Eczema (atopic dermatitis), stress, and mental health

Eczema affects more than just the skin

Dry, itchy skin. Painful rashes. Sleepless nights. Some of the most common symptoms of eczema (atopic dermatitis) have the most significant impact on physical and mental health.^1,2

It can feel stressful managing persistent symptoms, but then stress and anxiety just make them worse. Understanding the connection between skin and stress can help keep your skin and your well-being as healthy as possible.³

Can stress cause eczema?

Even though stress doesn’t directly cause eczema, it is one of the most common triggers for flare-ups. That’s because stress has effects on both the immune system and the skin barrier. It can make symptoms last longer and become more difficult to manage. This is often referred to as the “stress-skin” connection.³

Skin health is tied to stress

When under stress, the brain and body react in tandem. This back-and-forth communication allows the release of hormones to help manage stress. Some hormones like cortisol disrupt the skin barrier and the immune system, leading to itch and other eczema symptoms.³

Once released, stress hormones activate specialized cells that contribute to causing itch. Irritated skin then sends distress signals back to the brain.³

The “stress-skin connection” forms a vicious cycle where stress worsens symptoms, and discomfort increases stress levels.³

Protecting the skin barrier is essential

Psychological stress can also weaken your skin’s natural barrier, the outer layer that keeps moisture in and protects against germs and irritants. A healthy skin barrier is essential for preventing dryness, irritation, and flare-ups.³

When the skin barrier is damaged, it becomes harder for the skin to heal. It becomes more vulnerable to infections, inflammation, and further damage.³

How can you manage the emotional impact of eczema?

Acknowledge the impact Living with eczema (atopic dermatitis) can be extremely challenging and lead to feelings of anxiety and depression. The itch, rash, and inability to concentrate can all contribute to heavy emotional stress.^2,4

Recognize the signs Consider seeking help if you feel sad or low energy, are losing interest in hobbies, or have trouble sleeping or concentrating. These are signs that stress may be affecting your quality of life.⁴

If you are feeling anxious or depressed, discuss proactive steps with your healthcare team to better control the emotional impacts of eczema.

How can reducing stress help avoid flare-ups?

Eczema (atopic dermatitis) usually starts in childhood, often in the first 6 months of life, and it can be severe and long-lasting. However, adults can also develop the condition at any age. Eczema is more common in females than males and in black children compared to white children.^1,2

If you feel like you’ve tried it all and itch persists, don't lose hope. Everyone finds relief in different ways. Talking to a dermatologist can help you discover other options that may work better for you.

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Exercise

Exercise releases endorphins, the so-called "happy hormones," which can help improve mood and reduce stress.⁵

If sweating tends to trigger your eczema, keep your skin comfortable by taking a cool shower after exercising and promptly changing into fresh clothes.²

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Sleep

When itch disrupts your sleep at night, it can increase stress levels and contribute to a cycle where stress and poor sleep worsen eczema symptoms.²

To improve sleep, keep your room dark, cool, and clean, and limit electronics an hour or so before bedtime. Alcohol also affects sleep quality, so limiting beverages can help you get better rest and avoid potential flare-ups.⁵

Explore the results from the clinical studies to learn how NEMLUVIO^® helped patients improve their sleep by relieving itch.

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Relaxation and self-care

Research suggests that regular meditation and mindfulness can help lower overall stress hormone levels, which are linked to the body's "fight-or-flight" response.^6,7

Some relaxation activities that may help include:

Deep breathing exercises: Taking long, slow breaths to calm the mind
Yoga: Combining physical postures with breathing techniques
Being closer to nature: Spending time outdoors to relax
Creative activities: Engaging in hobbies like painting or writing

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Eczema support groups

Joining a support group allows you to share experiences and coping strategies with others living with eczema. If you’ve ever felt self-conscious or hidden your skin, connecting with others who have been there too can provide valuable support and reassurance.

Following organizations like the National Eczema Association on social media can also help connect you with the eczema community and stay updated on news and research.

Have you tried everything, but itch keeps coming back?

Eczema is stubborn. Keep your head up and know that treatment options for eczema continue to evolve and better manage symptoms.^2,4

Not an actual patient.

Frequently Asked Questions

What is an eczema flare?

The term “flare” or “flare-up” is often used to describe a period of increasingly itchy skin and red or dark rashes, that continue to worsen over days or weeks. It can also lead to infections or complications that may require hospitalization if left untreated.^8,9

If an eczema (atopic dermatitis) flare-up is caught early, your skin has a chance to heal. The longer it takes, the more difficult it may be to restore the condition of your skin. Though there is not always a reason for a flare-up, knowing your triggers can help anticipate and keep flare-ups under control.⁸

How does stress impact the skin barrier?

Stress and anxiety can weaken the skin barrier, potentially leading to sensitive or dry skin, as well as conditions like eczema. Managing stress is crucial for maintaining a strong skin barrier and overall skin health.³

What is the difference between acute and chronic stress-induced eczema (atopic dermatitis)?

Short-term (acute) stress is temporary, while long-term (chronic) stress lasts over time. Both can negatively impact skin health, worsening conditions like psoriasis, eczema, acne, and hair loss. Chronic stress is more likely to contribute to persistent eczema flare-ups due to prolonged hormone release and immune system disruption.³

Discover the triggers of an eczema flare-up

Explore the different causes of eczema and the key risk factors for flare-ups.

Causes of Eczema

References: 1. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Atopic dermatitis. Accessed March 24, 2025. https://www.niams.nih.gov/health-topics/atopic-dermatitis 2. National Eczema Association. Atopic dermatitis. Accessed March 24, 2025. https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis 3. Zhang H, Wang M, Zhao X, et al. Role of stress in skin diseases: a neuroendocrine-immune interaction view. Brain Behavior and Immunity. 2024;116:286-302. doi: 10.1016/j.bbi.2023.12.005 4. Silverberg JI, Mohawk JA, Ciruli J, et al. Burden of disease and unmet needs in atopic dermatitis: results from a patient survey. Dermatitis. 2023;34(2):135-144. doi:10.1089/derm.2022.29015.jsi 5. National Eczema Society. Stress and eczema. Accessed March 24, 2025. https://eczema.org/information-and-advice/triggers-for-eczema/stress-and-eczema 6. Nathan N. Harvard Health Blog. Stress may be getting to your skin, but it’s not a one-way street. Published April 14, 2021. Accessed March 24, 2025. https://www.health.harvard.edu/blog/stress-may-be-getting-to-your-skin-but-its-not-a-one-way-street-2021041422334 7. National Eczema Association. Alternative treatments for eczema. Accessed March 24, 2025. https://nationaleczema.org/treatments/complementary-alternative 8. Johnson J. National Eczema Association. What is an eczema flare? Updated September 2022. Accessed March 24, 2025. https://nationaleczema.org/blog/definition-of-eczema-flare 9. Ballard A. National Eczema Society. Staph & eczema: A skin-duo you need to know about. Updated November 28, 2022. Accessed March 24, 2025. https://nationaleczema.org/blog/staph-eczema-a-skin-duo-you-need-to-know-about.

Important Safety Information

Indications: NEMLUVIO^® (nemolizumab-ilto) is a prescription medicine used:

to treat adults and children 12 years of age and older with moderate-to-severe eczema (atopic dermatitis or AD) in combination with prescription therapies used on the skin (topical) when the eczema is not well controlled by topical therapies alone. It is not known if NEMLUVIO is safe and effective in children with atopic dermatitis under 12 years of age.
to treat adults with prurigo nodularis. It is not known if NEMLUVIO is safe and effective in children with prurigo nodularis under 18 years of age.

Do not take NEMLUVIO if you are allergic to nemolizumab-ilto or to any ingredients in NEMLUVIO. Before taking NEMLUVIO, tell your healthcare provider about all of your medical conditions, including if you:

are scheduled to receive any vaccination. You should not receive a live vaccine right before or during treatment with NEMLUVIO.
are pregnant or plan to become pregnant. It is not known whether NEMLUVIO will harm your unborn baby.
are breastfeeding or plan to breastfeed. It is not known whether NEMLUVIO passes into your breast milk and if it can harm your baby.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

NEMLUVIO may cause serious side effects, including: allergic reactions (hypersensitivity). Stop using NEMLUVIO and tell your healthcare provider or get emergency help right away if you get any of the following symptoms:

Breathing problems or wheezing
Swelling of the face, lips, mouth, tongue, or throat
Fainting, dizziness, feeling lightheaded
Fast pulse
Swollen lymph nodes
Joint pain
Fever
Skin rash (red or rough skin)
Nausea or vomiting
General ill feeling
Cramps in your stomach area

The most common side effects of NEMLUVIO include:

Eczema: headache, joint pain, hives (itchy red rash or wheals), and muscle aches
Prurigo Nodularis: headache and skin rashes: atopic dermatitis (a type of eczema), eczema, and eczema nummular (scattered circular patches)

These are not all of the possible side effects of NEMLUVIO.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Please see full Prescribing Information, including Patient Information.