Atopic Dermatitis and Physical Activity

Physical activity and exercise are great habits to promote overall health, but patients with atopic dermatitis might experience flares triggered by sweat and heat.1,2 How do we exercise safely with AD?

Health benefits of exercise go beyond looking good.

People with atopic dermatitis are not getting enough exercise, and are more likely to be overweight.3,4 This can be a problematic because being overweight or obese not only increases the risk for atopic dermatitis,5 it also increases the likelihood of developing other health conditions like heart disease, high blood pressure and diabetes.3,4 That is why maintaining a healthy body weight is recommended.5

Exercise can also potentially help individuals with atopic dermatitis by modulating their immune system.6,7 Aerobic exercise has already been proven to improve atopic dermatitis, with some indications that it might do so via changes on the inflammatory immune responses in the skin.6 Regular exercise over a long period seems to bring more immune benefits compared to short bouts of high intensity activity.7

In addition, exercise can also have positive mental health benefits, as it can release endorphins that make you feel good, and may help you get a better night’s sleep.1,2  It also can be used as a tool to reduce stress and improve mood, which in turn can benefit the skin.2

How can exercise trigger flares?

Sweat and heat are two of the most commonly reported triggers for flares.8 We sweat in order to regulate our body temperature, which tends to rise when performing physical activities.1,2 As sweat evaporates, it cools the skin and prevents overheating.2

However, excessive sweating causes skin dryness by drawing fluids out, and dry skin can lead to itching.1,2 In addition, sweat contains salts, which forms deposits on the skin’s surface as the water evaporates, and may irritate sensitive skin.1,2

There is also the potential for skin irritants and trigger allergens in typical exercise locations.1,2 When exercising outdoors, you can be exposed to pollen, dust, animal dander and UV radiation.1,2 Meanwhile, indoor gyms can have germs, dried sweat, and other substances from other people on equipment and other surfaces.1,2 Swimming pool water can contain chlorine and other chemicals, while beaches and lakes can harbor germs and other pollutants.9

What can we do to avoid flares during exercise?

Physical activity can lead to flares, but this is not inevitable.1,2 With planning and preparation, and by following some simple tips, you can exercise safely.1,2

  • Choose the right kind of exercise.

If running or spin class is causing flares, explore other options.1,2 There are many lower intensity or lower impact aerobic exercises like yoga, pilates or tai chi.2 Weight training might be a good option, as you can take breaks in between sets, avoiding too much overheating.1 You might also want to consider swimming, a great activity for keeping cool while staying in shape.9

  • Identify an appropriate workout venue.

If you want to go to a fitness club, look for one that is clean, roomy and well-ventilated with shower facilities.1 Just remember to bring your own toiletries and towels.1 Home workouts have the advantage of allowing you a lot of control over ambient temperature, and easy access to medication and fresh clothes.1 If you like the great outdoors, choose a cool time of the day, like early morning or evening, and remember to use sunscreen!1

  • Think about what you are going to wear.

Generally speaking, tight workout gear made of synthetic fabrics are a bad idea.1,2,10 Natural fabrics like cotton, silk, and bamboo are less irritating for sensitive skin; while loose clothing keeps you cool for longer, and won’t trap sweat as much. 1,2,10 Make sure to have a clean towel handy as well, to gently dab sweat off as it forms.1,2

  • Pay attention to hydration and moisturization.

Keeping cool means staying hydrated, so make sure that you drink plenty of water before, during, and after exercise.1,2 This also helps maintain skin moisture and replaces fluids and electrolytes lost through sweat.1,2 Maintain skin moisture by applying moisturizing cream or lighter application of ointment about an hour prior to physical activity to allow for absorption.1,2,

  • Post exercise plan.

Take a shower immediately after you cool down to wash off sweat, dirt, and/or pool water.1,2,9 Resist the temptation to take a hot shower or soak. The heat might feel good for sore muscles, but it will tend to cause more skin irritation.2 Start with a warm or lukewarm shower, then gradually let the water cool down as you continue to wash.2 Bring your own cleansers and toiletries, and remember to moisturize your skin thoroughly after you dry off.

What do I do when I get a flare during physical activity?

Don’t panic. Slow down at the first sign of a flare, no matter how mild.1,2 Safely reduce the intensity of your activity to allow your body the chance to cool down.2 Wash off your sweat with a clean towel or water. 2 You might also use a cold compression wrap or cooling towel. 2

If your symptoms calm down, then you can continue at this new lower level of exertion.1,2 However, if the symptoms persist or start to escalate, gradually come to a stop and prepare to manage your flare.2 Don’t worry about your exercise for that day, you can let your skin calm down and try again tomorrow.2 

Don’t be discouraged. Exercise can seem like a big stumbling block, but oftentimes all you need to do is let your body slowly get used to physical activity.2 With a little bit of planning and preparation, you can successfully incorporate healthy exercise into living life with atopic dermatitis.1,2

References:

  1. National Eczema Association. (2018, updated 2021). “How to exercise safely with eczema”. https://nationaleczema.org/exercising-eczema/ (Accessed October 28, 2021)
  2. Fuller J. (2014, updated 2021). “Eczema and exercise”. National Eczema Association. https://nationaleczema.org/eczema-exercise/ (Accessed October 28, 2021)
  3. Andersen Y.M.F., Egeberg, A., Skov, L. & Thyssen, J.P. (2017). Comorbidities of atopic dermatitis: beyond rhinitis and asthma. Curr Dermatol Rep, 6(1), 35-41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556128/
  4. Ghamrawi R.I., Ghaim, N. & Wu, J.J. (2020). “Atopic dermatitis: a review of common comorbidities”. Practical Dermatology. https://practicaldermatology.com/articles/2020-sept/atopic-dermatitis-a-review-of-common-comorbidities (Accessed October 26, 2021)
  5. Physicians Committee for Responsible Medicine (2020). “PCRM’s Nutrition Guide for Clinicians: Atopic Dermatitis”, https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342028/all/Atopic_Dermatitis (Accessed October 28, 2020).
  6. Son,W.K., Yoon, W., Kim, S., et al. (2020). Can moderate-intensity exercise ameliorate atopic dermatitis? Exp Dermatol, 29(8), 699-702. https://onlinelibrary.wiley.com/doi/10.1111/exd.14138
  7. Yiannakopoulou E. (2018). Immunomodulatory effect of physical exercise: from immunosuppression to immune protection. Virology Immunol J, 2(3), editorial.  https://www.medwinpublishers.com/VIJ/VIJ16000148.pdf
  8. Silverberg, J.I., Lei, D., Yousaf, M., et al. (2020). Association of itch triggers with atopic dermatitis severity and course in adults. Ann Allergy Asthma Immunol, 125(5), 552-559.e2.https://pubmed.ncbi.nlm.nih.gov/32544530/
  9. National Eczema Society. “Swimming and eczema”. https://eczema.org/information-and-advice/triggers-for-eczema/swimming-and-eczema/ (Accessed October 28, 2020).
  10. National Eczema Society. “Clothing and eczema”. https://eczema.org/information-and-advice/triggers-for-eczema/clothing-and-eczema/ (Accessed October 28, 2020).

MAT-MY-2101515 (12/2021)

Health information contained herein is provided for general educational purposes only. Your healthcare professional is the single best source of information regarding your health. Please consult your healthcare professional if you have any questions about your health or treatment.