Key takeaways

  • Stress is a common trigger of the chronic skin condition known as eczema. It can cause a spike in cortisol levels in your body, leading to flare-ups.
  • While studies do show a link between stress and eczema, not all research directly connects the two. It’s always best to discuss symptoms and possible causes with your healthcare team.
  • Avoiding and limiting stress and other eczema triggers may help reduce flares. You can also discuss treatment options with your doctor, including over-the-counter topical creams.

Atopic dermatitis, also known as eczema, is a chronic inflammatory condition that may cause dry, itchy rashes on your skin. These can sometimes be painful and could lead to feelings of stress and anxiety.

Stress is one of the most common triggers of eczema, according to the American Academy of Dermatology Association (AAD).

The exact cause of atopic dermatitis is unknown.

However, researchers suggest it may develop as a reaction within your skin, triggered by environmental, genetic, and immune-related factors.

Short-term (acute) and long-term (chronic) stress may affect eczema slightly differently, with some research noting that chronic stress may be worse for eczema:

  • Acute: An acute stressor may cause a rapid spike in cortisol (sometimes called the stress hormone) and adrenaline or noradrenaline. This could trigger your immune system to release TH1 cells, potentially leading to inflammation.
  • Chronic: Long-term stress may lead to a higher baseline level of cortisol, which could affect how your immune system responds to acute stressors.

Participants in a small 2023 study reported that chronic psychological stressors affected their eczema more than acute stressors. These stressors were related to work concerns, family, school, and unexpected events.

Researchers noted that psychological stressors might cause an immune-mediated inflammatory response, which could affect the skin barrier. The skin barrier is the outside layer of your skin. It’s responsible for retaining moisture and protecting the body from environmental irritants.

However, it’s important to note that not all studies have found a link between stress and eczema.

For example, a 2023 study indicated that work-related stress had little impact on eczema symptoms. The researchers note this could be because eczema most commonly shows itself during childhood rather than for adults.

As such, more research is needed to fully identify the link between eczema and stress.

Some research shows that mental health conditions like anxiety and depression may be common triggers of eczema outbreaks.

A small 2022 study involving 36 females showed that stress, anxiety, and depression significantly affected eczema symptoms. Researchers also reported that eczema symptoms increased the levels of these three mental health conditions.

Similarly, a 2019 study that included 526,808 adults with eczema showed that eczema was linked to a greater risk of developing anxiety and depression. Depression was also associated with more severe eczema symptoms.

Anxiety or depression may cause somatization, which is when you experience physical symptoms resulting from psychological stress. An eczema outbreak is one possible type of somatization due to anxiety.

Speak with a healthcare professional if you think you may have anxiety or depression. These conditions typically require the supervision of a medical professional, such as a doctor.

They can typically provide a proper diagnosis and help develop a treatment plan for you.

There are many preventive measures you can take to help you manage your stress levels and avoid eczema breakouts. The Centers for Disease Control and Prevention (CDC) recommends the following tips:

  • Connect with others: Volunteering, participating in community events, joining an eczema support group, phoning your friends and family, and joining a club are some ways to socialize and stay connected.
  • Stay active: Getting at least 150 minutes of physical activity each week (20–30 minutes per day) may help reduce stress and relieve inflammation. It’s important to do activities you enjoy to help keep you motivated.
  • Breathing exercises: Meditation, yoga, and other deep breathing exercises can help you relax.
  • Diet: Eating a well-balanced diet of fruits, vegetables, lean protein, and whole grains may help lower stress levels. Foods high in unhealthy fats, sugars, and salt may increase stress.
  • Sleep: Get at least 7 hours of sleep every night.
  • Limit or avoid behaviors that negatively affect the body: Limit alcohol consumption and avoid smoking and using illegal drugs, as these may increase your stress.

A healthcare professional may also recommend cognitive behavioral therapy (CBT) to help you manage stress. This therapy may help you identify and manage certain behavioral, thought, and emotional patterns associated with stress.

According to the United Kingdom’s National Health Service (NHS), several other eczema triggers have been identified, including:

  • environmental allergens, such as pollution, pollen, animal dander, and mold
  • food allergies, which can include eggs, cow’s milk, and fish
  • dry, cold, and low humidity weather
  • body soaps, cleaning products, and laundry detergents with fragrances, dyes, or alcohol
  • certain clothing materials, such as wool and nylon
  • excessively dry skin
  • skin infections
  • hormonal changes

Consult a healthcare professional

Consider speaking with a healthcare professional if you think stress is causing your eczema symptoms to flare up.

They may ask you about your symptoms and review your treatment plan. This may include adding, removing, or modifying dosages for certain medications.

They may also recommend seeing a mental health specialist, such as a counselor or therapist, and joining a support group.

Stress is not a direct cause of eczema symptoms, but it could trigger an immune response. This could cause inflammation and lead to an eczema flare-up.

Some lifestyle changes may help relieve stress and reduce eczema symptoms. These may include staying physically active, eating a well-balanced diet, getting enough sleep, and avoiding smoking, among others.

Stress-related eczema symptoms may look the same as other eczema rashes. However, you may identify them as stress-related if they follow a particularly stressful period or event.

Some topical creams are available over the counter to help relieve symptoms of stress rash.

Consider discussing different topical cream options with your doctor to try if you’re experiencing eczema and a possible stress rash.

Eczema is a chronic skin condition that can be difficult to manage, especially when it causes stress.

Stress is also a common eczema trigger that could cause your symptoms to worsen or reappear.

Lifestyle changes, at-home remedies, and treatments could help you manage your eczema and cope with it in a positive way.

Speak with a healthcare professional if your symptoms are not improving. They can help develop a treatment plan to manage stress and relieve symptoms.