Ways to Regulate Your Nervous System With Eczema

Eczema, or atopic dermatitis (AD), is a chronic inflammatory disorder of your skin. Your immune system plays an important role. But your skin has hundreds of nerve endings, too. When you have eczema that’s moderate to severe, those nerves can be hypersensitive. As your immune system drives inflammation, it activates those nerve endings. Those activated nerve endings send signals to your brain. Those signals lead to the chronic itching and scratching that often comes with eczema. All that itching and scratching driven by your nervous system can worsen your flares.

When you’re under stress or anxious all the time, it can trigger your immune system to make eczema and its symptoms worse. It can make all those nerve endings in your skin even more prone to sending those signals to scratch, even when your itching isn’t that bad. All of these factors help to explain why that itch-scratch cycle can be so hard for you to break. While it’s impossible to say why you have eczema and someone else doesn’t, there’s some evidence that stressful experiences in the past can increase your AD risk. 

Along with allergens, irritants, hormonal changes, and infections, stress is recognized as a top eczema trigger. At the same time, your eczema symptoms can worsen stress by getting in the way of your ability to sleep and do everyday activities. Studies have shown eczema often comes with difficult feelings, including discomfort, frustration, embarrassment, and anxiety. You may worry about scarring or your next flare. It might keep you from spending time with friends in the way you want to do. Steps you take to lower your stress can calm your nervous system, improving your mental well-being and your skin.  

Exercise is good for your physical health. But exercise also eases stress. It can help you think more clearly and make depression less likely. Studies show exercise leaves people feeling good about themselves. It might help you sleep better at night, too. To get the benefits of exercise for your mind and body when you have eczema, try these tips:

• Wear loose fitting clothes; skip the spandex.
• Take a walk outside instead of going to a sweaty gym.
• Stop and rest when you need to.
• Rinse the sweat away.

If aerobic exercise is too hot and sweaty during a flare, you can still get many benefits of exercise including stress reduction from lower-impact approaches like yoga. Yoga combines physical postures called asanas with breathing techniques and meditation. Studies show it eases stress and helps with sleep and anxiety. Tai chi and qi gong are other restorative practices that move your body while focusing on your breath and calming your mind. To get started with yoga, try a simple child’s pose. First, rest on your hands and knees. Next, let your knees spread outward while your body sinks down toward the floor. Reach your arms forward along the floor while you close your eyes and breathe. 

Your vagus nerve controls your bodies’ rest and digest functions. Devices that stimulate the vagus nerve with electrical pulses have been used to treat seizures and depression. While more study is needed, doctors also think they might help with a wide range of other conditions, including atopic dermatitis. Stimulating your vagus nerve can help your body and heart rate slow down. It can also lower anxiety and stress. Some everyday activities that may stimulate your vagus nerve include:

• Exercise
• Deep breathing
• Cold plunges
• Listening to music or humming
• Meditation

These activities aren’t proven to work for eczema in this way, but they are generally safe to try.

Mindfulness-based stress reduction (MBSR) encourages you to approach stress without judgment and to practice self-compassion. You can learn MBSR by taking a course for several weeks with a silent retreat and more practice at home. One recent trial offered some of the first evidence this calming practice can help with eczema. People in the study who had 90-minute sessions in MBSR for eight weeks showed improvements in quality of life and the severity of their eczema. For more mindfulness at home, try:

• Deep breathing
• Repeating phrases to yourself such as “I am well” or “My skin is enough”
• Building calming rituals into each day
• Meditating quietly on your own or with a smartphone app

Cognitive behavioral therapy (CBT) is a psychological approach often used for depression, anxiety, substance use, and other problems. It’s based on the idea that mental health problems are related to ways of thinking that aren’t helpful. It aims to help you learn new ways of coping, including learning how to calm your mind and body. One study looked at whether CBT delivered through the internet could help adults with eczema. The findings in more than 100 people showed CBT helped with AD symptoms. Those in the study had less intense itching along with other improvements in their perceived stress, sleep, and depression.

Habit reversal therapy (HRT) is a type of CBT that focuses on habits you want to stop by replacing them with something else. This form of therapy also includes relaxation training to make it easier to avoid the habit you’d like to break. When you have eczema, this form of therapy focuses on breaking the itch-scratch cycle that’s driven by hypersensitivity in your nerve endings so your skin can heal. One study tested HRT in which people with AD were told to clench their fist or hold onto an object instead of scratching. People who used HRT along with topical treatment were able to scratch less compared to those who used the topical alone.

Hypnosis may involve a hypnotist or hypnotherapist who can guide you with relaxing verbal cues and imagery into a state of relaxation and focus. It can help to relieve anxiety, stress, and symptoms of many chronic health conditions. It’s possible to put yourself in a similar state on your own using relaxation, slow breathing, and visualizations. Small studies that have tested hypnosis for people with eczema suggest it can help ease the symptoms.

Some hobbies you can do at home may relieve stress in similar ways by putting you into a calm, focused, and relaxed state that encourages you to let other worries go while keeping your hands busy. Some ideas for activities that may calm your nerves when you have eczema include:

• Reading 
• Gardening
• Cooking
• Painting
• Drawing or doodling
• Knitting or crocheting
• Journaling
• Bird watching
• Listening to music

Other changes to your living environment and daily habits can help to support a greater sense of calm, which may help with your eczema. Some ideas include:

• Limiting or avoiding noise
• Turning off the lights, especially at night
• Limiting your social media use or not using social media
• Finding time to connect with loved ones in person
• Taking steps to improve your sleep, including going to bed at a regular time