Keeping a Positive Body Image

Gabby Bachner, a pharmacy student at the University of Georgia in Athens, found out she had eczema soon after she went to college. The specific type she has, called contact dermatitis, happens when her body touches something that causes an allergic reaction. Bachner, who works in a pharmacy, found that her scrubs and certain lotions triggered her eczema flare-ups.

Eczema can cause a number of unpleasant symptoms, including:

These changes can also have an emotional and mental impact. Bachner says her eczema flares definitely affect her self-confidence.

Your skin is your largest organ, so problems with the way it looks can have a psychological impact.

Lower self-confidence can take a toll on your mental health. “With eczema both in children and adults, we do know that there’s a higher rate of depression, ADHD, anxiety, and also a lot of sleep disturbances,” says Mamta Jhaveri, MD, assistant professor of dermatology at Johns Hopkins University in Baltimore.

People with eczema have a higher chance of getting depression and anxiety than those without it. The odds are even higher if you have severe eczema. This can lead to a frustrating cycle. “Stress makes eczema worse and eczema makes stress worse,” Jhaveri says.

There are three main ways eczema can affect your mental health:

• Chronic itch. Eczema often causes an itch you can’t control. When you’re in public, it can be hard to hide your scratching. This could lead to stress, anxiety, and worries about what others think.
• Inflammation. Chronic conditions like eczema result from inflammation. Jhaveri says it can zap your energy levels and make it hard for you to focus.
• Visible symptoms. Eczema often affects places that are hard to cover up, like your face, eyes, hands, or limbs. These areas might get swollen, scaly, cracked, or bloody, any if which could lower your self-image.

Bachner says past vacations with eczema were never stress-free. Before a trip, she would often get a pedicure. Lotions used during the treatment led to eczema flares on her legs. And since many eczema therapies don’t work right away, she couldn’t get the outbreak under control before she left. That made it difficult to feel confident in a bathing suit. She was afraid people would mistake her condition for an infection.

The combination of lower self-confidence, itch, and fatigue can make it hard to be around others during a flare. People with eczema often crave a comfortable and private setting. You may need to stay home and take care of your skin.

“It does lead to a lot of missed work, missed school, and people sometimes opt out of social interactions,” Jhaveri says. “Eczema can also impact intimacy. … If it impacts the face or any intimate parts, it can impact relationships.”

When Jhaveri treats someone with eczema, she also uses anxiety and depression rating scales to gauge how their skin condition affects their mental health.

But the first line of treatment is always to control the eczema. “Sometimes that in itself will help the mental side effects,” she says. If skin symptoms don’t go away, Jhaveri will help people find more assistance.

The path to building confidence is slightly different for children than it is for adults. There are some things parents can do to help build their child’s self-image:

• Ask about their peers. It’s important for parents of a child with eczema to ask about their school and social life. If you think your child’s peers are bullying them because of their condition, address it as soon as possible.
• Work on sleep. You and your child’s doctor can help solve your child’s eczema-related sleep problems. They may suggest your child take melatonin supplements or use anti-itch medication to help them sleep at night. Good sleep is directly linked to a child’s self-image. With more sleep, they’ll feel more confident and focused on school, which will boost their self-image.

These steps can help adults improve their mental health and body image:

• Get professional help. If eczema is taking a toll on your confidence, talk to a therapist or psychiatrist. They can help you regain self-assurance and provide tips on how to deal with the mental aspect of a skin condition.
• Join online support groups. Jhaveri often suggests that people with eczema join support groups on Facebook or get involved with the National Eczema Association. These outlets help you connect with others and share tips for gaining confidence.
• Talk to your family. If you’re comfortable doing so, it can help to tell your close family how eczema affects you emotionally. This way you’ll have someone to talk to or lean on when your self-image isn’t at its highest.
• Practice mindful meditation. Stress relief can play a big role in your body image and confidence. Jhaveri suggests meditation or another relaxation technique, like yoga, tai chi, or music therapy. All those things can help you reconnect with your inner self, she says. That can help you see the impact eczema has on your self-image.
• Write it down. Jhaveri says it may help to write a story or journal about how your skin condition affects you. Sharing it with someone you’re close to can help you release bottled up emotions and may help to you accept your feelings.
• Take a step back. Bachner says that one of the best things she does to regain her confidence is to think logically. It’s easy to feel like everyone is focused on your eczema, she says. But most people won’t even notice your flares unless you point them out. It’s important to remember that self-confidence comes from self-acceptance. “It’s not your fault that you have eczema,” Bachner says. “Try not to let it bog you down. … People aren’t paying attention to what you think they are.”