Exercise and Eczema

We know that physical activity is among the most crucial components in maintaining optimal health. But for an individual with a chronic skin condition, exercise may become more of a barrier to health than an avenue. Atopic dermatitis (AD), otherwise known as eczema, is one of the most common skin conditions and can often deter an individual from engaging in regular exercise. It has been determined that individuals suffering from AD commonly report that heat, sweat, and exercise exacerbate their skin symptoms.^[1] The most common of these symptoms is an itch, and any exacerbation of AD can lead to a perpetual cycle of itch and scratch, worsening the rash’s condition.

Researchers have sought to determine whether or not individuals with AD actually engage in less exercise overall than healthy individuals not affected by the skin condition. A Swedish study found the results of an exercise behavior questionnaire indicated that adults affected by AD were as active in moderate exercise as compared to a group without the skin condition.^[2] These results surprised the researchers, as they expected the group with AD to engage in less physical activity. 

Conversely, another study assessing the level of vigorous exercise and sports participation among children with AD found that these children are less likely to engage in vigorous exercise or participate in sports.^[3] These results show that children with AD may lead more sedentary lifestyles, which can affect their growth and development. 

Other studies are uncovering the specific variables in the relationship between eczema and exercise. An animal model study assessed whether high-intensity swimming exercises (HISE) affect mice with AD. The researchers engaged the AD mice in 4 weeks of HISE and measured four indicators of inflammation: skin thickness, mast cell infiltration, serum immunoglobulin E (IgE), and histamine levels.^[4] After 4 weeks, the researchers found that HISE did, in fact, increase inflammation in these mice- worsening their AD. Researchers of the study suggest that the increased stress from vigorous exercise might have led to the increased inflammation.^[4] The effects of water on the skin and hydration status may also play a role and more research is needed to try and eliminate external variables, to better elucidate the effects of exercise alone on AD severity. 

One systematic review attempted to assess the relationship of vigorous physical activity among individuals with AD, but found varying results. The studies reviewed had outcomes that drew positive associations, negative associations, and no association at all between vigorous physical activity and eczema. One factor that likely led to the variability in findings was that the definition of physical activity was inconsistent. No overall conclusion could be made by the systematic review.^[5] 

Overall, the research into the correlation between AD and exercise has been varied, and sometimes conflicting. As some studies have already concluded, more research on this topic is warranted.^[5] What is evident is that there exist numerous and wide benefits from regular physical activity for individuals of all ages, despite the presence of AD. These benefits include improved fitness, reduced body fat percentage, improved cardiovascular health, protection against neurodegenerative and cardiovascular diseases, protection against aging and many other reasons. Because of the importance of exercise for overall health, those with AD likely still benefit from regular physical activity, despite the potential for rash flare-ups. Sometimes, the benefits really do outweigh the risks. 

1.    Silverberg JI, Song J, Pinto D, et al. Atopic Dermatitis Is Associated with Less Physical Activity in US Adults. J Invest Dermatol. 2016;136(8):1714-1716.

2.    Lonne-Rahm SB, Sundstrom I, Nordlind K, Engstrom LM. Adult atopic dermatitis patients and physical exercise: a Swedish questionnaire study. Acta Derm. Venereol. 2014;94(2):185-187.

3.    Strom MA, Silverberg JI. Associations of Physical Activity and Sedentary Behavior with Atopic Disease in United States Children. J Pediatr. 2016;174:247-253.e243.

4.    Kim SH, Kim EK, Choi EJ. High-intensity swimming exercise increases dust mite extract and 1-chloro-2,4-dinitrobenzene-derived atopic dermatitis in BALB/c mice. Inflammation. 2014;37(4):1179-1185.

5.    Kim A, Silverberg JI. A systematic review of vigorous physical activity in eczema. Br. J. Dermatol. 2016;174(3):660-662.

6.    Parikh T, Stratton G. Influence of intensity of physical activity on adiposity and cardiorespiratory fitness in 5-18 year olds. Sports Med. 2011;41(6):477-488.

7.    Dougherty RJ, Ellingson LD, Schultz SA, et al. Meeting physical activity recommendations may be protective against temporal lobe atrophy in older adults at risk for Alzheimer's disease. Alzheimers Dement (Amst). 2016;4:14-17.

8.    Sallam N, Laher I. Exercise Modulates Oxidative Stress and Inflammation in Aging and Cardiovascular Diseases. Oxid Med Cell Longev. 2016;2016:7239639.