Living with a chronic skin condition like atopic dermatitis (AD) is more than skin deep. Apart from managing flare-ups and working to stay clear of triggers, dealing with AD can come with a hoard of mental and emotional challenges. Research shows that one’s gut microbiome may also play a part in the development and severity of AD. Symptoms of AD often begin in childhood, but they can persist into adulthood and even develop later in life. 

AD is also not one-size-fits-all. “Skin tone, age, and individual triggers all play a role in how it presents,” says Sarah Sung, MD, FAAD, a board-certified dermatologist and founder of Perq Dermatology. On lighter skin, for example, eczema may appear red, while on darker skin, it often appears darker brown, purple, or even ashen. Some people with AD mostly deal with itching and dryness, while others must combat painful cracks, infections, and thickened skin from long-term scratching. Some only flare up in the winter, while others are triggered by heat and humidity, Dr. Sung explains.

Apart from the physical challenges of the skin condition, AD can also have a real impact on one’s mental health. “Constant itching can lead to sleepless nights, leaving people exhausted,” says Dr. Sung. “Flare-ups on visible areas like the face or hands may also cause self-consciousness, leading to anxiety about social interactions or even avoiding them altogether.”

With that in mind, I spoke to five people with AD about their experiences, what remedies have worked for them, and the self-care rituals they swear by, whether to manage their stress or affirm their beauty when dealing with a flare-up.

Bea: Hydration and Low-Impact Exercise 

Bea was first diagnosed with atopic dermatitis at age 12. In her case, her eczema is usually triggered by stress, weather changes, and sweat. “Typically it flares up around the joints—the area between the arms, the armpit, and behind the knees,” she explains. “I get dry patches around the skin that make it insanely itchy, and if I scratch it’ll leave scars around that area.”

For Bea, seeing a dermatologist and allergist has been life-changing for understanding her AD. It has helped her spot what is an allergic reaction versus what is an eczema flare-up, but “sometimes they go hand in hand, which is probably why transitional periods are when my AD flares up the most,” she says. “I learned that I’m allergic to certain types of pollen and those usually show up in the spring and fall. The allergy stresses me out and that triggers my AD.”

Apart from applying a tacrolimus ointment (shown to effectively treat moderate to severe atopic dermatitis, even more than low-potency corticosteroids) whenever she has a flare-up, Bea makes sure to keep her skin hydrated through a comprehensive shower routine that includes body oils and lotions. “I also use a humidifier every night when I sleep,” she adds.

Taking an antihistamine whenever she feels an itch is another preventative measure Bea takes to help her avoid scratching, and thus breaking skin. 

Chinenyem: Mindful Skincare

Chinenyem’s mother first noticed eczema-like dry patches on her daughter’s skin when she was a baby, but Chinenyem wasn’t officially diagnosed with atopic dermatitis until she was in elementary school. “I vividly remember having a large rash—literally shaped like a dinosaur—on my right leg. I told my mother, and before I knew it, we were on our way to the doctor’s office,” she says. 

Throughout childhood and adolescence, Chinenyem struggled with eczema flare-ups that left dark hyperpigmentation on her neck, arms, legs, and face. “It caused me a lot of emotional pain and seriously impacted my self-esteem.”

For Chinenyem, her AD is triggered by stress, certain dietary products like dairy and gluten, and sweat. She manages her symptoms and avoids flare-ups through a whole foods diet (research shows that eating processed foods is shown to increase the risks of AD), targeted skincare, and consistent self-care, which includes exercise and therapy. “I’ve committed to 1.5 hours of exercise during the week and 2.5 hours on weekends. Keeping my weight in check, staying strong, and maintaining flexibility help calm my immune system and reduce flare-ups,” she says.

As I apply them, I speak affirmations and Bible scriptures over my body and mind, reminding myself of my strength, beauty, and healing,” she says. “This daily self-care ritual and overall intentional lifestyle have been key to keeping my eczema under control.”

Mandi: Herbal Remedies

For Mandi, finding a solution that works for her AD has been a lifelong journey. “At a young age, I struggled with this chronic condition, and at age 12, I was prescribed strong steroids that led to substantial weight gain, which affected my self-image and self-worth,” she says.

Mandi’s triggers for her eczema include: dairy, sun exposure, and heat. “Summers were some of the hardest months for me over the years. Heat and sun exposure often triggered flare-ups and caused the eczema to spread to new areas,” she says. 

Over the course of her three pregnancies, Mandi began experiencing flare-ups in new spots, too, like her hands, neck, and face. Research shows that immunological changes in pregnancy can increase activity for those with known eczema or provoke onset AD for those with no prior history. “Currently, my neck is the most affected region and I continue to battle with flare-ups weekly,” she says.

Apart from adjusting her diet to eliminate dairy, Mandi has also turned to Herbal Face Food Soap to manage her AD. “This plant-only remedy has become a staple in my skincare routine,” she says. “It has been one of the only remedies to help flare-ups and reduce their frequency.” Mandi’s daughter, who also struggles with eczema, has also turned to the same herbal soap to manage summer flare-ups and minimize sun spots and hyperpigmentation. 

Laney: Being Kind to Yourself

Laney was diagnosed with atopic dermatitis as a baby, so AD has always been a part of her life. 

Her eczema is often triggered by a change in temperature, exercise, overheating, and even certain clothing items. “It’s safe to say I am always thinking about my skin and the world around me, all day, every day,” she says. She’ll recognize a flare-up because her skin will suddenly become intensely itchy, and once she starts to scratch, it’s hard to stop. “Imagine having intensely itchy skin and then not being able to touch or soothe it because you know it makes it worse,” she says. “It’s definitely a battle.”

Laney takes multiple medications to manage her AD, including two biologics and a topical called Zoryve. Apart from doing her best to stay away from her triggers, Laney also places a lot of importance on maintaining a good skincare routine, both for her physical and psychological well-being. “I am never far away from a good jar or bottle of moisturizer,” she says. 

In addition to keeping her skin hydrated by moisturizing throughout the day, Laney also works hard to be kind to herself when she can’t control her flare-ups. “I found that one of the most important self-care acts is giving myself grace. I can’t control my skin, and I can’t let it control me.”

Michael: Anti-inflammatory Diet

Michael was first diagnosed with atopic dermatitis 20 years ago, as an adult. Michael’s AD is triggered by stress and dirt. As someone who works in construction (“I own an audio, video, lighting design and installation company,” he says), he’s exposed to this latter trigger almost daily. He’s had to find effective ways to keep his eczema under control throughout his daily life. He’ll recognize a flare-up because he’ll get dry, cracked, and itchy spots on his hands that bleed if scratched.

For example, thanks to his wife, Michael discovered Ora’s Amazing Herbal Touchy Skin Salve, which he slathers on his hands and sleeps in using cotton gloves whenever he has a flare-up. Recently, the pair got a shower filter per Robin’s recommendation and Michael has noticed the difference. “My skin and hair are softer and my eczema is better,” he says.

Michael and Robin’s sons unfortunately inherited Michael’s AD, but thanks to Robin’s expertise, they have been able to keep their children’s eczema in check. “She has them on topical and supplement regimens as well as on a healthy diet, and their skin looks great!”