Eczema and stress in adults

Stress can wreak havoc on the body. Common symptoms include sleep problems, fatigue, muscle aches, headaches, and chest pains. But have you considered that stress could also be to blame for your eczema flare-ups? While stress doesn’t cause eczema, research shows that it can be significant trigger. In this article, we’ll explore the link between stress and eczema to help you understand how to manage the condition effectively.

Is there a link between stress and eczema?

The impact of stress on eczema symptoms was highlighted in The National Eczema Society’s 2020 Patient Survey, ‘Eczema Unmasked‘. Around 50% of the survey’s respondents reported they believed stress to be a trigger for their eczema.

Conversely, living with active eczema has an undeniable psychological impact. The incessant eczema itch disrupts concentration and sleep making daily life just that bit more difficult to deal with. Depending on the location of the eczema, self-esteem can also be impacted which in turn can limit the social contact. The same study found that 74% of adult eczema sufferers felt that skin condition negatively affected their mental health. These findings are in line with other surveys¹ and is also supported by measurements of saliva cortisol (seen as a reliable biomarker for stress level) in eczema patients².

While stress cannot cause eczema, if can trigger a flare-up in people who are already susceptible to it. It’s not uncommon for people who ‘grew out’ of childhood eczema to suffer from stress-related flare-ups as adults.

But how does stress cause eczema flare-ups?

The most likely mechanism for this relationship between stress and eczema is thought to be a combination of the effects of cortisol and neuropeptides, both of which are released when the body is stressed. Neuropeptides are chemical messengers produced in by nerve endings and associated with stress. These chemicals are produced throughout the body and have been linked to skin inflammation³. Cortisol is a steroid hormone released by the adrenal glands. Under normal conditions it helps with maintaining blood pressure, regulating the immune system, reducing inflammation and managing stress. However, under stress the body produces much higher levels of cortisol and this can lead to inflammation.

Stress not only triggers eczema flare-ups, it also slows the body’s healing processes, meaning that stress induced eczema is typically slow to heal. According to an article published by Pfizer, when cortisol is released in large amounts due to ongoing, chronic stress, it suppresses the immune system, which can trigger eczema by increasing inflammation and reducing the skin’s ability to repair damage.

Does they type of stress affect eczema differently?

A 2018 research review⁴ found that short-term (acute) and long-term (chronic) stress may affect eczema in slightly different ways:

• Short term stress can cause a spike in cortisol and adrenaline or noradrenaline which create the ‘fight or flight’ . These spikes can trigger your immune system to release Th1 cells, which may lead to inflammation.
• Long-term stress may lead to a higher baseline level of cortisol, which could affect how your immune system responds to additional stressful events.

A second study in 2023 suggests that long term stress, like that caused by family or financial problems, work overload, school exam periods, lack of structure at work, and unforeseen events, affected eczema more than short term stressful events⁵. While this was a small study (just 28 participants), these conclusions are in line with other animal based research⁶.

Effective strategies for managing stress and alleviating eczema

For many of us, stress seems to have become an unavoidable part of our busy, modern lifestyles. However, it’s important to recognise the negative impact that too much stress can have on both our mental and physical health.

However, even if stress is one of your eczema triggers, stress related flare-ups are not inevitable. A small study found that teaching stress management skills reduced cortisol production in eczema sufferers under acute stress (a public speaking task) compared to the control group⁷.

So it really is worth finding the time to find to manage your stress levels. There will be times when stress is unavoidable. At these cases, you may need to rely on medical interventions, but it will still be worth trying to minimise the impact that stress has on you.

10 top tips for dealing with stress

We’ve put together the following checklist to help you find tress reducing strategies that works for you.

1. Address mental health problems – As we’ve learned, mental health problems like anxiety and depression can cause an individual significant stress. Therefore, if you’re experiencing mental health issues, it’s important to seek support from a healthcare professional.
2. Prioritise your own needs – Often, we put the needs of others before our own. To manage stress effectively, you must learn to listen to your body and prioritise your own needs when you feel your stress levels rising. This approach can help you to maintain mental balance and improve your overall well-being.
3. Learn to slow down – In a world that values speed and productivity, taking the time to slow down doesn’t come naturally to many people. However, carving out time in your busy day to rest and do something that is just for your enjoyment can significantly reduce stress levels.
4. Take time to switch off – Make it a habit to switch off digital devices at certain times during the day. Designating time to disconnect from emails, social media, and work commitments can help clear your mind and reduce the triggers of stress-related eczema. 
5. Learn to say no – Everyone should learn how to say no when they are already feeling stretched thin. Learning to say no can help you manage your workload, reduce stress, and reduce the risk of burnout.
6. Get outside more – Spending time in nature is proven to have a calming effect on the mind and body. Whether it’s a walk in the park or a cup of tea in the garden, exposure to nature can help ground you and lower stress levels. Personally, I love paddleboarding especially in the winter when it’s quiet.
7. Stay active – Regular physical exercise is a proven stress reliever. Find an activity that you enjoy, whether that’s yoga, swimming, football, running, or gentle walking. Moving your body and staying active can improve your mood and decrease symptoms of stress. Despite the problems of sweat aggregating eczema in some people, exercise is a useful tool in reducing both stress and itching in some people.
8. Get enough sleep – Sleep plays a crucial role in managing stress and helping the body to heal. Ensuring you get enough sleep can help to minimise stress and manage eczema flare-ups. This can be difficult if itchy or painful eczema is keeping you awake, so it’s important to manage eczema symptoms at night. Adult eczema sleepwear like the ScratchSleeves PJ top can help protect the skin and prevent nighttime scratching.
9. Eat a balanced and nutritious diet – What you eat affects your mood, energy levels, and physical health. A diet rich in fruits, vegetables, lean proteins, and whole grains can fortify your body against the effects of stress.
10. Practice breathing techniques – Mindful breathing exercises can significantly reduce stress in the moment. Techniques such as deep breathing, guided imagery, and meditation can help you remain calm and prevent stress from building up in your body.

What else can trigger eczema?

While stress is a common trigger of eczema in adults, many other factors can exacerbate the condition. Our blog has a section on eczema triggers that is packed full of useful information.

Our sources

1. Mental Health and Skin Disease – All Party Parliamentary Report, 2020. https://www.psoriasis-association.org.uk/media/APPGS/Mental_Health_and_Skin_Disease_Report_FINAL.pdf
2. Mizawa, M, et al. “Stress Evaluation in Adult Patients with Atopic Dermatitis Using Salivary Cortisol.” BioMed Research International, 2013.
   https://pubmed.ncbi.nlm.nih.gov/23971022/
3. Zhang, Y, et al. “Current Views on Neuropeptides in Atopic Dermatitis.” Experimental Dermatology, Nov. 2021.
   https://pubmed.ncbi.nlm.nih.gov/33963624/
4. Meštrović-Štefekov, J, et al. “Psychological Stress in Patients with Atopic Dermatitis.” Acta Dermatovenerologica Croatica : ADC, Dec. 2018, https://pubmed.ncbi.nlm.nih.gov/30665478
5. Lönndahl, L, et al. “Psychological Stress and Atopic Dermatitis: A Focus Group Study.” Annals of Dermatology, Oct. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579569/
6. Grip, L, et al. “Substance P Alterations in Skin and Brain of Chronically Stressed Atopic-like Mice.” Journal of the European Academy of Dermatology and Venereology : JEADV, Feb. 2013. https://pubmed.ncbi.nlm.nih.gov/22251186/
7. Schut, C, et al. “Psychophysiological Effects of Stress Management in Patients with Atopic Dermatitis: A Randomized Controlled Trial.” Acta Dermato-Venereologica, Jan. 2013. https://pubmed.ncbi.nlm.nih.gov/22983681/
8. The Mind-Body Connection. The Eczema Society. https://eczema.org/blog/the-mind-body-connection/

You can browse our adult eczema clothing in our online shop. Don’t hesitate to contact us if you have any questions about our products.