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How to Exercise With Atopic Dermatitis

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Exercise, of course, is essential for physical fitness, as well as physical and mental health. But if you have atopic dermatitis, the most common form of eczema, you may have experienced challenges when it comes to working out.

“For some people, the heat and sweat that’s generated with exercise can aggravate the skin,” says dermatologist Debra Wattenberg, MD, founder of NY Skin RX in New York City.

But a fear of flares shouldn’t discourage you from exercise. “There are no real restrictions for patients with atopic dermatitis during exercise medically,” says MaryAnn Bentz, MD, the chair of dermatology at Yale New Haven Health's Lawrence and Memorial Hospital in New London, Connecticut. While certain aspects of working out may be bothersome, including friction and the aforementioned heat and sweat, you can usually find ways to avoid or reduce each issue, she says.

Here, we offer tips on the types of exercise that may work best, how to get started, and what limits to watch out for.

The good news is that atopic dermatitis itself doesn’t place specific limits on the kinds of exercise you can do. “There are no best types of exercise for people with atopic dermatitis, and all can participate in sports with minimal adjustments,” says Dr. Bentz.

What you choose to do for exercise depends on your personal preferences, as well as how severe your specific atopic dermatitis symptoms and triggers are (plus any other health conditions you may need to consider).

Whether it’s aerobic exercise (aka cardio) or sports to increase your cardiovascular fitness, resistance training to increase muscle strength, or yoga or tai chi for balance and coordination, most forms of exercise can be adapted to account for atopic dermatitis triggers or symptoms by making simple modifications.

Exercise is rarely something you need to clear with your physician when you have atopic dermatitis, unlike many other conditions. “There are no special precautions to take nor concerns to discuss with your doctor, unless your atopic dermatitis is severe,” Bentz says.

That said, your doctor can help if you do have concerns. “No question is too small,” says Nicholas Brownstone, MD, an assistant professor of dermatology at Mount Sinai in New York City.

When you’re preparing to start a new exercise routine, consider whether your atopic dermatitis is well managed with medication as a starting point. “There are many great biologic medications for eczema. We would encourage patients with moderate to severe atopic dermatitis to talk to their doctor about getting on one of these, so we keep their skin calm and flare-free on a more consistent basis,” Dr. Brownstone says.

Choosing Your Workout

When you have atopic dermatitis, here’s what to consider when you’re deciding on a new workout regimen:

Choose something you enjoy. This may be obvious, but it’ll make it easier to stick to a regular routine if you love it. Ask yourself: Do you enjoy being outdoors, in a gym, or in a studio atmosphere? Do you love the calm and focus that a solo workout can bring, or does being in a group energize you?

Pick a workout that minimizes exposure to your triggers. Excessive sweat, heat, and friction can all be bothersome for eczema, Bentz says. So opt for a workout that allows you to regularly pause to towel off, can be done in a cool environment, and doesn’t require restrictive clothing or equipment that rubs against sensitive skin. Similarly, allergens and pollution can be an issue, so work out indoors when levels are high.

Chlorinated water can also be an issue for some people with atopic dermatitis. “Pool swimming can be irritating, but moisturizing before and after can help,” Bentz says. And cold, dry air can exacerbate eczema, so outdoor activities might not be ideal in the winter, Brownstone says.

Consider your symptoms. If hand eczema is acting up, Brownstone says, opt for a treadmill workout over weight lifting, for example, to spare further irritation. “Certain sports like wrestling could increase the risk of infections if someone had extensive raw areas, but it's still possible to participate,” Bentz says.

Getting Started

Here’s what to think about when you’re getting started:

Plan in advance. At the beginning of each week, figure out when you can make time for physical activity.

Start low and go slow. Begin with short increments of low-intensity exercise and slowly increase from there.

Stay hydrated. “Drinking water and staying hydrated — that’s universal. Everyone exercising should drink plenty of water,” says Dr. Wattenberg. Getting adequate hydration is important for keeping skin hydrated, too.

Moisturize your skin. Before exercising, apply moisturizer, Benz says. After a workout, having a quick shower and moisturizing before changing into dry clothes can help prevent flares, she adds.

Alternate different types of exercise throughout the week. For well-rounded fitness, it’s recommended to combine cardio, with a goal of at least 150 to 300 minutes of moderate-intensity cardio (or 75 to 150 minutes of high-intensity activity), plus resistance (strength) training for all major muscle groups on two or more days per week. Neuromotor exercise (like yoga, tai chi, Pilates, and dance) is recommended by experts to maintain good balance, coordination, and reflexes.

Use caution when disinfecting equipment. While it’s important to clean whatever you’ll be using during a workout, such as machines or mats, it can backfire if you’re sensitive to cleaning products. Wipe down equipment with plain water after disinfectant is used, Brownstone says, because chemicals can be harsh on eczema-prone skin.

Skip hot showers and saunas. Heat may feel good on sore muscles, but it doesn’t do any favors for skin when you have atopic dermatitis; it can actually make skin drier.

Keep track of your progress. Tracking your activity can be motivating — take note of how long you’ve kept up a routine, as well as increases in intensity and time, or in the number of reps you can do.

Practice acceptance. Having an all-or-nothing attitude toward working out can be demoralizing; recognize that some exercise is more beneficial than none, and do what you can.

“You want to avoid exercise when you’re severely flaring,” Brownstone says. Working out when symptoms are already exacerbated can risk making them even worse.

And as Benz noted, having raw, exposed skin can increase your risk of infection. Also consider skipping your workout if you already have an active skin infection, she says.

Other than flares, guidelines for exercise are the same as for most people. Consider taking a few days off from working out if you experience the following:

  • Symptoms of another illness
  • Injuries
  • Fatigue
  • Loss of motivation or feeling moody or depressed
  • More intense or prolonged muscle soreness
  • You stop seeing improvements
  • Sleep issues
If you feel overworked and need a break but still want to move your body, consider:

  • Gentle stretching
  • Taking a walk
  • Restorative yoga (or other gentle neuromotor exercises)
Your body needs occasional breaks to rest, and flares are often a fact of life with atopic dermatitis, so don’t be hard on yourself if you notice the aforementioned signs and need to take time off from your routine. If flares are often preventing you from working out, however, speak with your dermatologist about your treatment plan.

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