Have you wondered if you’ll be able to get your eczema flare-ups under control? Jordan Younger, also known as the Balanced Blonde, has tried many different approaches to managing her eczema. Now she’s stepped up with some questions for Dr. Morgan Rabach, a board-certified dermatologist, on the best ways to manage the condition with lifestyle changes.

This Q&A session covers the basics of how stress affects eczema, why sunshine really does reduce symptoms, and whether food allergies trigger flare-ups.

1. How does stress affect eczema? Are there any relaxing or stress-reducing practices you recommend?

Stress can cause eczema to flare. When we experience stress, our bodies go into fight-or-flight mode and respond by increasing production of stress hormones like adrenaline and cortisol. These stress-induced hormones then suppress the immune system and cause an inflammatory response in the skin.

Yoga, meditation, lots of sleep, and exercise are helpful ways to reduce stress.

2. How do you think different foods affect eczema? Are there any dietary approaches you recommend?

There isn’t enough evidence to support food as a cause of eczema. However, if you have proven food allergies, they will make your eczema worse. If you notice your eczema flaring or itching around your mouth after eating certain foods, I would recommend eliminating those foods from your diet.

3. How does sunlight affect eczema? How do I balance getting some sunshine (and vitamin D) with protecting my skin?

Sunlight helps eczema by boosting your immune system and by making vitamin D. Spending about 20 to 30 minutes in the sun each day would be beneficial in managing eczema. In addition, I would recommend using an SPF 30 sunscreen every day.

Sunlight is helpful for eczema because UV light activates specialized immune cells, called regulatory T cells. These act to reduce the inflammatory immune response that causes eczema.

The production of vitamin D in the skin also causes the release of a family of antimicrobial proteins known as cathelicidins. Cathelicidins help reduce bacteria that are often present in greater numbers on eczematous skin. This leads to reduced inflammation and rash.

4. I’ve heard that probiotic creams may someday be helpful for eczema. Do you have any thoughts about that? What about taking probiotic supplements?

We only have initial data suggesting that probiotic creams may help eczema, but the National Institutes of Health have described this research as “promising.” Long-term studies may yield exciting results.

Probiotic supplements do help some people with eczema, and are safe and easy to take.

5. Can laundry detergents and perfumes trigger eczema symptoms?

Yes. Laundry detergents are a huge trigger for eczema. It’s helpful to buy laundry detergents that are fragrance- and dye-free, like All Free Clear or Tide Clear.

Perfumes contain allergenic compounds, and people with eczema should avoid them. I suggest people who like to use perfume spray it on their clothing rather than on their skin.

6. Are there any herbal supplements or vitamins that you recommend for eczema? How about natural topical remedies? Is it common for people to try these approaches?

I don’t recommend natural or organic topical remedies because often these products contain herbal and botanical products that are highly allergenic. The best products are fragrance- and dye-free, and made for people with eczema.

There are no vitamins or herbal supplements that have proven beneficial for people with eczema.

7. Are there any mental wellness concerns that commonly come up with eczema? For example, do you find people are self-conscious or anxious about their skin or appearance?

People with eczema and other skin conditions that are visible to others can be stressed by this. Chronic itching is also mentally challenging. I like to talk to the people I treat about strategies for dealing with these concerns. Eczema support groups and stress management techniques like yoga and meditation are helpful.

8. For those of us who live with chronic illnesses and autoimmune conditions that trigger our eczema and other skin issues, what do you recommend for chronic illness-related flare-ups?

Everyone with eczema needs a consistent skin care routine that includes soaps and products that are healthy for their skin. For flare-ups, see your dermatologist right away to get your eczema under control.

In general, there is no clinical relationship between chronic illness and eczema. However, there is a relationship between eczema and certain autoimmune conditions.

Primary immunodeficiency diseases are characterized by abnormalities in specific components of the immune system. These abnormalities can cause increased susceptibility to infection. People with primary immune deficiency are at a higher risk of having eczema.

People with asthma and seasonal allergies may also be more susceptible to having eczema.

9. Is it possible for chronic eczema to heal deeply enough to completely go away or into ‘remission’ forever?

We see children “grow out” of their eczema all the time. In adults with chronic eczema, flares can be almost completely controlled with a tailored skin care routine that they work on with their dermatologist.

Some people may also need medication to prevent flare-ups. However, even if a person needs medication to get their eczema under control, it’s possible that they may at some point be able to reduce or stop taking medication, and remain symptom free.

Dr. Morgan Rabach is a board-certified dermatologist with expertise in cosmetic procedures such as neuromodulators (Botox and Dysport), dermal fillers (Juvéderm, Restylane, Radiesse, and Sculptra), and the full spectrum of medical dermatology. In addition to her private practice, she is assistant professor in the Department of Dermatology at Mount Sinai Hospital. After graduating from Brown University with honors in biology, Dr. Rabach earned her medical degree from New York University School of Medicine. She completed her medical internship at Yale New Haven Hospital and her dermatology residency at SUNY Downstate Medical Center where she served as chief resident. Dr. Rabach’s practice encompasses medical, surgical, and cosmetic dermatology, and she tailors her treatments to the individual needs of each patient.