Share to Pinterest A recent review looks at links between eczema and mental health. María Soledad Kubat/Stocksy, Photo, StocksyA review of the evidence to date suggests that eczema is associated with a 63% increased risk of depression or anxiety.Possible explanations for the increased risks include social isolation and disturbed sleep due to itching.There may also be physiological links between the three conditions, via disruptions in hormones, the immune system, and the nervous system. Treatments can help relieve both eczema and its associated psychological problems.
Eczema is an inflammatory skin condition that causes patches of dry, flaky, itchy skin that can crack. It is the most common form of atopic dermatitis.
According to the National Eczema Association, 31.6 million people in the United States have some form of eczema, which is about 10% of the population.
They note that the prevalence of atopic dermatitis in children in the US has increased from 8% in 1997 to about 12%.
Many studies have shown that eczema increases the risk of anxiety and depression, but estimates of the magnitude of the risk vary widely.
A review of the best available evidence has now shown that eczema is associated with a 63% increased chance of developing depression or anxiety.
When the researchers analyzed these two mental health conditions separately, they found that eczema was associated with a 64% increased risk of depression and a 68% increased risk of anxiety.
To make their estimates, they collected data from 20 studies involving a total of 141,910 people with eczema and 4,736,222 controls who did not have the condition.
The researchers, from the Sixth Affiliated Hospital of Kunming Medical University in Yuxi, Yunnan, China, have published their results in PLOS ONE.
The authors speculate that itching, sleep disturbances and social isolation may increase a person’s risk of depression or anxiety.
“Social isolation and stigma can certainly occur, as many patients experience their dermatitis on parts of their bodies that are public, such as the face, neck, and hands,” said Beth Goldstein, a dermatologist at the Central Dermatology Center and co-founder from Get Mr., who was not involved in the new investigation.
“Intimate relationships can also be very difficult to navigate,” she told Medical News Today.
“It is extremely important to address the mental health component of eczema because the stress can cause flare-ups or exacerbate existing symptoms,” says Vivian Shi, MD, a dermatologist at the University of Arkansas for Medical Sciences in Little Rock, AR. who is a member of the National Eczema Association’s expert panel.
“Treating the mental health component of eczema in addition to the physical symptoms is crucial to maximize the benefits of treatment,” she added.
The authors of the new analysis emphasize that the physiological mechanisms linking eczema and mental health remain unclear.
But they note some interesting studies that suggest there may be shared physiological causes, such as oxidative stress and inflammation.
They also cite research in a mouse model of eczema that showed the animals exhibited anxiety and depression-like behaviors. The scientists behind this study showed that the behavior was linked to changes in parts of their brains involved in reward processing.
Another study found that the antidepressant fluoxetine (Prozac) reduced the symptoms of atopic dermatitis in mice while also relieving their anxiety-like symptoms.
Fluoxetine was found to suppress both psychological stress and inflammatory responses.
In humans, clinical studies have shown that a drug called dupilumab, which inhibits immune signaling molecules, not only improves eczema but also reduces anxiety or depression.
There can be a cycle of psychological stress, increased inflammation, and skin flare-ups in people with eczema.
The National Eczema Association says hormonal disruptions associated with atopic dermatitis can affect the nervous and immune systems and the skin cells themselves. This increases inflammation and disrupts the skin’s barrier function.
At the same time, psychological stress can inhibit the skin’s recovery.
The organization says people with atopic dermatitis, especially children and teens, may face stigma from their peers.
Stress and anxiety can stimulate the production of inflammatory molecules, such as histamine, which in turn causes itching. Scratching can then damage the skin and make inflammation worse.
In a survey by the National Eczema Society in the UK, 74% of people reported eczema negatively impacting their mental health, and 66% said it led to feelings of loneliness and social isolation.
Less than half of these individuals said they had received professional psychological support to help manage these problems.
Children with eczema are particularly vulnerable to stigma, social isolation and self-esteem problems.
“It’s important that you talk to people about your skin when you’re not feeling too well, when you’re not in the best mood,” says Daniel, a teen with eczema.
“It’s absolutely important that you talk to people because they need to know you’re not feeling great,” he said in a UK National Health Service (NHS) eczema and mental health video.
“If you surround yourself with positive people, you will never hear a bad comment. You will always have people watching out for you,” he said.
In addition to asking others for help, the National Eczema Association recommends journaling and stress relief techniques, such as walking, mindfulness and yoga.
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