How to Feel More Confident When Atopic Dermatitis Flares Up

Scientists should really study how our skin seems to know the worst times to act up: a sudden breakout the morning of a first date, a stress rash the week of a big work presentation, or, for those with eczema, an itchy, flaky flare-up exactly when you need it least. For baddies with chronic skin conditions like atopic dermatitis, life can feel like it stops when symptoms show up, making hiding from the world feel preferable to covering hot spots or dealing with itching on the go.

But atopic dermatitis flare-ups don’t have to control your life. In fact, there are plenty of physical and emotional tactics to help you keep your head high and your life on track when flare-ups start. Ahead, skin care experts talk all things confidence and atopic dermatitis, from the best ways to manage skin symptoms to how to preserve your peace through every phase of a flare.

Understanding Your Atopic Dermatitis

“Also known as eczema, atopic dermatitis is a chronic inflammatory skin condition characterized by red, scaly, itchy, and dry patches,” explains board-certified dermatologist Dr. Marisa Garshick. “It occurs as a result of a compromised skin barrier, which makes it harder for the skin to retain moisture and protect itself from irritants and allergens.” While eczema can often feel like a taboo topic, the condition is incredibly common. According to the National Eczema Association, a whopping 31.6 million people worldwide struggle with atopic dermatitis — about 10% of the population. So, the first thing to remember when it comes to inconvenient flare-ups is that you’re far from alone.

“People can get eczema as a baby, in their 20s, in their 80s, and sometimes not at all depending on the expression of their genes,” explains board-certified dermatologist Dr. Jeanine B. Downie. “In your 20s, atopic dermatitis often presents with flesh-colored or slightly red patches anywhere on the body and can often arise with itching as the only symptom. If you have a history of allergies, asthma, or eczema, all of them can be encoded in the same gene.”

While many eczema patients have dealt with the condition their entire lives, atopic dermatitis can look different in adulthood than in youth, so understanding how it changes over time is important for managing symptoms long term. “Adults commonly experience atopic dermatitis on the hands, face, around the eyes, and in areas where the skin bends, although it can really occur anywhere,” says board-certified dermatologist and Mohs surgeon Dr. Dendy Engelman.

Engelman also notes that eczema inflammation may look pink or red on lighter skin tones, while on deeper skin tones it can appear purple, gray, brown, or darker than the surrounding skin. “I always remind younger patients that adult eczema doesn’t necessarily look like the eczema you may remember having as a child,” she explains. “Repeated rubbing and scratching can also cause the skin to become thicker or lead to discoloration over time, so addressing the itch and inflammation is important.”

Managing Your Eczema: How To Keep Your Cool When Your Skin Won’t Chill

Skin flare-ups are not just physically uncomfortable; they’re emotionally difficult too, and it can feel like the only solution is isolation until the worst is over. But managing atopic dermatitis breakouts isn’t as impossible as it feels. Small adjustments to your self-care routine can help keep flare-ups at bay and keep you comfortable when things get itchy. “With atopic dermatitis, consistency is much more important than having an elaborate routine,” says Engelman. “Take short, lukewarm showers rather than long, hot ones, and use a gentle fragrance-free cleanser and moisturizer while the skin is still slightly damp to help seal in hydration. I generally prefer richer creams or ointments for eczema patients.”

In general, Garshick recommends patients look for products with hydrating, barrier-boosting ingredients like ceramides. “I also recommend avoiding fragrances, harsh exfoliants, and overly complicated skin care routines, which may lead to skin irritation,” she says. “It can also help to avoid certain fabrics and use gentle detergents to avoid extra irritation on the skin.”

If you have eczema, you know that a bad flare-up before a big event is your worst nightmare, and stressing over the possibility of a freak-out will only make matters worse. Instead, Garshick recommends minimizing potential triggers and keeping things simple. “I recommend sticking to a consistent, gentle skin care routine in the days leading up to the event, using a fragrance-free moisturizer regularly and avoiding introducing any new skin care products, exfoliants, or potentially irritating treatments,” she says. “If you know you are prone to flares, speak with your dermatologist ahead of time about having a treatment plan in place, including prescription medications if needed. It is better to be proactive rather than wait for a flare to develop.” This can help you feel more in control of your symptoms and make it easier to maintain confidence and a positive outlook.

Reframing The Flare Up: Important Reminders For Tough Skin Days

Beyond the physical adjustments that can help you feel better during a flare-up, mindfulness exercises can help you when your skin takes a turn, keeping you out of that mental eczema rabbit hole. “Living with a chronic skin condition can understandably be stressful, painful, and frustrating,” begins synergistic skin care expert and esthetician Madalaina Conti. “The cause is often a complex variety of genetic and environmental factors which can be hard to pin down. What I find to be the most helpful for clients dealing with chronic skin conditions is pattern recognition. While you are figuring out your triggers, it’s helpful to journal different lifestyle factors and see if you can identify any commonalities for when you experience a flare. It’s not about being obsessive over food or lifestyle, but giving yourself agency over your body and being able to make more empowered decisions over time.”

Engelman reminds patients that eczema is a medical condition and not a reflection of your self-care. It’s essential to remember that atopic dermatitis never was and never will be your fault. It’s a part of life as a chronic skin condition patient, and beating yourself up over bad moments is never the answer.

“You can follow your routine perfectly and still experience a flare,” Engelman assures. “Skin conditions are visible in a way that many other health conditions aren’t, so I never minimize how much that can affect someone’s confidence, particularly when you’re young and feel like everyone is looking at your skin.”

Luckily, today we have more tools for treating atopic dermatitis than ever before. “If eczema is affecting your confidence, sleep, social life, or daily activities, you don’t have to simply live with it,” Engelman says. “Talk to a board-certified dermatologist. The goal isn’t just to make the skin look better. It’s to control the condition so that your skin isn’t dictating how you feel or what you feel comfortable doing.”

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