What Stress Management Techniques Can be Used for Atopic Dermatitis?

Stress management techniques include a variety of approaches designed to help people cope with stress and reduce the negative impact of stress on the body.

How does stress cause flares?

Stress plays a role in the development of atopic dermatitis (AD), as stress negatively affects the immune system and creates more inflammation, as well as being a common trigger for relapses of AD. People with AD have an increased response to stress, including a higher amount of cortisol released in the body. Cortisol is known as the “stress hormone” and is best known for its involvement in the “fight-or-flight” response of the body. Early exposure to stress in children can lead to a persistent sensitization, which increases a vulnerability to stress later in life.¹

Impact on skin barrier

Stress negatively affects the skin barrier function, which can lead to more moisture loss and increased susceptibility to infection. People with AD already have a compromised skin barrier, and stress can further reduce the skin’s ability to keep germs out and keep water in.¹

Stress from eczema

Living with a visible skin condition like AD can also be a source of stress and can negatively impact an individual’s quality of life. Because of the impact of stress on AD and the additional stress experienced by those living with AD, stress management strategies can be beneficial.¹

Mind-body approaches

The mind-body connection recognizes that emotional, mental, and behavioral factors can directly affect our health, and mind-body techniques can improve quality of life and may help reduce symptoms of AD. The mind-body connection does not imply that the mind is the cause of disease. However, researchers have found that mind-body techniques such as mindfulness and meditation can have benefits, such as reducing stress and improving mood.

Mind-body approaches include:

• Yoga
• Biofeedback
• Guided imagery
• Self-hypnosis
• Deep breathing exercises²

Some studies have also shown that hypnotherapy and biofeedback may improve symptoms of eczema, including reducing the skin surface damage and lichenification (the thickened patches of skin). Another mind-body technique that has shown promise in clinical trials on reducing itch and loss of sleep due to itch is progressive muscle relaxation therapy, in which the individual is guided to relax muscle groups in the body from the toes to the head.³

Acupressure

Acupressure targets strategic points on the body defined by Chinese medicine. Acupressure uses gentle to firm finger pressure on these points rather than the needles used in acupuncture. The ancient healing practice of acupressure believes there are points on the skin that are especially sensitive to bioelectrical impulses.

Stimulation of these points triggers the release of endorphins, naturally occurring chemicals in the body that relieve pain. Acupressure’s benefits include releasing muscle tension, promoting circulation, and enhancing the body’s life force to aid in healing. Small trials have also suggested that acupressure has benefits on itch and lichenification.^3-5

Massage

Massage is a general term that describes using touch to press, rub or manipulate the skin, muscles, tendons, and ligaments. Massage is often used to reduce stress and pain and relieve muscle tension. There are several different types of massage.

Some of the most common types are:

• Swedish massage – Swedish massage is the most commonly used massage technique and is a gentle approach mainly used for relaxing and energizing.
• Deep tissue – Deep tissue massage uses slower strokes with more pressure to access the deeper layers of muscle and connective tissue. It is often used for muscle damage after injury, such as whiplash or back strain, or to break up scar tissue.
• Sports massage – Sports massage can be similar to Swedish or deep tissue massage and is used to prevent or recover from athletic injury. Sports massage helps recovery from physical activity and keeps the body flexible.
• Trigger point massage – Trigger point massage concentrates on areas of tight muscle fibers, which form after injury or overuse.
• Chair massage – Chair massage generally focuses on the upper body and is performed on a person who is seated in a portable massage chair.^4,6

Massage may provide benefit to people with AD. Studies that have compared topical treatment alone to topical treatment with massage found that massage significantly improved symptoms of redness, scaling, lichenification, and itching.³