Eczema and depression: The 4 Cs of taking control

So the news broke this week that if you have asthma, eczema or hay-fever you are more likely to suffer from depressive illness than those who are less itchy, wheezy or sneezy. Well, hold the phone! Big news to everyone other than people who suffer from asthma, eczema or hayfever. An understanding of the skin-mind connection has been growing steadily over the last few years and thankfully is now becoming increasingly recognised by a small, but growing, proportion of medical professionals. Read more here about the background to this.

An analysis of over 200,000 people has led to the hypothesis that the inflammation in the body set off by allergic reaction could be contributing to an increased likelihood of psychiatric illness. But, and here’s the biggy, the simple stress of coping with the allergic reaction may also go some way to explaining the link.

Last month I spoke about the cycle of negative states that we can find ourselves locked into – spinning and spiralling out of control. And the itch-scratch-itch cycle is only the half of it. When we scratch we feel like a failure, when we damage our skin we look horrendous and feel full of self-loathing, when we look horrendous we feel shame and we hide away, when we hide away we feel lonely, isolated and depressed. Then we feel stressed, then we itch, then we scratch. Then we begin all over again.

Breaking the cycle of negative states is essential if we are to heal our skin and our minds.

So we need to try and somehow break this negative, devastating and damaging cycle. I wrote a little bit about this last month in how I stopped scratching my eczema and started to take care of myself. But, it really got me thinking about the chain of events that inevitably leads to this endless cycle of negative physical and emotional states and how to break it once with self-care and compassion at the heart of it all.

And that’s when it hit me. The four Cs of taking control of your eczema:

Care → Compliance → Confidence → Control


Let’s take this one first because it’s at the heart of everything. You’ve got to have enough self-worth to want to care for you and for your skin. This leads on from how I stopped scratching my eczema and started to take care of myself

Self-care and self acceptance. So the first thing you need to do is give yourself a bit of a talking to. It’s important to accept that your eczema is an incurable skin condition. At its most powerful it CAN stop you going about your daily business, you might not be able to bend your fingers or your knees. You are different and you do need to take care of yourself. There are no miracle cures, no miracle creams, potions or elixirs no matter what you read in the papers or online. The boring truth is this. It is a commitment and the sooner you get used to that the better. You have to feed, nourish, care for – and above all – love your skin and train yourself not to damage it.


The importance of having a good skin care routine cannot be underestimated. It can help to eliminate the allergens that collect on the skin through the course of the day and help to protect your compromised skin barrier. Take a look at my advice on creating and actually complying with a skin care routine that will protect and strengthen your weakened skin here.


Having the confidence to face the world when you really don’t want to can have an incredible impact on the way you manage your eczema. Sometimes hiding away seems like the kindest thing you can do for yourself on those truly awful eczema days, but if your eczema is not physically preventing you from participating in life (and believe me I do know that there are days when it really is not possible) then it is actually doing you more harm than good. The isolation and withdrawal that you experience only contributes to those truly awful negative states. Isolation means more scratching and more negative thoughts. Read my 10 ways to take on the world with a face full of eczema

You probably haven’t realised just how much your eczema has cost you in the past – but it doesn’t have to be that way.  Take a look at Your eczema might be costing you more than you think. 


Only when you have decided that you are worth looking after will you start the journey along the road to taking back control.

Two dermatologists from the US, Dr Richard Fried and Dr Fran Cook-Bolden have looked closely at the ‘skin-mind’ connection in the treatment of eczema, psoriasis, and other common skin disorders. They have evidence that,

“many patients with skin diseases such as psoriasis, acne, or eczema, actually get worse when they are stressed, when they are under times of depression or anxiety.”

Not surprising to any of us who have had the inevitable flare-ups around exam time, interviews, wedding days! But, while the gradual withdrawal from public life might seem like the most comfortable option, the isolation that we feel  can contribute significantly to longer term depression.

“This self-perpetuating negative interaction between stress and impaired skin function and often underlies the so-called ‘vicious cycle’ that exists between skin and negative emotional states,” says Dr Fried.

According to Dr Fried, the patients who make improvements under his care are able to look back and see how their response to the way they looked affected their lives. “Only after patients are improved do they look back and realize how much their psoriasis, eczema, or rosacea has robbed them of their interaction with life,” says Dr Fried.

I know it takes a huge amount of effort to get out there during an eczema flare-up – but every time you win that battle you confirm to yourself that it can be done. You don’t have to ‘rob yourself’ of anything.  Unless your eczema is physically preventing you from interaction with life – then you have an opportunity to break that negative cycle. To get out and enjoy yourself,  to crush the bad habits of feeling anxious about the way your skin looks to others.

With care, compliance and confidence you can make a start on finally taking back control and stopping the cycle of negative states dead in its tracks.

Of course, all of this comes with a VERY big caveat. If you are suffering from any depressive illness you must visit a medical professional and get to the root cause. 

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