Stress and Eczema: Causes, Links, and Further Insights
Stress can play a significant role in the development and exacerbation of eczema, a common skin condition that often appears in early childhood.
Having a family history of eczema, hay fever, asthma, or allergies may contribute to the development of eczema. However, stress can also trigger eczema flare-ups, especially in those with a predisposition.
The connection between stress and eczema involves several mechanisms. Stress hormones like cortisol and immune system dysregulation play key roles. When under stress, the body releases cortisol, a hormone that can suppress some immune functions but also promote skin inflammation through complex pathways. This hormonal imbalance can lead to eczema flare-ups.
Stress also impacts the balance of immune cells and cytokines that regulate inflammation and skin barrier function, worsening eczema symptoms. In particular, stress-induced cortisol and other molecules may further activate signalling pathways such as JAK/STAT and MAPK, leading to increased production of pro-inflammatory cytokines (IL-4, IL-6, IL-1β, TNF-α) that exacerbate skin inflammation and damage the skin barrier.
Moreover, the immune imbalance in eczema involves an overactive Th2 immune response (T-helper type 2 cells), which produces cytokines like IL-4, IL-13, and IL-31 that increase inflammation, IgE antibody production, and histamine release from mast cells, causing redness, swelling, and itching.
Psychological stress also triggers neuroimmune pathways affecting skin nerve endings and inflammatory responses, contributing to the itch-scratch cycle that worsens eczema.
To help manage stress and prevent eczema flare-ups, using relaxation techniques such as meditation, yoga, or creative activities can be beneficial. Additionally, using fragrance-free skin products, detergent, and clothing can help reduce irritants that may provoke eczema. Improving sleep quality by creating a comfortable and quiet bedroom, taking a warm bath or shower before bedtime, and avoiding caffeine and alcohol before bed may also help.
For those experiencing depression or anxiety along with eczema, seeking guidance from a mental health specialist is recommended. In cases where over-the-counter medicines or home remedies have been ineffective, eczema is affecting daily life, lesions cover a large area of the body, lesions appear infected and have red streaks or produce pus, stress is affecting daily life, or stress-management strategies are not working, contacting a doctor is advisable.
Joining an Asthma and Allergy Foundation of America support group can help a person feel less alone, providing a community of understanding and support.
In a 2020 survey by the National Eczema Society, 57% of females and 41% of males reported that stress worsened their eczema. This highlights the importance of stress management in managing eczema.
Regular exercise is another effective way to manage stress, possibly due to the release of certain hormones and neurotransmitters. Avoiding extreme temperatures and protecting the skin can also help prevent eczema. Moisturizing after bathing and whenever the skin feels dry with a fragrance-free cream or ointment is recommended.
Cytokines, small proteins that affect immune and inflammation responses in the body, may also play a role in the link between stress and eczema. Understanding these connections can help in developing more effective treatments for eczema.
In conclusion, the mechanisms linking stress to eczema are a combination of hormonal (cortisol) effects, immune dysregulation skewed toward Th2 responses, inflammatory cytokine release, and skin barrier impairment, all of which interact to worsen the chronic inflammatory state of eczema. By managing stress and adopting preventive measures, individuals can help reduce the impact of eczema on their lives.
- Stress hormones like cortisol, caused by stress, can suppress some immune functions yet promote skin inflammation, leading to eczema flare-ups.
- Overactive Th2 immune responses, which produce cytokines like IL-4, IL-13, and IL-31, are involved in the immune imbalance in eczema and exacerbate inflammation, IgE antibody production, and histamine release.
- In a 2020 survey, 57% of females and 41% of males reported that stress worsened their eczema, highlighting the importance of stress management.
- Regular exercise, as a method for managing stress, may help reduce the impact of eczema on an individual's life by improving hormonal and neurotransmitter balance.
