest to them and share how they’re feeling,” stresses Andrew.
“One of the things we hear time and time again is ‘I thought it was just me’, as many people with eczema have never met anyone else with the condition and feel they’re the only one going through all these things.”
He says some patients develop anxiety or depression because of their condition, and it’s important to recognise when you might need to speak to a GP about how you’re feeling too.
5
TRY TO DO WHAT YOU ENJOY
WHILE taking part in some activities can be challenging for those with eczema – as you may, for example, over-heat while playing a sport like football, leading to a bout of itching, or you might find grass and mud irritates your skin – the NES advises people to try and find a work-around solution.
“Participating in something you enjoy isn’t only a great temporary distraction from your skin, but also releases ‘happy hormones’ which contribute to your overall wellbeing,” says Andrew.
“The people who find a way to participate despite their skin always feel so much better for it.”
6
TAKE CONTROL
MANY people with eczema (70%) say they feel helpless because of their condition, and demoralised because they keep trying things that don’t work.
“The key here is to take control of the situation so you feel you’re moving in the right direction,” says Andrew.
This might involve keeping a daily diary so you can monitor how your skin changes and identify things that have caused a deterioration. Perhaps you need to book a longer appointment with your GP to review your condition, what’s worked and what hasn’t, and discuss new ways forward, which might include a referral to a dermatologist.
In addition, the NES offers information and support.
“It might feel as though you’re helpless and powerless, but there are things you can do to move forward,” stresses Andrew.