Atopic dermatitis is a chronic skin condition characterized by an impaired skin barrier, leading to dryness, inflammation, and intense itching. This compromised barrier makes the skin highly reactive to environmental factors, including temperature changes and chemical irritants. The use of a sauna presents a complex situation for individuals with eczema, as the intense heat and subsequent sweating can either provide therapeutic benefits or trigger a significant flare-up. Deciding whether to use a sauna requires understanding the precise mechanisms by which heat and sweat interact with already sensitive skin.
Understanding How Heat and Sweat Irritate Eczema
The primary concern for eczematous skin in a high-heat environment is the dual challenge of vasodilation and the chemical properties of sweat. Heat exposure causes blood vessels near the skin’s surface to widen (vasodilation), which increases skin temperature and heightens sensitivity. This increased circulation can lead to redness, inflammation, and make the skin feel warmer and itchier.
Sweating introduces a potent irritant to the compromised skin barrier. Sweat contains sodium chloride (salt), which is deposited on the skin as the water evaporates. This concentrated salt acts as a chemical irritant on the sensitive skin barrier, often causing a stinging or burning sensation. Evaporation also rapidly strips moisture from the already dry skin, exacerbating the problem.
Upon exiting the sauna, the rapid temperature shift triggers a significant increase in transepidermal water loss (TEWL). This causes the skin to lose moisture quickly, leading to dehydration and dryness if not immediately addressed. Since a weakened skin barrier is already prone to dehydration, this moisture loss can trigger the itch-scratch cycle and worsen chronic inflammation.
Precautionary Steps for Sauna Use
Individuals with eczema who choose to use a sauna must adopt a protocol focused on mitigating the irritant effects of sweat and preventing post-session dryness. Preparation should include ensuring adequate hydration by drinking plenty of water, as this helps prevent the concentration of salts in the sweat. Session duration should be limited, starting at a brief five to ten minutes and gradually increasing the time only if the skin shows tolerance.
During the session, maintaining hygiene is important, which involves sitting on a clean, dry towel to avoid direct contact with hot surfaces. The most crucial steps occur immediately after leaving the heat, starting with a rapid cool-down protocol. This involves taking a lukewarm shower to gently wash off all sweat residue and salt, which are the main chemical irritants.
The water temperature must be lukewarm, not cold, as abrupt temperature changes can shock the skin and trigger further irritation. Following the shower, a fragrance-free emollient or prescribed moisturizer must be applied immediately to the still-damp skin. Applying the moisturizer while the skin is damp helps to lock in the water and effectively counteract the drying effects of the heat and TEWL.
Differences Between Traditional and Infrared Saunas
The type of sauna used can significantly influence the degree of irritation experienced by sensitive skin. Traditional saunas operate by heating the air in the room, typically reaching high ambient temperatures between 150°F and 200°F (65°C to 93°C). This intense dry heat causes a greater increase in core body temperature and promotes profuse sweating. For eczema sufferers, the higher ambient heat and intense sweating can be irritating to the skin barrier.
In contrast, infrared saunas use light waves to directly heat the body, allowing them to operate at significantly lower ambient air temperatures, usually ranging from 120°F to 150°F (49°C to 66°C). This method heats the body from within without the extreme heat stress of the surrounding air. The lower operating temperature often results in a gentler experience and potentially less profuse sweating, which may be better tolerated by sensitive skin.
While the gentler, lower-temperature environment of an infrared sauna is less likely to provoke a severe inflammatory reaction, both types still induce sweating and elevate skin temperature. Therefore, the post-sauna care protocol remains equally important regardless of the heat source.