Eczema and stress: What’s the link?

The factors that trigger eczema flares vary between people. Stress is a common trigger, as it causes the body to release cortisol and other hormones that increase inflammation. Inflammation in the body makes eczema symptoms worse. 

Living with eczema can also increase the likelihood of having a mental health condition. A large study from 2020 found people with atopic eczema were more likely to experience new depression or anxiety. And like eczema, research has also linked stress and inflammation to depression. 

How does stress cause eczema?

Eczema is a chronic inflammatory condition that causes dry, itchy skin. It affects about 30% of people in the United States.

The symptoms of eczema — mainly dry, itchy, and inflamed skin — flare up when inflammation increases in the body. While inflammation is your body’s natural way of fighting infection and injury, excess inflammation can lead to conditions like eczema. 

Stress is linked to eczema because it causes physical changes in your hormone and nerve systems (the neuroendocrine system). The body releases hormones like adrenocorticotropin and cortisol in response to stress. These hormones weaken the skin’s protective barrier, leading to eczema flares. 

Stress can also indirectly cause eczema through the foods you eat. Many people are more drawn to foods high in sugar and saturated fats (like pastries and sweets) when stressed — and these foods can increase inflammation in the body.

Sleep disorders and irregular sleep schedules can also contribute to inflammation. Often, stress can interfere with sleep, further increasing the risk of an eczema flare. 

Treatments for stress-induced eczema

Treatment for eczema focuses on reducing flares and improving symptoms. You can work with a dermatologist to find the right plan for you.

Treatment options for stress-induced eczema include:

• reducing stress, such as taking regular breaks, prioritizing self-care, or developing a relaxation routine
• avoiding other eczema triggers, such as scented soaps and fabric softeners, cold weather, or excess sweat
• taking baths and using moisturizers to help heal the skin
• trying light therapy in a dermatologist’s office or hospital

Your doctor can also recommend topical (applied to the skin) or systemic (taken orally or as an injection) medications. These may be available over the counter or by prescription. 

Topical medications for eczema include:

• a class of corticosteroids called glucocorticoids, such as methylprednisolone (Medrol) or dexamethasone (Dexonto)
• glucocorticoid injections, such as methylprednisolone injections (Depo-medrol or Solu-medrol)
• topical calcineurin inhibitors (TCIs) like tacrolimus (Protopic) and pimecrolimus (Elidel)
• crisaborole ointment (Eucrisa)
• ruxolitinib cream (Opzelura)
• coal tar

Systemic medications for eczema include:

• abrocitinib (Cibinqo)
• dupilumab (Dupixent)
• tralokinumab-ldrm (Adbry)
• upadacitinib (Rinvoq)
• azathioprine
• cyclosporine
• methotrexate
• mycophenolate mofetil

If you need help covering the cost of eczema medication, Optum Perks free Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication or search for a specific drug here.

All of these medications work differently. Topical corticosteroids work in part by reducing inflammation and suppressing the body’s immune system. Janus kinase (JAK) inhibitors like upadacitinib target the immune system, but only specific enzymes. 

Medications come with side effects, and some can have harmful interactions with other medications. A doctor can discuss the side effects with you when prescribing a new medication. 

If you have stress eczema, preventing stress is an important way to keep the condition under control. 

Preventing stress eczema

Managing stress is an important part of treating stress-induced eczema. If you can keep stress under control, you can prevent or reduce flares. 

The National Eczema Association recommends the following steps to reduce stress triggers:

• try keeping up with a regular mindfulness practice, like meditation
• get plenty of rest
• exercise regularly
• eat a healthy, anti-inflammatory diet, which may include fruits, vegetables, healthy fats, and green tea
• socialize with friends and family

Scientific evidence suggests meditation may lower stress. A 2016 study compared 31 experienced meditators to a control group. The meditators had lower levels of cortisol and inflammatory markers, as well as lower perceived levels of stress, in response to a psychological and physical stimulus. 

If your child or teen has eczema, the American Academy of Dermatology Association recommends the following ways to help them manage stress:

• help them to connect with other kids who have eczema
• learn about your child’s stress and guide them to cope
• check in about how their eczema treatment plan works for them
• be a role model for stress management and healthy lifestyle

Hobbies and activities you enjoy can also reduce stress. For example, a 2016 study of 39 adults found cortisol levels dropped after 45 minutes of making art. Creative outlets may therefore help you keep eczema under control. 

Summary

Eczema is a common condition that affects the skin. Stress can sometimes make symptoms worse, as it causes inflammation in the body.

The same inflammatory pathways that cause eczema are also linked to mental health conditions such as depression, which people with eczema are more likely to experience. Reducing stress can help keep eczema under control.