Eczema and Stress: Understanding the Psychosomatic Connection

Eczema, or atopic dermatitis, is often seen as a purely physical condition—one that results in dry, itchy, inflamed skin. However, the connection between eczema and the mind runs deeper than many realise. Emotional stress doesn’t just affect your mood; it can directly influence your skin’s health. This psychosomatic link—where psychological factors impact physical symptoms—is especially important when it comes to chronic conditions like eczema.

How Stress Affects the Skin

Stress triggers a complex chain of hormonal and immune responses. When you’re stressed, your body releases cortisol, a hormone designed to help you cope with threats. While cortisol can be helpful in short bursts, prolonged stress keeps it elevated, which can weaken the immune system and impair the skin’s barrier function.

Key ways stress impacts eczema:

• Weakened skin barrier: Stress reduces the production of ceramides and lipids in the skin, making it more prone to dryness and irritation.
• Increased inflammation: Chronic stress boosts inflammatory pathways, which can trigger or worsen flare-ups.
• Delayed healing: Stress impairs the body’s ability to repair damaged skin, prolonging recovery from eczema outbreaks.
• Heightened itch response: Stress and anxiety can increase the perception of itch, leading to more scratching and skin damage—a cycle known as the itch-scratch-stress loop.

The Itch-Scratch-Stress Loop

This cycle is central to the relationship between eczema and stress. It begins when stress exacerbates itchiness. Scratching offers temporary relief but ultimately causes more skin damage and inflammation, which then leads to more stress—and so the cycle continues.

Signs that stress is worsening eczema:

• Flare-ups during emotionally intense periods (exams, job changes, family conflicts)
• Poor sleep due to stress and itching
• Skin not responding to usual treatments during high-stress times
• Increased urge to scratch, even without visible triggers

The Role of Mental Health in Eczema

Living with eczema itself can also be emotionally taxing. Persistent symptoms, visible skin lesions, and social discomfort often lead to anxiety, embarrassment, or even depression. In fact, studies show that people with chronic eczema are more likely to experience:

• Low self-esteem
• Social withdrawal
• Mood swings
• Sleep disturbances due to itching

This two-way connection means that eczema affects mental health, and mental health affects eczema—making stress management a key component of long-term care.

Strategies to Break the Stress-Eczema Cycle

While stress may not be the root cause of eczema, managing it can greatly reduce symptom severity and improve quality of life.

Effective approaches include:

• Mindfulness and meditation: Even 10 minutes a day can help calm the nervous system.
• Regular exercise: Improves mood and reduces inflammation, but choose low-sweat activities if sweat irritates your skin.
• Breathing exercises: Simple pranayama techniques can regulate stress responses.
• Sleep hygiene: Create a calming bedtime routine to reduce nighttime itching and anxiety.
• Support systems: Talking to family, friends, or a therapist can ease emotional burdens.

Skincare practices that soothe both skin and stress:

• Gentle moisturising routines can be made calming rituals with the use of soft music or aromatherapy.
• Lukewarm baths with oats or neem water can ease itching and provide mental relaxation.

A Holistic View

Traditional health systems have long acknowledged the mind-skin connection. In Ayurveda, eczema is often seen as a manifestation of internal imbalance worsened by emotional stress or suppressed emotions. Herbs like brahmi and ashwagandha are traditionally used to support emotional resilience and reduce systemic stress, complementing topical and dietary management.

Eczema is not just skin deep—its symptoms and triggers extend into the mind and emotional health. Stress may not cause eczema directly, but it can worsen its intensity, prolong flare-ups, and reduce the effectiveness of treatments. By recognising the psychosomatic connection and incorporating stress-reduction techniques into daily life, individuals can gain better control over their condition and improve their overall well-being.