How Atopic Dermatitis Can Affect Your Mental Health

Atopic dermatitis is the most common form of the inflammatory skin condition eczema. Eczema symptoms include flare-ups of dry, scaly patches of skin and hives. The itching and pain that often accompany an eczema outbreak can be quite upsetting and uncomfortable.

In addition, when eczema flare-ups are in visible places, such as the face, neck, or hands, it’s easy to feel embarrassed or self-conscious. You may be tempted to avoid social interaction until a flare-up subsides. As a result of the physical and emotional toll eczema takes, the condition is often accompanied by feelings of stress, anxiety, and depression.

Managing eczema symptoms often requires a combination of topical medications and other treatments, as well as lifestyle adjustments and a proper skin care regimen. And because eczema and mental health are so closely related, it can be just as important to take care of your emotional concerns as it is to manage the health of your skin.

Atopic dermatitis can be caused by several different factors, including an abnormal immune system response, environmental triggers, family history, and stress. A 2019 study suggests that while stress alone may not necessarily trigger an eczema flare-up, it may make it more likely for people predisposed to atopic dermatitis to have an outbreak.

The connection between stress and eczema may be due to the effects of stress hormones, such as cortisol and adrenaline. High levels of these chemicals can bring on an inflammatory response, which can exacerbate eczema symptoms and trigger a flare-up or make an existing outbreak even worse.

Because stress may help trigger eczema flare-ups, which then cause additional stress to the individual, a vicious cycle can take over. Reducing your stress levels may improve your mental health and skin health. Consider the following strategies to ease your stress:

• Exercise regularly, but be aware that heat and sweat can irritate the skin, so choose the location and nature of your workout carefully.
• Practice meditation and breathing techniques to help you relax.
• Get plenty of sleep — at least 7 to 8 hours per night.
• Know your stress triggers and try to minimize your exposure to them.

When stress levels soar, anxiety or depression can sometimes follow close behind. You may worry that your eczema will only get worse or that the flare-ups will affect your relationships, your job, and other aspects of your life. Those anxious thoughts and feelings may worsen your symptoms and interfere with your day-to-day functioning. If not treated, those worries may descend into feelings of hopelessness and withdrawal from the people and activities you used to enjoy — hallmarks of depression.

The relationship between eczema and depression risk is well studied. A 2018 review of 10 studies involving more than 180,000 people indicated that having eczema increased the risk of depression and that doctors treating individuals with eczema should be aware of the connection between the two conditions.

A 2020 study similarly suggests that not only are people with atopic dermatitis more likely to develop depression and anxiety, but the risk of depression increases as the severity of the eczema also increases.

Though atopic dermatitis is an inflammatory skin condition, it can easily affect your mental health, too. A National Eczema Foundation survey revealed that about 30% of people with atopic dermatitis have also been diagnosed with depression or anxiety. It’s likely many others with atopic dermatitis have anxious or depressive symptoms, but have not been formally diagnosed.

While you may feel as though you can handle the emotional or psychological complications of eczema on your own, consider talking with a psychiatrist or therapist about your feelings and about ways to reduce the stress of living with eczema. You may also benefit from joining a support group for people with eczema. You can meet individuals who face similar struggles and perhaps learn some strategies that have worked for other people. And you may also feel better if you can provide some support and advice to someone else grappling with a mental health challenge due to eczema.