Atopic dermatitis (AD), frequently referred to as eczema, can appear for the first time in adolescence and young adulthood, but can also sneak up in late adulthood. More often than expected, AD can lead to confusion and frustration when navigating the dating world. Intimacy requires exposure and vulnerability, which can be a challenge for people with AD when the physical and emotional symptoms of their skin condition are top of mind.
These symptoms can negatively affect their self-esteem and ability to relate to potential romantic partners. Learn how AD can make it challenging for people to thrive in romantic relationships.
Shame and Rejection
Misinformation about atopic dermatitis can lead to rejection that’s more painful than the itch. “A lot of times, people make judgments about hygiene or things that are really irrelevant,” said Anna Chacon, MD, FAAD.
A 2018 article in the BMJ Open Journal reports that “Culture, societal and other social influences appear to play a role in this stress experience, based on common misconceptions, for example, that skin diseases are contagious or a consequence of poor hygiene.”
Shelby Smith, 33, shares how eczema appeared in her romantic life during a formative moment in middle school. Smith’s crush was about to make a move but paused when he saw visible symptoms of eczema on her wrists. “He was about to grab my hand, and he stopped,” she told us during an interview. “His commentary towards me was ‘What is the alligator skin on your wrist?’” she adds, mimicking a disgusted tone.
The insult stung even worse when he began ignoring her in the hallway and reported what he saw to their peers. “Afterwards, a nice little rumor went around school about me having alligator skin,” Smith continued.
Research shows that the decline in the quality of life of childhood eczema may be accompanied by feelings of shame and school bullying, and can cause social isolation and depressive symptoms.
The experience changed how Smith presented herself to the world as she got older. “My initial thought was to cover it up. You can’t say anything about what you don’t see,” says Smith.
Self-Image and Self-Esteem Issues
“Eczema started rearing its ugly head when I started dating,” says Ryan Parker, 26. “I became very insecure about my skin.”
In addition to actual rejection, atopic dermatitis can lead to the fear of rejection. Self-image and self-esteem issues are associated with this condition. According to the Journal of Clinical and Experimental Dermatology, 29% of patients with eczema (which includes AD, eczema, and hand eczema) report sexual problems. Previous studies have also found that almost 1/4 of 3,485 patients report that the appearance of their skin impaired their sex life.
My initial thought was to cover it up. You can’t say anything about what you don’t see.
Regardless of how we might be perceived, talking about your AD can help. Instead of assuming you know what your partner will say, it’s important to speak about your experience. Parker, who was misdiagnosed until he was 20, was pleasantly surprised by his husband’s reaction when they were dating.
“Those little things just didn’t matter to him at all,” says Parker.
Licensed professional counselor Lakendra Weaver considers discussing health challenges with a partner as a chance to connect on a deeper level. “I definitely think it’s an opportunity for two people to get closer,” she explains.
Practical Tips for Managing Atopic Dermatitis
Managing atopic dermatitis might require going against some of your romantic instincts. For example, you might want to pass on that special designer fragrance you’re counting on to set the mood and head to the drugstore instead. “I suggest bland, bland, bland, non-fragranced items that are usually not very expensive,” advises Chacon.
If you’re tempted to turn towards natural oils as an alternative, beware. “I wouldn’t recommend it at the moment,” says Chacon. She says people have reported allergies and irritations even from ‘botanical items’ that contain fragrances. “I would recommend using non-scented things like Vaseline for moisturizer,” she adds.
The easiest piece of it that people don’t think about is just creating a better skin barrier.
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MIMI OLIFF, CERTIFIED PHYSICIAN ASSISTANT
“The easiest piece of it that people don’t think about is just creating a better skin barrier,” says certified physician assistant Mimi Oliff. Oliff mentions selecting “detergents that are all free and clear” as a helpful option. “During a flare, it is also important to avoid using harsh exfoliants like scrubs, dry brushing, and active ingredients like retinol, BHAs, and AHAs on affected areas,” adds dermatologist Melanie Palm, MD, MBA.
The dainty necklace or chandelier earrings you were counting on to set off that little black dress might not be a great idea, either. The British Journal of Dermatology cites nickel as a risk factor for certain kinds of eczema. “I couldn’t wear a lot of pretty things that I saw other girls get to wear,” says Smith.
When to Seek Professional Help
Eczema treatment has come a long way in recent years. Powerful treatments—such as creams, oral medications, and injections—have empowered those who are facing AD. When symptoms start affecting your everyday life, talk to your healthcare provider.
For mental health treatment, Weaver recommends seeking therapy to fortify your relationship with yourself before starting a new relationship. “It’s essential to have that self-acceptance before you start a relationship,” she says. “If I’m fully at a place of self-acceptance when I communicate with this partner about the eczema, I can talk about how it’s impacting me and decide, ‘Hey is this person gonna be someone who’s able to support me?’”
Building Confidence in Your Love Life
Seeing other people in her life deal with alopecia, hyperpigmentation, and other visible health challenges normalized what Smith was going through.
Instead of hiding herself, Smith believes in taking a “head-on” approach to talking about her eczema with potential partners. “Whoever is going to love me is going to love every part of me. And I don’t have to constantly explain myself for why I am the way that I am just like I wouldn’t want friends to have to explain why their body does what their body does,” said Smith.
“I looked at people, and I noticed that everybody has something.”
What This Means For You
If someone weeds themselves out by rejecting you for any aspect of your physical appearance, that says much more about them than anything about you. If atopic dermatitis impacts the way you feel in relationship to yourself and others, it may be helpful to practice gentle acceptance, compassion, and care for yourself mentally, emotionally, and physically.
Remember you are worth kindness, respect, and love. Know there are many people out there who will love you inside and out, and intentionally choose to surround yourself with those who can see, honor, and cherish all of you.
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