“Stress eczema” isn’t its own diagnosis, but stress is one of the most common triggers of eczema for people who already have the skin condition. 

In a 2020 survey by the National Eczema Society, 57% of women and 41% of men reported that stress made their eczema worse. And there’s Reddit thread after Reddit thread of eczema sufferers discussing stress’ negative impact on their skin. 

Not only can stress lead to eczema, but in what might feel like an impossible cycle, an eczema flare-up can lead to more stress. 

With the right combination of DIY and clinical strategies, stress management tools, and in some cases, mental health support, you can learn to reduce stress, improve your eczema, and break out of the stress-eczema cycle.

What’s the link between stress and eczema?

Rachel Day, MD, Lead Dermatologist Zest, a premiere virtual dermatology clinic, explains that stress has the ability to both lower our immune system and make it overactive. “In eczema, we have an overactive immune system in the skin. So stress creates a vulnerability where that continues to go unchecked and is possibly worsened.”

Release of hormones 

Stress also releases a surge of hormones that can be harmful to your skin. One of those hormones is cortisol (aka the stress hormone), which can lead to inflammation, like an eczema flare-up. 

Another one of those hormones is histamine, commonly connected to allergic reactions. Histamine can leave you feeling itchy, and itchiness can jumpstart an eczema breakout. 

Weakened skin barrier

Stress can also weaken the skin barrier function, which is the outermost layer of skin meant to keep out any harmful substances or microorganisms, leaving your skin more susceptible to irritation. 

Dr. Day points out that when you’re stressed, you may also have a harder time taking care of yourself and sticking to your skincare routine. “Somebody might skip a dose or two of a topical they’re using for eczema or forget to moisturize. Little by little, we can fall off these routines and open the gap to have another flare.”

What are the symptoms of stress eczema?

The main difference between stress-induced eczema and eczema triggered by other factors? You’ll notice a spike in symptoms during or right after periods of high stress. 

The physical appearance of stress eczema usually looks the same as typical eczema symptoms, Dr. Day says.

• Dry, sometimes scaly skin
• Red patches of skin
• Thickening or hardening of the skin
• Severe itching
• Swelling of the skin
• Raw or tender skin

What are the symptoms of stress?

Sometimes, it can be hard to recognize stress—especially if you’ve been experiencing it for a long period of time, you might get used to it or start to accept it as normal. 

Here are some hallmark symptoms to look out for:

• Exhaustion
• Trouble sleeping
• Muscle tension
• Jaw clenching 
• Irritability 
• Headaches
• Digestive problems
• Mild chest pain or feeling like your heart is racing
• Decreased libido 

How to manage stress eczema

The key to managing stress-induced eczema is, you guessed it, keeping stress in check. 

It can take time to figure out what stress management strategies work for you, and for it to make a difference on your skin, but it will pay off. 

First and foremost, you probably want to know: what can I do to find relief right now? 

Soothing your skin for eczema

These are Dr. Day’s top tips, emphasizing hygiene and self-care practices that best keep your skin protected and hydrated.

1. Stay moisturized. Using a gentle, fragrance-free lotion, moisturize at least twice a day and every time you get out of the shower.
2. Try an over-the-counter product. There are a few different over-the-counter options for treating eczema, including oral antihistamines, pain relievers, and topical hydrocortisone, a low-potency steroid. All of these treatments are intended to relieve itching and reduce inflammation. 
3. Avoid liquid soap. Dr. Days explains that while some liquid soaps might have a “sensitive skin” label when you go to scrub it on your skin with a loofah or washcloth, that can damage the skin barrier. Opt for gentle, fragrance-free bar soap.
4. Keep showers short. Long, hot showers can dry out your skin. To help keep it moisturized, keep your showers shorter and turn down the temperature a bit.
5. Wear breathable clothing. Wear loose-fitting clothing and lightweight fabrics like cotton or linen. Clothes that are too tight, itchy, or warm can leave your skin irritated and more prone to a flare-up.
6. Consult with a dermatology provider. A doctor can give you personalized advice based on your unique skin, triggers, and symptoms. While wait times to see an in-person dermatologist can be months long, Zest offers next-day appointments and 24/7 messaging support to help you find relief exactly when you need it.

Reducing stress for eczema

As you stick to a daily skincare routine and follow best self-care practices for eczema, here are some proven stress-management strategies to implement.

1. Do things that make you feel relaxed. Maybe it’s yoga, watching your favorite TV show, or hanging out with your friends. Whatever leaves you feeling grounded and care-free, make time to prioritize these things.
2. Try not to panic about your flare-up. This might be easier said than done, but stressing about your flare-up just leads to, well, more stress. Try to distract yourself from thinking about it. Focus on doing those things that make you feel relaxed. 
3. Practice mindfulness. Mindfulness is the act of noticing your thoughts, feelings, and sensations with the goal of staying present in your body and surroundings. Some ways to practice mindfulness are by taking deep breaths, actively noticing what you see, hear, smell, or taste, or naming the feelings and sensations happening in your body. 
4. Get a good night’s sleep. Try to practice good sleep hygiene—that is, create a routine for yourself that helps you wind down, turn off screens, and feel sleepy. 
5. Move your body. Exercise fills our brains with those good-feeling chemicals, like endorphins. It’s also known to support overall health, lower stress, and improve sleep. 
6. Eat a balanced diet. When we’re stressed, it’s easy to eat too much or too little. A lack of proper nutrients will make it more challenging to fight off stress, so make sure you’re getting a good variety of vitamins, minerals, and proteins.
7. Talk to someone. Whether it’s a trusted loved one or a therapist, sharing your thoughts and feelings with someone can help you feel less alone. Getting your frustrations out in a healthy way can help lower stress. 
8. Join an eczema support group. Talking with other people who get it can be another great way to connect and find release. Look for a support group in your area or find one online, like this private Facebook group.

Is it more than stress triggering your eczema?

Dr. Day says that if you’re experiencing a level of stress that is significantly impacting your functioning, then that’s a sign something deeper could be going on. 

According to a 2022 meta-analysis, those with eczema have an increased risk of developing anxiety or depression. Some researchers have theorized that this link is due to the burdens caused by eczema, like itching, disrupted sleep, and social isolation, but the association between these conditions is not clear. 

Some signs of anxiety include:

• Excessive worrying
• Feelings of impending doom
• Feeling nervous, restless, or on edge
• Trouble concentrating
• Having the urge to avoid things that bring you anxiety
• Physical symptoms like muscle tension, increased heart rate, sweating, or fatigue

Some signs of depression include:

• Feelings of hopelessness
• Feelings of emptiness or sorrow
• Lethargy or fatigue
• A lack of excitement about things that used to excite you
• Feelings of irritability or frustration
• Sleep disturbances, like sleeping too much or not enough

The good news is that both anxiety and depression are highly treatable. If you suspect that you’re dealing with one of these mental health conditions, talk to your primary care doctor or reach out to a licensed mental health professional for support.

Zest is here for whole-person support to help you take control back from eczema. Reach out today for a next-day appointment.