Introduction

Having eczema can be challenging to manage. You may find that as a result of your eczema, depression or anxiety may be more likely to occur, and finding a way to look after your physical and mental health together can feel tricky. At Smile, we know that sometimes you may need a bit of extra support managing your condition in order to live well.  

You feel uncomfortable as your skin itches constantly. You try not to scratch it, as it’s sore from where you have had to before. You feel insecure as you examine the dry patches that have caused your skin to crack. It makes you sad that your skin looks and feels different to others. Statistics from the National Eczema Society show that 1 in 5 children and 1 in 10 adults will have experienced many of these symptoms when managing eczema.

These symptoms are usually associated with the most common type of eczema; atopic dermatitis. Other types of eczema such as dyshidrotic eczema and stasis dermatitis may cause additional symptoms such as burning sensations, rashes and blisters or discolouration in the legs, respectively. All types of eczema can be very uncomfortable to live with, and as a result you may find that you are affected emotionally as well as physically by what is happening.

Despite it being a relatively common condition that can affect a lot of people, having to manage it daily can feel draining and at times overwhelming. It can be especially challenging to manage when you have flare ups, which can happen multiple times a month and make the symptoms worse. It is understandable that it may be difficult to manage both your physical and mental health sometimes because of this.

The effect of eczema on your mental health

Although eczema can be unpleasant and you may experience discomfort, there are multiple ways to make the symptoms more manageable, including moisturisers and creams. In some cases you may want to use bandages as well to help heal wounds and sores that may have occurred by making sure they don’t get further irritated. Whilst eczema treatments are there to make your eczema easier to manage and reduce risks of infections caused by untreated eczema, having the condition may still lead to feelings of depression or anxiety. 

It can be draining to live with eczema daily because it is a long term, ongoing condition. It is also a condition that can affect your self esteem as it affects the way you look. Additionally, it may potentially cause social isolation if you feel too insecure to go and socialise with people for fear of judgement. These factors could all make emotions like depression and anxiety worse. 

Though the most common eczema triggers are things like soaps or the weather, there is also stress related eczema. This can sometimes be challenging to manage as experiencing stress may cause your eczema to flare up, but having eczema can cause you to feel more stressed and anxious. This means you can find yourself in a constant cycle managing the two. To help with the feelings of anxiety or stress you may be experiencing, it can be helpful to do things like going for walks or talking to your friends to improve your general wellbeing.

Severe eczema and how this can affect your mental health

Severe eczema can be much worse than a standard eczema diagnosis because when your eczema flares up, the symptoms will feel much more intense. For example, itchy skin is usually experienced by those with eczema but severe eczema will cause this sensation to feel more painful and more uncomfortable. In some cases these symptoms will persist for longer periods of time as well, which can make daily living very hard and can feel quite stressful. 

A lot of the time, a cream or moisturiser is enough to make eczema manageable, but severe eczema might need to be treated with medication instead. If it is not managed well and left untreated, it may lead to hospitalisation if you develop a serious skin infection. 

Severe eczema may also be more challenging to manage because it means that you are more likely to have allergies and asthma in addition to your eczema. Having to manage multiple conditions can create a lot of worry because you have to make sure that you are managing all of them well in order to not have any health complications.

Discomfort when managing eczema

The physical symptoms of eczema can make living with the condition feel very uncomfortable. This may be the case at night especially, as eczema can be worse then. If you are staying awake feeling an itchy sensation, it means you will not be getting enough sleep, which then can affect how you perform in your daily life. Things such as work or school will suffer as a result. 

Your general mood will not only be affected by a lack of sleep, but you will also feel disappointed if that then means it is affecting other areas of your life. You may find yourself feeling irritable or upset generally because of the discomfort of the condition. This itself can cause mental health challenges such as depression, as you may worry that you can’t manage your eczema well enough

How eczema can affect you socially

As eczema is a condition that can be visible to others, there are lots of people with eczema who feel embarrassed about the way that their skin looks and find themselves experiencing feelings of insecurity. In a survey carried out by the National Eczema Society, 91% of people with eczema said that their condition made them self conscious, which shows just how many people are emotionally affected by their condition. 

In some cases eczema can clear up when you are a child, meaning that it is either significantly clearer or completely gone. Even when this does happen, it can have a lasting effect on the way you view yourself. These feelings of insecurity may be brought on by others making comments about the way you look because of your eczema, or can be brought on by your own viewpoint of yourself, believing that you are less attractive or not ‘normal’ because of your eczema. 

These thoughts can lead to social isolation as you may not want to go out and enjoy yourself if your eczema is visible, or you may feel restricted by what you can do in case you irritate your eczema. You may also want to avoid the embarrassment of feeling itchy in public as it could make you feel like you're being judged by others. 

If you know someone who has eczema, it is important that you try and help them to avoid social isolation. You may notice that your friend or family member isn’t being very sociable and avoiding interactions where possible. To make sure this isn’t affecting your relationship with this person and vice versa, encourage them to be more social by spending time with them and offering them support. 

This social support will hopefully not only stop them from experiencing potential loneliness and isolation, but may help them feel more positive and less anxious or sad about their condition. As a friend or family member it may be hard to understand why they are experiencing these emotional changes, but by talking to them about it, you will be able to support them. 

The Smile app has a range of blogs which cover many physical chronic health conditions, including eczema. These blogs are written by people in the community who have first hand experience with a condition. Ruth Holroyd has written a blog entitled ‘you have no right to my medical story’, which may offer some advice on how to support and help someone who is managing eczema.

The effects of eczema on your daily lifestyle

When you have eczema, you may find that you have to think more carefully about things like what you wash your clothes in, in case the products cause your eczema to flare up. You may have to consider what activities you want to do for fun, as things like sport can cause a flare up if you do an excessive amount of exercise. Even things like having a shower can be painful for some. Parts of daily life that most people don’t have to consider or think twice about, people with eczema have to think about and make the appropriate adjustments in order to live well. 

There may be other effects on your day to day life, as eczema can sometimes be expensive to manage, especially if you need special treatments for your eczema or need to wash your clothes in particular washing formulas. This might then cause financial implications to your life, which may make you feel stressed about how you are going to support you and your family. As stress can cause eczema flare ups, mindfulness techniques and breathing exercises can be helpful to manage feelings of anxiety

How parents of a child with eczema are impacted

It is not only those who are experiencing eczema first hand that are impacted by the effects of the condition. Young children will be reliant on their parents to help them treat their eczema well, which puts a lot of pressure on them to make sure the condition is being managed well. 

As a parent, you will feel responsible for your child’s health and do everything you can to look after them and manage the condition, which can sometimes feel very emotionally draining and stressful. One of our Smile therapists, Francesca Sawer talks about carrying responsibility and says, “when we're not fixing it we can then feel guilty and when we feel guilty it drives us to work hard to try and find a solution.” These emotions of stress and guilt can be hard to manage sometimes, and it is important to seek support if you also feel emotionally affected by your child’s condition. 

It will be hard to watch your child relentlessly scratching at their skin or feeling uncomfortable, but it can affect children emotionally as well as physically. Some children may find themselves being bullied because their condition means their skin looks different to others, or other children might ask questions that unintentionally make fun of their eczema. This will of course make them feel sad and they may feel lonely if they are being socially excluded. This means that you will have to support your child emotionally as well as physically. It might also upset you as well, watching your children experience that and knowing that they are being singled out.

How to get mental health support when managing eczema

In the UK, 50% of adults with eczema have also been diagnosed with anxiety or depression. This means that half of those managing eczema may be finding it difficult to balance their mental health alongside their condition. If you need help, there are many resources to help manage potential feelings of anxiety, depression or any other tricky emotions that have occurred as a result of having eczema. 

The Smile app has lots of content and expert-led workshops that are there to support your mental health when you have a physical chronic health condition. Our team of therapists offer advice on managing many feelings and challenging situations including carrying responsibility, social support, EFT for sleep to help keep calm when facing sleeping difficulties associated with eczema and an introduction to mindfulness. 

Eczema may at times feel uncomfortable or difficult to manage and it is a perfectly reasonable response to feel stressed, anxious or depressed because of the condition. However, it is important to realise that if you need them, there are lots of resources and tools that make it possible to manage both your physical and your mental health well.

Smile is a mental health app for people managing chronic physical health conditions. To access the resources mentioned above, download the app now from Google Play or ​Apple App store.