Warmer weather can be both a blessing and a curse if you have eczema – some people see a marked improvement in their skin, while others experience a decline. So what steps can you take proactively to help?
Be ‘sun smart’ by applying sunscreen, staying in the shade between 11am and 3pm, wearing clothing that offers additional protection (such as long-sleeved tops or items that have built-in UV protection) and putting on a hat and sunglasses.
But don’t rely on it! Even if you’re sitting completely in the shade you are still indirectly exposed to the sun’s rays when they are reflected off surfaces such as water, sand and concrete. Always protect your skin, even in the shade.
If you have eczema, moisture loss is already a significant issue for your skin. Warmer temperatures therefore mean you need to take on more liquids to ensure your body stays well hydrated.
Avoid extremes of temperature
Try to maintain an even body temperature, i.e. don’t go directly from an air-conditioned office to a sunny park on your lunch break.
Keep your cool
Sweat can be a huge irritant for those with eczema so choose clothing that allows your skin to ‘breathe’, such as loose-fitting garments made of natural fibres.
If you are using a moisturiser that is greasy or oily, be careful not to overdo the application of the moisturiser as this can cause a ‘frying’ effect in the sun. Leave a gap of at least 30 minutes between applying emollient and sunscreen to ensure that the sunscreen retains its protective properties.
Review your medication
Many drugs, including some used to treat eczema, can cause phototoxic reactions so be sure to review the patient information. People who are using topical calcineurin inhibitors such as tacrolimus (Protopic) and pimecrolimus (Elidel) are advised to protect the treated area from sunlight (by covering up or applying sunscreen) to avoid the theoretical risk of developing skin cancer.
Plan in advance
Sun cream is one of the biggest sources of frustration for those with eczema and needs to be tackled early:
- While a product may have suited your skin the last time you bought it, always check if the formulation has changed before buying it again.
- If you find something that works, consider stockpiling a few bottles in case the manufacturer suddenly stops making it – always monitor the ‘use by’ dates though.
- If you’re still seeking that elusive ‘good fit’ with your skin, approach brands about supplying you with a sample to try prior to purchase and test it on your inner arm once a day for 5 days.
- Many people with eczema find that mineral-based sunscreens are less irritating than chemical absorbers, but this isn’t true for everyone.
- Unperfumed products are less likely to trigger a flare.
More tips can be found on our Sun and eczema page.
Dr Anthony Bewley, Consultant Dermatologist at Barts Health NHS, explains the complex links between eczema and psychological well-being. This article, based on a talk given by Dr Bewley, was published in Exchange 175, March 2020.
Emotional impact of eczema
Eczema is much more than just a skin disease. It can really affect how you feel, how you behave and your self-esteem. There are two common misperceptions about how eczema can affect your skin. The first is that small amounts of eczema don’t matter and don’t cause psychological distress. But small amounts of eczema can be really troublesome, and can really matter when it affects intimate parts of the body, the scalp – or, for that matter, any part of the body.
Some people with eczema cope well and seem to thrive psychologically but others struggle. What’s really important is that individuals, their family and friends, and their healthcare professionals do not undermine the experience of living with eczema by saying things like ‘Stop scratching’, ‘It’s only eczema’ or ‘It’s just your skin; it’s not that important.’
The second misperception is that a ‘hidden’ disease does not matter. Eczema affecting the face and hands carries its own challenges. When I was at school (I had eczema as a teenager), other children would sometimes say ‘What’s wrong with your hands?’, or ‘What’s that on your skin?’ But eczema underneath clothes is just as itchy, and individuals with eczema know that it’s there even if nobody else can see it.
Topical treatments for psoriasis and eczema require a significant time commitment, which adds to the stress of coping with the skin disease. And the messages from healthcare professionals about which cream to use, and where, can be confusing.
Avoiding confusion about treatments
- Write down any instructions from your doctor or nurse during your consultation.
- Ask for clear signposts to non-promotional, non-advertising information sources about how to cope with eczema.
The brain-skin connection
A 2013 report by the All-Party Parliamentary Group on Skin (APPGS) recognised that although mental health needs have increased in recent years, they are still viewed as largely separate to physical needs. However, nerves in our bodies have neuropeptides that connect the brain to the skin, so it’s not surprising that if you’re feeling anxious and/or depressed, it may have an effect on your skin.
Conversely, anger, depression, anxiety and low self-esteem can all be psychological effects of eczema. Stress leads to skin disease, and having a skin disease is very stressful, so the whole cycle between stress and skin disease is perpetuating. Experiments show that if you have stressed individuals and non-stressed individuals and you do skin stripping (which is where the top layers of the skin are removed), the stressed people repair that damage much more slowly than the non-stressed people.
So it’s not just about the inflammation that we get: the repair and recovery from having an inflammatory skin disease is also very important.
Sometimes, eczema can cause low morale and, in extreme cases, suicidal thoughts. If you know someone with eczema, please don’t be afraid to ask them if they are okay and how they are coping in life and with their eczema. By asking someone how they feel, you actually halve the risk of that person acting on suicidal thoughts. It’s so important to talk about any extreme feelings with your healthcare professionals as well.
Sleeplessness is another psychological effect of eczema and it can lead to dysfunction, which increases stress. ‘The itch’ is one of the things linked to sleeplessness. From research, we know if you have a chronic long-term sleeplessness, in extreme cases it can lead to suicidal thoughts and self-harm. The main links with suicidal behaviour and people with eczema are the sleeplessness and the involuntary, unrelenting itch.
Getting psychological support
The APPGS report highlighted: ‘It is vital that health professionals are knowledgeable of, and sympathetic to, the patient’s physical and mental needs. Patients should feel able to express their concerns and have their worries allayed.’ So, if you have a longstanding skin disease like eczema, it’s really important that you have access to something that will address the psychological impact of having a skin disease.
Struggling to cope with the psychological aspects of your eczema?
- Tell your GP. GPs are usually helpful about signposting individuals to helpful psychological support. Sometimes, GPs will even suggest medication.
- Look up your local Improved Access to Psychological Therapies (IAPT) service. Most regions have their own service, so look up the one local to you online.
- Seek counselling or support from local UKCP-registered practitioners. Trained counsellors and psychotherapists can help patients find their own answers to life’s issues (www.psychotherapy.org.uk).
GPs and psychological services may not be seeing patients face-to-face at the moment, but should offer telephone or video call options.
Run-down of self-help techniques
Mindfulness is a technique that trains people to focus on the moment, to avoid stressing about ‘what may be’, and to observe dispassionately any negative thoughts.
A technique that trains one to relax, become more self-focused and self-reliant, and to distance oneself from the day-to-day stresses of life.
Relaxation techniques include other techniques mentioned – but also simply chilling out and allowing oneself to have some space and time to oneself.
Many people have a fear of hypnosis based on sensational theatrical shows, but hypnotherapy is not about that theatrical sensationalism. Instead, it trains people to relax and focus on strengthening resilience and holistic wellbeing.
Habit reversal therapy
Habit reversal therapy (HRT) was developed in 1973 and was used in the beginning as part of treatment for some compulsive anxiety-related disorders. According to studies, HRT reduced about 99% of the nervous habits after three weeks of training. Soon after, it was also successfully used to decrease the amount of scratching in patients with itch-related dermatoses, such as eczema and psoriasis. Further studies showed that those who had medical treatment in addition to HRT, when compared to patients who had medical treatment alone, had greater improvement in the clarity of their skin and a greater decrease in scratching.
So what actually is HRT? It’s a therapy that identifies the habit component of the ‘itch–scratch’ cycle in the hope of breaking it. It usually comprises four consultations, each being an hour long. In the first consultation, the healthcare professional will identify the habits and the most likely times of the habits and then give the person with eczema a clicker counter. Over the next four weeks following their initial appointment, they are asked to click every time they scratch or rub at their skin.
To try to replace the habit of scratching at the skin, the person with eczema will adopt a different non-harmful habit, such as clenching their fist. HRT has been proven through research to be an effective way of breaking the ‘itch–scratch’ cycle.
Don’t suffer in silence
The most important message is that individuals with eczema don’t need to suffer in silence. Living with eczema is a challenge both for your skin and for your psychological well-being. There is help and support available to help with both. Managing the skin and the psychological aspects of living with a skin disease gets the individual with eczema better more quickly and for longer.
National Eczema Society is seeing an increased demand for our services during these difficult times. More people with eczema, and their families, than ever are calling our Eczema Helpline to get advice as they struggle to get appointments to see their GP or other healthcare professionals. Guidelines on frequent handwashing and the use of hand sanitizers as well as social isolation and stress are having a strong impact on people’s ability to manage the condition. Those who are taking strong immunosuppressant medication are also concerned that this makes them more vulnerable to the virus.
By donating and fundraising you can help make sure that we keep our Eczema Helpline and other services open and continue to support people across the UK during these difficult times. There are various ways you can help.
Make a donation
You can donate on our website – it’s secure, easy and quick. We value and appreciate ALL your donations, large and small and everything in between.Donate
Join the exciting new 2.6 Challenge!
Sunday 26 April was the scheduled date for the 2020 Virgin Money London Marathon. Because of coronavirus, there will be no runners tackling the 26 mile course to raise money for charities like ours. In response, Save the UK’s Charities have created this new challenge. All you need to do is think of an activity based around the numbers 26 or 2.6 and complete it on or from Sunday 26 April. This could be a pledge to run or walk 2.6 miles as your daily exercise, do 26 minutes of Tai Chi or yoga, hold a handstand or use a skipping rope for 2.6 minutes.
You can find more ideas on challenges and set up your page at https://www.twopointsixchallenge.co.uk/. You can then ask your family and friends to sponsor you and donate to the NES. Don’t forget to share pictures of your challenge on social media using #TwoPointSixChallenge and don’t forget to tag us too!
Donate when you shop online
As more of us are shopping online you can also donate to us if you regularly shop with Amazon by using smile.amazon.co.uk. This Amazon-operated website offers the same products, prices and shopping features but Amazon donates 0.5% of the net purchase price to National Eczema Society from eligible purchases, at no cost to you. Simply log in to smile.amazon.co.uk, go to ‘charities’ and select ‘National Eczema Society’. Don’t forget to log into the Smile account each time you shop.
You can also donate through other shopping websites, like The Giving Machine.
Fundraise at home!
Become a virtual fundraiser and challenge yourself and your family at home! As fundraising events are being cancelled, you might instead want to set up your own fundraising activity at home. This might be a cooking session with your kids, a treasure hunt in your garden, a mini-fashion show or an educational project to keep them active and occupied. Or you might want to take on an art or craft project and share what you create on social media. Whatever you do remember to ask you friends and family to sponsor you and share images or video of what you do with us through social media.
We greatly appreciate your support and we welcome all donations, no matter how small, that can help us continue to support people with eczema and their families across the country.
If you’re struggling with your eczema and need a GP appointment, remember that GP practices are providing telephone and video consultations at this time. The video below from the NHS explains how to contact your GP practice for advice.
The COVID-19 NICE guidance says that dermatology departments should ‘optimise the use of teledermatology, such as telephone and video consultations’. If your dermatology appointment has been cancelled due to the crisis, try to find out whether a telephone or video consultation would be possible instead.
We’ve put together some tips to keep your mind and body active and well in the coming weeks. If you have any other tips or suggestions, we’d love to hear them – please contact us at email@example.com.
Keep up a good eczema management regime
It’s important to make sure you’re managing eczema as effectively as you can at home. Now is the perfect time to revisit the basics of eczema care:
- Apply emollient (medical moisturiser) at least twice a day, and every few hours if the skin is very dry. With clean hands, apply a thin and even layer downwards in the direction the hair grows, to avoid blocking the hair follicles, and smooth it gently into the skin, allowing it to soak in.
- If the emollient comes in a tub rather than a pump dispenser, it should be decanted using a clean spoon before each application in order to avoid cross-contamination with bacteria.
- Don’t spend too long in the bath/shower (15 mins maximum, ideally) and use warm rather than hot water. Long baths and showers make the skin more fragile, making subsequent scratching likely to cause greater damage. Wash your face and body using your leave-on emollient or an emollient soap substitute rather than soap or shower gel. However, we recommend that people follow the Government’s advice at this time where hand-washing is concerned, and wash hands with soap and water.
- Keep your fingernails short to minimise scratching damage.
- If you or someone in your household has a skin infection, avoid sharing towels, bedding or clothing until the infection has cleared.
- We have information on different treatments and how to use them on our Treatments pages. If you have any questions, please email us at firstname.lastname@example.org or call us on 0800 089 1122. Remember that GPs are offering phone and video appointments, so if you need advice from a GP, please contact your GP practice.
Exercise is known to reduce stress and improve mood. Unless you’re self-isolating or shielding and don’t have a garden, it’s a good idea to go outside for exercise where possible, for a change of scene and some fresh air. Here are some tips for eczema-friendly exercising outside and/or indoors:
- There are plenty of free yoga/pilates/HIIT/general fitness videos on YouTube for all ages, and fitness and ability levels. Just search (for example) for ‘yoga videos’ and see which take your fancy. Check out the NHS Fitness Studio videos too.
- Gardening and housework can also count as exercise! Now is the perfect time of year for a spot of gardening (if you have a garden) or spring cleaning. How about doing a thorough hoover of all the soft furnishings, reducing the house dust mite population? Housework is more fun if you listen to your favourite tunes while doing it.
- If sweatiness and getting itchy are a problem, use cold gel or ice packs to keep you cool while you exercise. A pure water spray on your skin or clothes would also limit your need to sweat while exercising.
- If you’re working out on a treadmill or exercise bike, you might find it helps to use a fan to blow over you as you exercise. Air conditioning isn’t great for people with eczema, as it’s drying.
- If you’re doing exercise that involves grip – or mat-based exercises – make sure not to get too much emollient on your palms before exercising, or you might slip.
- If you’ve worked up a sweat, have a shower as soon as possible after exercising, and re-apply your emollient after gently patting yourself dry with a soft towel.
Be entertained and relax
There are lots of ways to keep yourself entertained: reading books, listening to audiobooks, watching films and TV series, taking up a neglected craft project, starting a new craft project, trying out new recipes.
Have a look at the websites of your favourite theatres or museums to see whether they are holding any virtual events. The National Theatre and Sadlers Wells, for example, are making some of their past productions available to watch for free. The British Museum has an interactive website and the Vatican Museum allows you to take 360° tours of some of its galleries.
If you’re feeling stressed, you might find guided visualisations or ASMR videos helpful. You can search for examples of these on YouTube.
If you have a birthday coming up and can’t celebrate it in the usual way, how about making it special by holding a Facebook birthday fundraiser for National Eczema Society?
Connect with others
Keeping in touch with family and friends with phone and video calls can help your emotional wellbeing. One-to-one calls are easy using a mobile, but you can get groups together using apps such as Skype, Zoom, Google Hangouts or Houseparty. If someone in your family or group of friends already uses one of these, ask them to help you set it up.
If you enjoy writing letters, search online for ‘coronavirus penpals’ and you’ll find the details of several care homes which are asking members of the public to write to care home residents.
Getting a good night’s sleep can be challenging for people with eczema at the best of times. If you’re feeling stressed it can be even more difficult. Here are some sleep tips:
- Try to stick to regular bedtime and waking times.
- Don’t exercise too close to bedtime.
- Keep naps under an hour and avoid napping after 3pm.
- Avoid checking the news or social media in the evening if you know it makes you anxious.
- Wind down an hour before bed by listening to a gentle audiobook or music, trying relaxation exercises or having a bath.
- Use emollients and other treatments well enough in advance of bedtime to allow them to soak in and not overheat your skin (especially if you’re using a thick ointment).
- Try mindful bedtime breathing. This exercise is a good one to help you unwind when you’re lying awake at night with thoughts racing through your head: As you lie in bed, simply acknowledge the sensation of your body against the sheets and duvet and your head against the pillow. Turn your awareness to your breath in and out but do not try to change the rhythm of your breathing. (If you like, you can place your hands on your abdomen and feel the movement of the breath.) Continue to focus on your breathing. If your thoughts wander from your breath, simply acknowledge the fact that this is natural – the mind has a tendency to wander! – and gently bring your attention back to your breath flowing in and out of your body.
- You might find guided sleep meditations helpful. Search for ‘guided sleep meditation’ on YouTube and have a scroll – there are plenty to choose from!
Last updated 19.05
We appreciate that this is a difficult and confusing time for everyone, and we aim to support you through it as best we can. As COVID-19 is a new condition, there is much about it that is unknown. Please check back frequently as we will update this page as new information that may be relevant to people with eczema comes to light. For more general information on coronavirus/COVID-19, please see the NHS website.
What should I use for washing my hands?
The Government advice is to wash hands with soap and water more often and more thoroughly than usual to remove the virus if present. However, frequent washing of hands with soap can cause problems for people with eczema, including dry skin and hand eczema.
The purpose of handwashing is to remove virus particles and bacteria by washing with water. Using soap or emollient while washing hands can help remove any dirt or flaking skin that might harbour virus particles and generally aid the cleansing process.
On 25 March 2020, the dermatologist professional body (British Association of Dermatologists) said that washing hands with emollients may not be as effective as using soap for removing the virus. This is because virus particles could be left on the skin within the residual emollient that has not been washed away.
With this latest health advice, National Eczema Society is now recommending people with eczema follow the Government guidance to wash hands with soap and water, rather than an emollient soap substitute, as much as practically possible. It is very important people find ways of managing dry skin and hand eczema that may be caused or worsened by frequent washing with soap.
Strategies for this include:
- After washing hands with soap and water, re-wash using emollient to help protect the skin.
- Use emollients to moisturise the hands after washing and at other times during the day when the skin feels dry and sore.
- Dry hands well after washing by gently patting them dry, not rubbing.
- Rehydrate sore dry hands overnight, using an ointment and wearing clean cotton gloves.
- Wear nitrile gloves if you need to handle detergents or other cleaning products that can irritate the skin. These provide a physical barrier for the skin and can be purchased from chemists or from online shops.
- If you develop more severe hand eczema or suspect your skin is infected, you should contact your GP and may need prescription medicine to reduce the inflammation.
If you feel you need to use sanitising gel (which may irritate your eczema), apply your usual emollient afterwards to minimise any irritant effect. There is no eczema-friendly hand sanitiser, as they all contain alcohol, which dries out the skin.
In public places where you can’t avoid touching surfaces, try not to touch your nose, eyes or mouth (or your child’s) because the virus gets in through mucous membranes.
Which types of face coverings are the most eczema-friendly?
Face coverings made from 100% cotton that can be washed regularly are probably the most eczema-friendly type of covering. Cloth ear loops are less likely to irritate the skin than elastic ones. Also consider coverings that tie around the back of the head. ‘Mask headbands’ or hats with buttons are another option. With these, the elastic loops around the buttons rather than your ears. ‘Neck gaiters’, ‘buffs’ or ‘tube scarfs’, which are basically a tube of material, might suit too – if 100% cotton.
Make sure the covering fits snugly around your nose and mouth but isn’t tight.
Avoid applying ointment emollients to the face shortly before you put on a covering, as they might make the face too hot.
- Etsy has lots of different types of face coverings for sale. Search for the type you’re interested in.
- ‘Handybands’ from Seasalt have been recommended to us by a Facebook follower.
- There are lots of guides and video tutorials showing you how to make different types of face covering, for example: BBC, YouTube.
If you have eczema or a family member with eczema, and have suggestions for eczema-friendly face coverings, we’d love to hear them.
Am I more likely to develop COVID-19 as a result of having eczema?
There is no evidence to suggest that people with eczema are more likely to develop COVID-19 or to experience a more severe form of the condition if they do develop it.
If I have open cracks or splits in my skin, am I more likely to pick up COVID-19?
We don’t know for certain at the moment whether this is or is not the case. However, because coronavirus seems to be spread through respiratory droplets from the coughs and sneezes of an infected person that land in the mouths, noses and airways of people nearby, it seems to be unlikely that a damaged skin barrier would increase the risk of developing COVID-19.
I am taking an immunosuppressant drug/biologic drug/oral steroid – should I stop taking it?
It is important that you ONLY discontinue medication on advice from your dermatologist.
I am taking an immunosuppressant drug/biologic drug/oral steroid – should I ‘shield’?
This depends on several factors, including the medication you are on and whether you have any other significant medical problem.
The British Association of Dermatologists has produced a helpful grid, which categorises people’s levels of risk and whether they should shield (i.e. stay at home at all times for 12 weeks) based on the medication they are taking and other factors. It applies to both adults and children.
Guy’s and St Thomas Hospital has produced FAQ on coronavirus and eczema, which explains in detail the difference between shielding and very careful social distancing, and provides a self-assessment risk calculator.
On 9 April 2020, the National Institute for Health and Care Excellence (NICE) published guidance for dermatological conditions, including eczema, where people are being treated with drugs affecting the immune response.
How can I cope with the stress caused by this situation, which is making my eczema worse?
Some of the ways we normally relieve stress and anxiety (e.g. exercise classes, meeting friends, going for long countryside walks) may not be possible at the moment, unfortunately.
You might find it helpful to do relaxation exercises and mindfulness exercises. The article on managing stress from our magazine Exchange on our Living with eczema page gives examples of relaxation and mindfulness exercises (pages 2 and 3). There are also plenty of guided visualisations available for free on YouTube, which are designed to help relieve anxiety and help you get to sleep, plus online yoga and fitness classes.
Try to keep up a good eczema management regime. Make sure you apply emollient liberally and frequently (at least twice a day, and every few hours when the skin is very dry), and use your other treatments as recommended by your healthcare professional. For more information on managing eczema, please see our booklets and factsheets. You can also contact us through our Helpline.
We have more tips on staying at home and managing eczema here.
People living in Scotland
The Scottish Government has produced guidance on COVID-19 and dermatological conditions (not cancerous) for people living in Scotland.