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Can Eczema Be Caused by Stress?

Reviewed on 2/22/2022
A woman scratching her back with red patches of skin
The cause of eczema is unknown, but stress can trigger a flare-up. Other eczema triggers include skin irritants, wool or synthetic fibers, cigarette smoke, cold or dry environments, sweating, rapid temperature changes, dust or sand, and metals (especially nickel).

Eczema refers to a group of chronic skin conditions that cause itchy, red, inflamed, scaly skin, including:

Eczema Causes & Triggers

The cause of eczema is not completely understood but people with a family history of eczema are at increased risk of developing the condition so it is believed that genetics, along with certain triggers, play a strong role. 

Stress can trigger eczema flare-ups and cause a worsening of eczema symptoms. There is a scientific link between eczema and stress. Stress in the body causes an increase in the production of stress hormones such as adrenaline and cortisol. But excess cortisol production can suppress the immune system and cause an inflammatory response in the skin. People who have skin diseases such as eczema are especially susceptible to this inflammatory response.

Other triggers for eczema symptoms may include:

  • Skin irritants such as soaps, cleansers, shampoos, disinfectants, perfumes, cosmetics, and fresh fruit juices
  • Wool or synthetic fibers such as polyester 
  • Cigarette smoke
  • Cold or dry environments
  • Sweating
  • Rapid temperature changes
  • Dust or sand
  • Metals (especially nickel)

What Are Symptoms of Eczema?

Symptoms of eczema include: 

  • Intense skin itching 
    • Itching may worsen at night
    • Scratching can increase itching and inflammation
    • Oozing, bleeding, or crusting may occur if skin is scratched open
    • Pustules, blisters, and red, hot skin may occur if a secondary infection occurs
    • Thickened, darkened, and scarred skin may result from repeated scratching 
  • Patches of inflamed skin
  • Scaly, rough patches of skin
  • Sensitive skin
  • Dry skin
  • Skin flaking 
  • Plugged hair follicles that cause small bumps
    • Usually on the face, upper arms, and thighs
  • Skin discoloration (especially red or pink)
  • Increased skin creasing on the palms and/or an extra fold of skin under the eye
  • Darkening of the skin around the eyes

What Is the Treatment for Eczema?

Eczema is a chronic condition that can periodically worsen(flare) in between times of mild to no symptoms. There is no cure for eczema but it can be managed with home care and medications. 

Home remedies to relieve or reduce symptoms of eczema may include: 

  • Identifying and avoiding triggers 
  • Keeping the skin hydrated
    • Emollients
      • Use thick creams or ointments 
    • Bathing
      • Lukewarm baths or showers can hydrate the skin and may relieve itching
      • Use unscented, mild soap or non-soap cleanser sparingly
      • Apply an emollient immediately after bathing or showering while skin is still damp
      • Avoid hot baths or showers, or those lasting more than 10 to 15 minutes which can dry the skin
      • Dilute bleach baths may be recommended decrease the number of bacteria on the skin that can cause infections or worsen symptoms 
  • Wet dressings (wet wraps) to help soothe and hydrate skin, reduce itching and redness, loosen crusted areas, and prevent skin injury due to scratching

Medications used to treat eczema include:

  • Over-the-counter (OTC) or prescription topical steroid creams or ointments 
  • Over-the-counter (OTC) or prescription oral antihistamines for itching 
  • Oral steroids (e.g., prednisone) may be used for a short duration to treat severe flares
  • Tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
  • Injectable biologics such as dupilumab (Dupixent) for adults with moderate to severe eczema that has not responded to other treatments
  • Immunosuppressive drugs for patients with severe eczema who do not improve with other treatments

Ultraviolet light therapy (phototherapy) may be used to help control eczema but it is reserved for patients with severe eczema who do not respond to other treatments because it is expensive and may increase the risk of developing skin cancer.

For people who have eczema symptoms that are triggered by stress, stress management is an important part of treatment. 

  • Relaxation
    • Deep breathing
    • Use a mediation app
    • Yoga or tai chi
    • Read
    • Play with your pet
    • Take a walk in nature
    • Distract yourself with activities that require use of your hands, such as writing, painting, knitting, baking, or playing video games 
  • Get a good night’s sleep
    • Itching from eczema can keep people up at night
    • Take a first-generation antihistamine such as diphenhydramine (Benadryl), hydroxyzine (Vistaril, Atarax), or cyproheptadine which cause drowsiness 
    • Try a warm bath or shower before bed and lather on the moisturizer 
    • Turn your bedroom into a sleep sanctuary 
      • Keep the room dark and cool 
      • Limit the use of electronics an hour or two before bedtime
  • Find an eczema support group
    • Talking to others who have the same problem and understand what you’re experiencing can help
  • Exercise regularly
    • Exercise is an effective way to combat stress and other negative emotions
    • Adults should aim for a minimum of 150 minutes of moderate-intensity physical activity each week, in addition to muscle-strengthening activities
    • If sweat triggers your eczema, take a cool or lukewarm shower soon after the workout and change your clothes

 

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Reviewed on 2/22/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/eczema-atopic-dermatitis-beyond-the-basics?search=Eczema&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://nationaleczema.org/eczema/

https://nationaleczema.org/eczema-emotional-wellness/