A woman wearing a black shirt scratching at a patch of eczema on her shoulder.
Stress eczema is eczema that is caused by emotional and mental stress.

Understanding Stress Eczema

Your emotional state may affect your skin more than you think. While we may not know the definitive cause of eczema, we do know that this chronic condition has both physical and psychological parts. When eczema is tied to stress, you can literally see it on your skin. This is known as stress eczema.

What Is Stress Eczema?

Eczema is a chronic skin condition that generally results in an itchy rash. Most people with it house an over-reactive immune system, which means it produces inflammation when it experiences a trigger. There are a variety of triggers for a flareup, such as allergies or irritants, but stress also induces the condition. If you have eczema and you experience emotional stress, depression, anxiety, panic, etc., your skin may show your stress. Emotional states of stress may bring on eczema symptoms or flare-ups may start (or get worse) when stress increases.

How Does Stress Eczema Differ From Other Types of Eczema?

Other types are generally triggered by something external to the body (an allergen, sensitivity to wool, air pollution, the list goes on), whereas stress comes from inside the body. Unlike other triggers that come, cause a reaction, and leave, stress eczema operates on a cycle. That is to say, stress or anxiety start a flare-up and the flare-up creates more anxiety and stress, which either intensifies the flare-up or leads to a new flare-up.

The Link of Stress and Eczema

Your body sends signals to your brain when you experience stress, and those with eczema have an increased response to stress. People who have it may be more prone to mental health issues (including stress) because of the way their bodies send messages to the brain during times of inflammatory response. The body tenses due to stress and it signals the brain to do something about it. The brain springs into action and has the body release more of the hormone cortisol, which suppresses the immune system and causes the inflammatory response in the skin. While the stress-to-eczema connection is clear, there is still much to learn about the relationship between eczema and mental health issues.

What Are the Causes?

Researchers think that those with this condition are susceptible to a trigger (stress) and a combination of their genetics. There are some people with a mutated gene that is responsible for creating filaggrin. Filaggrin is a protein that contributes to the maintenance of the protective barrier on the top layer of skin—less filaggrin may make a person more susceptible to eczema.

What Are the Symptoms?

This skin condition generally presents with the same physical symptoms:

  • Relentless itchiness that makes you want to scratch
  • Dry or flaky skin
  • Rash
  • Inflamed skin that appears red
  • May appear anywhere on the body, but more often found on the cheeks, chin, chest, neck, inner elbows, behind the knees, and other places
  • Oozing, crusting, or swelling

Stress eczema also comes with:

  • Difficulty sleeping
  • Emotional and wellbeing challenges
  • Problems concentrating

Risk Factors

Primary risk factors are a family history and age. Stress flare-ups are triggered during moments of fight-or-flight response in the body; if your genetics pass along the traits in your DNA, you are susceptible to heightened eczema response during times of stress. Younger people generally have it more often than adults, but adults can get it too.

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How Stress Eczema Is Diagnosed

The first step with any medical issue is to consult your doctor. They’ll be able to rule out other triggers like allergies or product sensitivities. They’ll get your personal and family medical history, give you a physical exam and may send you for blood tests or use patch testing in the office (to rule out other skin conditions). Your doctor will likely ask you about your stress levels or recommend another doctor more qualified to address stress and mental health needs. Based on the information they receive from you and the tests they conduct, they can make a diagnosis.

How to Treat Stress Eczema

There is a link between eczema and times of stress. Your healthcare professional may recommend:

  • Talking to a mental health specialist or therapist. If you are able to determine the cause of stress and get tools to minimize or eliminate it, you will have fewer flareups.
  • Topical steroids. This cream may help address symptoms, but not the source of eczema.
  • Joining an eczema support group. Join a community of people affected by stress eczema to share experiences, solutions, exchange ideas and connect with others who know what you are going through.
  • Getting more sleep. Studies show that getting enough quality sleep lowers stress levels.

Prevention Methods

There are many activities you can do to lower your stress levels to help break the stress cycle:

  • Daily relaxation habits, such as deep breathing/meditation, soothing music, yoga, tai chi, cuddling a pet, walking in nature, etc.
  • Make sleep easier with a warm bath or shower beforehand, keeping the room temperature cool and dark, and limiting the use of electronics before bed.
  • Moisturize your skin.
  • Exercise to combat stress and release hormones that improve mood. Get in at least 150 minutes of moderate-intensity workouts each week as well as muscle-strengthening workouts.
  • Switch to a Mediterranean diet since it contains many anti-inflammatory foods, like fish and other sources of omega 3 fatty acids, and probiotic-rich foods. Check in with your doctor before making any drastic changes to your diet to ensure you are consuming the best foods for your overall health.

The Takeaway

The key with treating stress eczema is addressing both the physical and psychological factors. Medicine only addresses the eczema breakout, while a mental health professional can help you uncover the source of stress. By minimizing stress in your life, you can reduce your stress eczema flareups.