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Exercise and eczema

This page contains two exercise-related articles from our magazine, Exchange.

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Could yoga and meditation help your eczema?

Exercise and eczema

Could yoga and meditation help your eczema?

Exchange talks to GP Dr Angelika Razzaque, a member of the Society’s Medical Advisory Board, about how yoga can reduce stress, and why this is so beneficial for people with eczema. This article was published in Exchange 190, Winter 2023.

The word ‘yoga’ comes from the same root as ‘yoke’ – which refers to the way that it joins together mind and body. Why is this especially relevant for people with eczema?

Yoga class

Any form of physical movement, from gardening to going for a walk, can take you away from your thought processes and into the ‘here and now’. But yoga has evolved over the years to help people tune in to what’s happening in your mind as well as the sensations in your body. (Some teachers refer to yoga as ‘open eye meditation’.) A lot of people use yoga for strength and fitness, which are valuable benefits, but underneath it there is a focus on mindfulness, looking after yourself and being in the present.

What is the relationship between eczema and stress?

The link between eczema and stress is well evidenced. An important part of my consultations with patients with eczema involves making sure they understand this link. Then we talk through their life circumstances and the stresses they face, before exploring ways they can minimise that impact.

To be clear, I would never suggest that someone finds a way to go through life without experiencing stress – that’s just not possible. But we can find ways to counterbalance the stress. The more stress we have, the more we need to nurture ourselves, to maintain a healthy balance. If someone has eczema, this is especially important as stress can trigger a flare.

Often when people have a flare, they think ‘Perhaps I’ve done something wrong’ or ‘Maybe I need some different treatments.’ Often I find it’s more a matter of identifying what particular triggers life is throwing up at the moment. Even if these factors can’t be removed, there are often things you can do to minimise their impact.

How can yoga help?

Yoga can contribute to a healthy balance – energising your body and providing structured time to look after yourself. It’s also good for your self esteem, too: after doing a class, you feel ‘I’ve done something really good for myself, rather than just sitting down all day.’ Other benefits include spending time in a calming physical environment, and making new social connections with others in a yoga class.

But the mindfulness and relaxation elements of yoga are crucial. Breathing techniques are a central part of yoga practice. Throughout the session, every physical movement is accompanied by a breath in or out. And even the most strenuous classes end with a meditative relaxation session to take your mind off the day-to-day challenges.

At a deeper level, yoga may affect your relationship with your body by cultivating a sense of curiosity, without judgement, about what is happening in your body and your mind.

If you have a condition such as eczema, you may often try to avoid noticing the feelings in your body altogether. Over time, yoga may help you see any unpleasant thoughts, emotions or sensations differently and tune in to pleasant feelings. It may make you more aware of symptoms at an earlier stage so that you can take early action. You will also learn to use the breath and physical movements to calm your whole self, including body and mind.

Can yoga help with symptoms like itching?

Over time, it may. An important aspect of managing eczema involves tackling the habits that people understandably develop over time. For example, the itch–scratch cycle is very much about habit. With support, people can break the cycle.

I can help as a clinician – for example, by motivating people and praising positive change. But practising regular yoga instils internal changes over time. So, reducing stress becomes second nature – for example, you might find yourself doing slow out-breaths without even realising you’d started. As you gradually become more self-aware, you feel less reactive to outside stimuli and more in control.

How can someone with eczema stay comfortable in a yoga class?

In terms of clothing, the focus is on finding something comfortable and light. There is no pressure to wear Lycra gym gear as this may irritate, although very loose clothing may flap around and cause itching. Choose something that doesn’t restrict movement and doesn’t rub against sensitive areas of your skin. The most important thing is that it feels comfortable.

You can bring your own yoga mat, which you may find helpful if you are self-conscious about leaving flakes behind.

There are many types of yoga and it’s worth experimenting to see which suits you, depending on your fitness levels, flexibility and experience. Hatha is a broad approach suitable for beginners, while vinyasa involves flowing movements. There are also meditative, calming styles such as yin yoga. There are benefits from all kinds of practices but even the rigorous styles incorporate mental relaxation.

If sweat sensitizes your skin, you might want to avoid particularly dynamic forms of yoga such as Ashtanga. Bikram yoga is a style that is practised in a hot room with a temperature of up to 41 degrees and a humidity of 40%. This might be uncomfortable for some, but even that may be worth a try – a sweaty environment might not affect you and the heat can increase flexibility, so it does have benefits.

If you’re in doubt, talk to the teacher first. Often your choice may depend on finding a teacher who you really like, or a class that is convenient to get to. Just try different styles and see what you like.

Do you notice the benefits of yoga in your work as a doctor?

Working in general practice can be incredibly pressured, and yes – the effects of yoga on mind and body certainly helps build my resilience and manage the challenges of a busy day.

When I’m faced with a complex or challenging scenario, a debrief with colleagues is not always possible as everyone’s busy. Practising breathing techniques helps me quickly reset and prepare for the next appointment, so that I’m 100% present for my next patient.

Because yoga also helps you be more attune to how you’re feeling, it makes me more aware of how I communicate with those around you. This helps me have positive relationships with my patients – which is key to consultation.

For me, connecting with people is a key part of the patient–doctor relationship: it’s part of the healing. For example. I will always walk out and collect my patient from the waiting area. Those little touches I think make a big difference to the healing process.

It helps me slow down so I really listen to what they’re saying and take the time to explore what’s going on for them and the possible options. It’s lovely when patients say our consultation has been really helpful or that have really felt listened to and taken seriously.

Ideas to minimise impact of stress

  • Sign up to a yoga class. There are free classes on YouTube such as Yoga with Adriene but the support of a teacher can feel very nurturing.
  • Notice how you are feeling and simply say to yourself ‘I am stressed’ or ‘I am anxious.’
  • Slowly count your out-breaths from 1 to 10 and then start at 1 again.
  • If you like apps, explore mindfulness, breathing and yoga apps to motivate yourself.

Exercise and eczema

Alice Lambert looks at how to get the most out of physical activity when you have eczema. This article was published in Exchange 172, June 2019.

We’re all aware of the benefits of exercise, but carving out the time for it can be a challenge. Sedentary jobs and long commutes lead to a lot of enforced sitting, and it can be hard to motivate yourself to exercise at the crack of dawn or after a tiring day at work.

Having eczema usually means spending extra time preparing the skin before exercise, too, and caring for it afterwards. Plus, if sweat is anathema to your skin, the prospect of exercise may feel as appealing as a barefoot trudge through ankle-deep slurry on a hot day.

Sweat is acidic and salty, and while that acidic characteristic is actually good for the skin’s surface, it can be an irritant, especially to inflamed eczema. In addition, the skin barrier is less effective if you’ve got eczema, so you’re more vulnerable to dehydration from excessive sweating.

That said, I believe there is a type of exercise out there to suit everyone, and that with the right preparation and aftercare the rewards of being active outweigh any aggravation or hindrance caused by eczema. In the words of Buddhist monk Thích Nhãt Hanh, “When it comes to health and well-being, regular exercise is about as close to a magic potion as you can get.” Stress is a major trigger for some people’s eczema, and exercise is known to reduce stress and improve mood.

Physical activity guidelines recommend that adults do two types of physical activity each week: aerobic and strength exercises. Aerobic exercise is any activity that gets the blood pumping and large muscle groups working, such as brisk walking, running, cycling, dancing and swimming.

Strength training involves working your muscles with some form of weight or ‘resistance’. Strength activities include push-ups and sit-ups, yoga, pilates and heavy gardening.

Swimming

  • Chlorine can irritate some people’s skin, but others find that swimming in a chlorinated pool has a soothing effect similar to taking a bleach bath. Since chlorine is essentially a bleach, and diluted bleach can reduce bacteria on eczematous skin, chlorine may actually help people with eczema.
  • If you’re using an indoor pool, apply emollient (ideally, an ointment emollient) before entering the water but after showering. It’s a good idea to put on more cream or ointment than you usually would, so it acts as an effective barrier to the water.
  • When swimming outdoors, use waterproof sun protection as well as an emollient. It’s best to apply emollient about half an hour before applying sunscreen – this will stop the sunscreen being diluted by the emollient and ensure the sunscreen keeps its reflective properties and protects your skin.
  • When you get out of an indoor pool, your skin is still exposed to chlorinated fumes around the poolside, so make your way to the changing area post-haste. Have a shower and use your usual emollient or soap substitute to wash with. Gently pat yourself dry with a soft towel, applying more emollient than usual while the skin is still damp.
  • If the pool showers use chlorinated pool water and you can get home quickly, it’s best to take a shower or bath as soon as you arrive home rather than at the pool.
  • If you’re pressed for time, it can be a hassle to dry yourself thoroughly, but it’s important to do so, as damp skin can cause irritation and possibly infection. If you have ear eczema, dry your ears with a warm (not hot) hairdryer.
  • If chlorine is a problem for you, ask the pool managers for the pool chlorination schedule and avoid swimming immediately after the pool has been chlorinated – the higher the chlorine level, the greater the risk of irritation. Alternatively, try to find a salt-water pool, or swim in fresh or sea water (especially in the summer months). Be aware that sea water can make broken skin sting.
  • Some people find that the eczema around their eyes is exacerbated by swimming goggles, or they develop contact dermatitis to components of the goggles (such as eye cup padding). You might find Swedish goggles more acceptable to your skin. These come without a gasket or seal around the eye cups and their fit can be customised. If you have ear eczema, it’s a good idea to wear custom-made ear plugs, which can be fitted at hearing-aid centres.
  • We have more information on swimming in our Swimming and eczema page.

Running

  • If excessive sweating is a problem for you, a long soak in tepid water before exercising might help.
  • Apply a cream emollient before your run, allowing enough time for it to absorb properly before exercising. An ointment emollient might feel too hot and trap sweat in.
  • Well-fitting sports clothing made from light, synthetic materials designed to wick sweat away from the skin won’t necessarily aggravate eczema – modern sportswear can feel soft and comfortable against the skin. However, clothes made from 100% cotton, bamboo or merino are probably less likely to exacerbate eczema. Tight clothing can cause problems from friction, so make sure clothing fits well.
  • Wash running clothes after each run.
  • If most deodorants irritate your skin, Green People’s scent-free roll-on deodorant and Salt of the Earth’s crystal classic deodorant stick are good options, as they’re free from common eczema irritants.
  • If you haven’t run before, keep your route local rather than travelling somewhere by car or public transport. You’ll probably want a shower as soon as possible after finishing your run, and having to travel home first (especially if you have to wait for a bus) may prove an itchy ordeal. If you do travel to run, take a small towel with you to pat away sweat, and a cold compress or ice pack to press against itchy skin before going home.
  • If you’re going for a long run, carry water with you. Remember to drink plenty of water afterwards too (this goes for all forms of exercise).
  • If you’re running at home on a treadmill, try using a fan to blow over you while you exercise. Air conditioning isn’t ideal as it creates abnormally dry air that might aggravate your eczema.
  • Have a tepid shower or bath as soon as possible after completing your run. Hot showers and baths are tempting, but they dry out and further irritate the skin. Wash with your emollient or soap substitute and re-apply emollient.

Cycling

  • As with running, apply a cream emollient before your ride, allowing enough time for it to absorb properly.
  • If traditional cycle wear causes you discomfort, wear well-fitting shorts or leggings and base layers made from cotton, bamboo or merino. Dress in thin layers that you can easily remove if you get too hot (assuming you have somewhere to put them!).
  • If you wear cycling gloves for grip and find that they make your eczema worse, try riding without gloves, making sure you use handlebar tape designed to help you grip, with plenty of padding.
  • If you wear gloves for warmth and they irritate your skin, wear thin cotton or silk gloves underneath.
  • If the chin strap on your helmet causes your eczema to flare, try placing or sewing a piece of material made from cotton, bamboo or silk on or around the strap, to form a barrier between skin and strap.
  • Sweaty after your ride? Have a tepid shower or bath as soon as possible, wash with your emollient or soap substitute and re-apply emollient.

Yoga and pilates

  • Good yoga teachers are keen to make sure everyone gets the most out of classes and will suggest adaptations for poses according to students’ different abilities. If you’re starting a new class, arrive early so you can speak to the teacher about your eczema and how it might affect your practise, or email them with any concerns in advance.
  • There are many different types of yoga, some more dynamic than others. If you’re starting out, try a gentle beginner’s class first. Approach ‘hot yoga’ (such as Bikram yoga) with trepidation and plenty of water – it’s practised in a hot room, and is guaranteed to make you sweat heavily.
  • Apply a cream emollient before the class and take a bottle of water with you – or bottles, if you decide to try hot yoga. Make sure any emollient applied to your palms or soles is fully absorbed or else you’ll slip.
  • Wear thin layers that you can easily remove or put on as needed. Even if you’re not attending a hot yoga class, some rooms can become very warm – especially if your teacher has a penchant for candles!
  • If you prefer to do yoga from the comfort of your own home, there are plenty of videos available for free on YouTube that teach you different sequences and poses.
  • Whether you do yoga at home or in a class, consider investing in a non-slip mat. If house dust mites are a problem for you, having your own mat means that you can make sure it is vacuumed regularly. Your own mat will also be free from traces of other people’s potentially irritating cosmetic products.
  • If you’re sweaty afterwards, have a tepid shower or bath as soon as possible.

Losing weight – if this is part of your motivation for exercising, there are health benefits to slimming down. Eczema is aggravated by skin rubbing on skin and moisture being trapped in skin creases – these are more likely to be problems for people who are overweight. Plus, as you lose weight, your core body temperature is less well insulated and the need to sweat will reduce.

Self-consciousness – if this makes you reluctant to exercise, try to remember that everyone is self-conscious about some part of their body. Focus on what your body can do rather than on what it can’t, and progress at a pace that’s comfortable to you.