Keeping a Positive Body Image

Gabby Bachner, a pharmacy student at the University of Georgia in Athens, discovered she suffered from eczema shortly after entering college. The specific type she has, called contact dermatitis, occurs when her body touches something that causes an allergic reaction. Bachner, who works in a drugstore, discovered that his scrubs and certain lotions had triggered his eczema flare-ups.

Eczema can cause a number of unpleasant symptoms, including:

  • Itchy, dry, cracked, scaly, or bumpy skin
  • Blisters
  • Swelling
  • Rashes

These changes can also have an emotional and mental impact. Bachner says his eczema flare-ups definitely affect his self-confidence.

Eczema and mental health

Your skin is your largest organ, so appearance issues can take a psychological toll.

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

People with eczema are more likely to experience depression and anxiety than those who do not. The chances 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.

Eczema can affect your mental health in three main ways:

  • Chronic itching. Eczema is often itchy that you can’t control. When you’re in public, it can be difficult to hide your scratches. It could lead to stress, anxiety, and worry about what other people are thinking.
  • Inflammation. Chronic conditions like eczema result from inflammation. Jhaveri says it can zap your energy levels and prevent you from focusing.
  • Symptoms visible. Eczema often affects places that are difficult to cover, such as the face, eyes, hands, or limbs. These areas can become swollen, scaly, cracked, or bloody, which could affect your self-image.

Bachner says vacations with eczema have never been stress-free. Before a trip, she often received a pedicure. The lotions used during the treatment caused flare-ups of eczema on her legs. And since many eczema therapies don’t work right away, she couldn’t get the outbreak under control before she left. It made it difficult to trust a swimsuit. She was afraid people would mistake her condition for an infection.

The combination of lower self-confidence, itching, and fatigue can make it difficult for others to be around during a relapse. People with eczema often need a comfortable and private environment. You may need to stay home and take care of your skin.

“It leads to a lot of missed work, missed school and sometimes people choose not to participate in social interactions,” Jhaveri says. “Eczema can also have an impact on privacy. … If it impacts the face or private parts, it can impact relationships. “

How to feel more confident

When Jhaveri treats someone with eczema, she also uses anxiety and depression rating scales to assess the impact of their skin condition on their mental health.

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

The path to building confidence is slightly different for children and for adults. Parents can do some things to strengthen their child’s self-image:

  • Learn about their peers. It is important for parents of a child with eczema to ask questions about their school and social life. If you think your child’s peers are bullying him because of his condition, fix it as soon as possible.
  • Work on sleep. You and your child’s doctor can help resolve your child’s eczema sleep problems. They may suggest that your child take melatonin supplements or use anti-itch medications to help them sleep at night. Good sleep is directly linked to a child’s self-image. With more sleep, they will 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 affecting your confidence, talk to a therapist or psychiatrist. They can help you regain confidence and provide advice 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 building confidence.
  • Talk to your family. If you are comfortable doing so, it may be helpful to tell your immediate family how eczema is affecting you emotionally. This way, you will have someone to talk to or to lean on when your self-image is not at its peak.
  • Practice mindful meditation. Stress relief can play a big role in your body image and your confidence. Jhaveri suggests meditation or another relaxation technique, such as yoga, tai chi, or music therapy. All of these things can help you reconnect with your inner self, she says. It can help you see the impact eczema has on your self-image.
  • Write a. Jhaveri says it can be helpful to write a story or journal about how your skin condition affects you. Sharing it with someone you are close to can help release bottled up emotions and can help you come to terms with your feelings.
  • Take a step back. Bachner says one of the best things she does to regain her confidence is to think logically. It’s easy to feel that everyone is focused on your eczema, she says. But most people won’t even notice your flares unless you report them. It’s important to remember that self-confidence comes from self-acceptance. “It’s not your fault if you have eczema,” says Bachner. “Try not to get stuck. … People don’t care what you think they are.



Gabby Bachner, Cumming, Georgia.

Mayo Clinic: “Atopic dermatitis (eczema)”, “Contact dermatitis”.

National health service: “Atopic eczema”.

American Psychological Association: “The Connection Between Skin and Psychology.”

American Academy of Allergy: “Adults with atopic eczema at risk for anxiety and depression.”

Mamta Jhaveri, MD, MS, assistant professor of dermatology, Johns Hopkins University, Baltimore.

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