The Surprising Link Between Stress and Eczema Flare-Ups

From verywellmind.com

It can be a never-ending cycle 

For Trisha Khanna, MD, her eyes would tell the story.

“When I am stressed, I will get eyelid eczema [and] I often wake up with itchy, red eyes,” says Dr. Khanna, fellow of the American Academy of Dermatology and a medical advisory board member at Codex Labs. She experiences what over 31 million people in the United States may already know — stress can severely affect eczema symptoms.

“Cortisol, the body’s primary stress hormone, plays a role in the body’s inflammatory response," explains Megan Collins, MA, LMFT, ATR-P, founder of NeuroArts Therapy & Consulting. "When released during stressful situations, cortisol can disrupt the skin’s ability to stay hydrated and repair, leading to flare-ups. Then comes the redness, itching, and overall skin irritation, similar to having hives after an allergy."

When released during stressful situations, cortisol can disrupt the skin’s ability to stay hydrated and repair, leading to flare-ups.

— MEGAN COLLINS, MA, LMFT, ATR-P

But the impact isn’t just physical. People with eczema can also experience mental and emotional challenges due to stress. Read on to learn more about the connection between stress and eczema flare-ups, practical tips for managing the condition, and steps you can take to alleviate stress and aggravated symptoms.

Common Triggers of Eczema Flare-Ups

One out of ten people will likely have eczema at some point during their lives. Eighty percent of people are diagnosed with the condition before the age of 6.

National Eczema Association. Eczema Stats.

“Eczema often begins in infancy or childhood, though it can develop at any age," explains Janis Kosma-Covey, PharmD, owner of Kosmatology. "While the exact cause of eczema is not fully understood, it is believed to result from a combination of a specific gene mutation, environmental factors, and an overactive immune system that compromise the skin’s natural barrier, making it more sensitive and reactive.”

It can lead to itchy, red skin, dryness, and inflammation. It can also interfere with sleeping.

In addition to stress, research shows a number of things can trigger eczema reactions, including:

• Microorganisms that live in the skin
• Animals
• Chemicals
• Certain fabrics like wool
• Respiratory conditions, like the flu
• Fumes that come from vehicles or wildfires

External triggers can be easier to manage. But when your mental state leads to flare-ups, it can require a different course of action.

The Stress-Eczema Cycle

Unlike many environmental factors, stress isn’t an exterior irritant to the skin. It causes a flare-up from the inside.

“When faced with a stressful situation, the body will go into a ‘fight-or-flight’ response,” notes Dr. Kosma-Covey. “During the ‘fight-or-flight’ response, stress hormones such as cortisol are released. When these hormones are released in large amounts or for extended periods of time, they suppress the immune system and increase inflammation throughout the body. The inflammation leads to worsening of eczema symptoms or a new flare-up,” she adds.

Studies show that stressful situations, like school exams, family issues, financial problems, and work challenges can all exacerbate eczema symptoms.

It can create a back-and-forth effect, where each condition impacts the other.

“Stress can make the eczema more noticeable, with redness, itchiness, and dry patches becoming more intense. The emotional response to stress, like scratching, can worsen the symptoms, creating a vicious cycle,” Collins states.

While it’s important to treat the physical symptoms, tackling stress and other mental health issues can bring relief to eczema flare-ups.

Managing Stress to Alleviate Eczema Symptoms

Stress causes both internal and external issues for people with eczema. Taking care of your mental health and learning how to manage stress can help reduce skin breakouts and alleviate itching. It can also help curb any worry or anxiety associated with dealing with eczema.

“One client recalled how periods of high anxiety at work directly led to increased flare-ups, with itchy, raw patches showing up on her hands and neck. She found that her symptoms improved when she practiced mindfulness and took breaks to manage stress,” shares Collins.

She found that her symptoms improved when she practiced mindfulness and took breaks to manage stress.

— MEGAN COLLINS, MA, LMFT, ATR-P

Other strategies to manage stress include:

• Physical exercise, which helps both physical and mental symptoms
• Breathing exercises
• Therapy
• Taking part in hobbies that you enjoy

Ideally, engaging in some of these activities will not only help you to be more calm and relaxed but will also keep stress-induced eczema flare-ups at bay.

Lifestyle Adjustments for Eczema Management

We get it—changing your habits and behaviours that have been ingrained for years isn't easy. But dealing with your eczema in a healthier way is a reward that’s worth it. Specific adjustments can help keep stress and eczema flare-ups at bay, including:

• Getting a good night’s rest. “Sleep is crucial for skin repair and immune function, and lack of sleep can increase cortisol levels and thus worsen eczema,” Dr. Khanna notes.
• Being mindful of what you eat. “Some people with eczema find that certain foods, such as dairy, gluten, or eggs, may trigger flare-ups. Keeping a diary can help pinpoint specific triggers you can share with your medical team,” advises Collins.
• Taking inventory of the products in your home. Everyday items, from makeup to carpet cleaner, can contain triggering chemicals.
• Finding a support group. People who understand your struggles and frustrations dealing with eczema, or who have experienced the impact stress has on the condition, can keep you encouraged on your journey. “Connecting with others who understand the struggles of eczema can lessen the mental toll,” Collins says.

Tips for Daily Management

Small actions can make a big difference in managing stress. Tips like avoiding long hot showers to keep your skin from drying out and wearing clothing that’s not too tight are beneficial. Keeping your skin well moisturized is also key.

“A good tip is to moisturize immediately after you shower while your skin is still damp. Ideally, you want to find a moisturizer that is thick, fragrance-free, and clean for sensitive skin. Another option is an over-the-counter hydrocortisone cream to help calm inflammation and treat patches of eczema. If your patches are persistent, then connecting with your dermatologist to get a prescription like tacrolimus is another option,” says Anna Chacon, MD, FAAD, board-certified dermatologist and founder of MiamiDerm.

Warning

Speak to your doctor about any steroid cream use. Regular steroid cream use can lead to thinning of the skin, breakdown, and worsening of the underlying problem.

Other tips include having a good water filter if you’re in an area with hard water, using an air purifier, and making your home as allergen-free as possible. You can also consult with a medical professional to help find a more customized approach for you.

Bottom Line

Stress can wreak havoc on the body in many ways. Eczema can cause problems from the inside out. Making the effort to remove potential flare-up triggers and usher in a more calming and relaxing atmosphere can be a worthwhile investment.

“Like any chronic health condition, managing eczema requires a holistic mind-body approach, and you shouldn’t have to go through it alone. Building a treatment team, utilizing coping skills, self-care routines and rituals, and garnering emotional support through the eczema community can effectively minimize flare-ups and promote overall well-being,” Collins concludes.

https://www.verywellmind.com/the-impact-of-stress-on-eczema-11690763

Psoriasis Diet: Foods to Eat and Avoid

From verywellhealth.com

While there is no single psoriasis diet that works for everyone, certain foods are known to trigger symptoms in many people living with the disease. On the flip side, certain dietary approaches have been shown to reduce symptoms of psoriasis, including a reduced-calorie diet or a gluten-free diet.

With that being said, foods that trigger psoriasis in one person may not trigger psoriasis in another. By keeping a food journal and working with a healthcare provider, you may be able to pinpoint which foods are problematic and which are beneficial if trying to manage this common but often challenging autoimmune disease. 

Claudia Totir / Getty Images

How Diet and Psoriasis Are Related

Psoriasis is a chronic autoimmune disease in which the body's immune system attacks skin cells with inflammation, causing them to multiply faster than they can be shed. This causes the cells to pile up on the surface of the skin, creating itchy, dry, scaly plaques.  The symptoms tend to come and go in episodic flares lasting for weeks or months.

Psoriasis flares can occur spontaneously for no known reason or be instigated by any number of triggers, including psychological stress, chronic infections, skin trauma, changes in climate, cigarette smoking, and other autoimmune diseases.

The association between psoriasis and food is less clear given that the triggers can vary from one person to the next. With that said, risk factors like obesity are greatly influenced by diet, while certain foods are known to promote or temper inflammation.

While there is no consistent diet to help treat psoriasis in all people, scientists have identified certain dietary patterns that contribute to psoriasis symptoms. These insights can help you build a personalized diet plan, often through a process of trial and error, with your healthcare provider.

Psoriasis and Weight Loss

Obesity is a well-known risk factor for psoriasis, increasing the risk of the disease by nearly twofold compared to people of normal weight. This is mainly due to high levels of chronic inflammation spurred by the build-up of fat cells in the body.

Not only does obesity increase the risk of psoriasis, but it also dramatically increases the failure rate of psoriasis treatments, including topical steroids and oral or topical immunosuppressants.

As such, weight reduction is an important step to not only improving your overall health but also alleviating symptoms of psoriasis.

This is evidenced in part by a 2014 study in the British Journal of Dermatology which concluded that, among people with obesity, a calorie-restricted diet coupled with routine exercise reduced the severity of psoriasis by around 48% after 20 weeks.

Foods to eat on a weight-loss diet include:

• Fresh, frozen, or unsweetened canned fruits
• Raw, grilled, steamed, or sautéed vegetables
• Fat-free or low-fat dairy, including unsweetened dairy
• Lean animal protein, including skinless poultry and fish, either grilled or baked
• Alternative sources of protein, including eggs, beans, nuts, and tofu

Foods to avoid include:

• Fried or breaded foods
• Fast food or processed foods (including processed meats and baked goods)
• Fatty red meat
• Foods high in salt, sugar, and saturated fat
• Whole milk or cheese
• Butter or cream sauces

A calorie-restricted diet should be directed by a healthcare provider or nutritionist to ensure you get the daily nutrition needed to remain healthy.

Psoriasis and Inflammation

Inflammation is a normal response to any disease or condition that causes the body harm. However, with psoriasis, the inflammatory response is inappropriate, targeting normal cells rather than harmful ones.

While medications are the first-line approach to tempering this inappropriate immune response, studies suggest that certain anti-inflammatory foods may also help.

According to research, inflammatory foods like sugar or trans fat can independently trigger psoriasis in some people. This is especially true for people with obesity, uncontrolled diabetes (whose bodies are already under chronic inflammation), or inflammatory bowel disease (an autoimmune digestive disorder).

Eating anti-inflammatory foods may have the opposite effect, easing the frequency or severity of psoriasis flares. These same foods also tend to be beneficial for people with obesity, diabetes, and inflammatory bowel disease.

According to a review of studies published in the International Journal of Molecular Science, foods closely linked to psoriasis flares include:

• Alcohol, including beer and wine
• Sugary foods, including those made with molasses and corn syrup
• Refined carbohydrates, such as white bread, white rice, and plain pasta
• Red meats
• Processed meats, such as sausage, bacon, and salami
• Butter, lard, coconut oil, and palm oil
• Fried foods

Food with anti-inflammatory effects include:

• High-fibre foods, including whole grains, beans, berries, and nuts
• Food rich in vitamin D, like low-fat dairy
• Foods rich in vitamin B12, like tuna, salmon, and eggs
• Food rich in selenium, like shellfish, Brazil nuts, and whole-grain pasta
• Food rich in omega-3 fatty acids, including all fatty fish
• Soybeans, including tofu and edamame
• Probiotic foods, like yogurt, kimchi, kefir, and kombucha

Psoriasis and Gluten

Psoriasis commonly occurs with other autoimmune diseases, during which the flare of one condition can trigger a flare of the other. One example is celiac disease (CD), a chronic autoimmune disorder triggered by the consumption of gluten (a protein found in wheat and several other cereal grains).

Studies have shown that the rate of psoriasis among people with CD is nearly three times greater than among people without CD. Based on these facts, some scientists have theorized that eating on a gluten-free diet may relieve symptoms of psoriasis, at least in some people.

This is evidenced by research published in the Journal of the American Academy of Dermatology in which a gluten-free diet eaten for three months helped ease the severity of psoriasis in not only people with CD but also those with non-celiac gluten sensitivity (NCGS). It appears to do so by lowering levels of antigliadin antibodies (the main antibody linked to both CD and NCGS).

On the other hand, a gluten-free diet does not appear to be useful in controlling psoriasis in people without CD or NGCS.

Foods to avoid on a gluten-free diet include those made with:

• Wheat
• Barley
• Rye
• Durum
• Semolina
• Spelt
• Malt
• Malt extract
• Malt vinegar
• Distilled vinegar
• Brewer’s yeast
• Triticale
• Hydrolyzed vegetable protein
• Hydrolyzed plant protein
• Modified food starch
• Caramel colour
• Dextrin 
• Maltodextrin
• Yeast extract

Foods to eat on a gluten-free diet include:

• Gluten-free grains like amaranth, buckwheat, quinoa, millet, sorghum, and rice
• Fruits
  
• Vegetables
• Unprocessed poultry, meat, and fish
• Beans, peas, and lentils
• Nuts and seeds
• Dairy

If you decide to try a gluten-free diet, it can take several months for the effects to be felt. Many experts suggest that you remain completely gluten-free for at least three months to see if any tangible benefits are achieved.

Other Considerations

When it comes to controlling psoriasis, how you prepare your food may be just as important as the foods you choose to eat. For example:

• Aim to cook in as little fat as possible, such as by grilling, broiling, steaming, or braising your food. Avoid deep-fat frying or pan-frying with a lot of oil.
• Choose healthy oils like extra-virgin olive oil and canola oils over unhealthy ones like coconut oil, palm oil, butter, or lard.
• Choose low-sodium or reduced-sugar versions of foods, such as canned vegetables and jam. Avoid artificial sweeteners in sugar-free foods which some studies suggest may promote inflammation.

It is also important to keep your diet balanced with the ideal mix of fruits and vegetables, fibre, lean protein, and healthy fat. This is especially true if you are on a weight-loss diet, wherein your daily calorie intake may be reduced by anywhere from 500 to 1,000 calories per day.

Regardless of the type of psoriasis diet you try, it is to your benefit to do so under the guidance of a health provider or qualified nutritionist.

Be sure to take it slowly at first rather than make radical changes that are difficult to sustain. With every adjustment of your diet, keep note of your symptoms in a journal, including any side effects you may experience. Over time, you should be able to build a personalized diet plan that helps keep psoriasis symptoms at bay.

Summary

The foods you eat may influence the frequency and severity of psoriasis symptoms. As these trigger foods can vary from one person to the next, different dietary strategies may be needed.

Some people may benefit from a weight-loss diet which reduces overall inflammation in the body. Others may benefit from a gluten-free diet if they have gluten intolerance or celiac disease. Others still may benefit from eating anti-inflammatory foods (like fatty fish and whole grains) and avoiding inflammatory foods (like red meat and sugar).

https://www.verywellhealth.com/changing-your-diet-to-cure-psoriasis-2788274