Living with adult eczema can feel like a constant struggle. New research shows it may impact more than just the skin. A recent large-scale study revealed a surprising link. Adults with eczema are 17% more likely to develop anxiety. And up to 14% more likely to face depression than those without it. 

That’s right. This common skin condition goes beyond physical discomfort. It also affects mental health in ways that might surprise you. If you thought eczema was “just a skin thing,” this study is about to change your perspective.

What Is Atopic Eczema, and How Does It Affect Adults?

Atopic eczema, or atopic dermatitis, is a chronic condition that leads to inflamed, itchy, and often red skin patches. Though it’s typically diagnosed in children, many people experience it well into adulthood. 

This condition can cause ongoing discomfort that impacts daily life and well-being. Affecting up to 10% of adults worldwide, atopic eczema remains a prevalent health challenge. Its chronic nature requires consistent attention and care for those affected.

What causes it? The exact cause of atopic eczema remains unclear. However, it’s widely understood to result from a complex interplay of genetic, immune, and environmental factors. People with a family history of eczema, asthma, or allergies have a higher chance of developing the condition. The immune system’s response is key, often overreacting to irritants and allergens, which leads to inflammation. Flare-ups can also be set off by environmental triggers like sudden temperature changes, allergens, and stress. These factors combined make eczema a complex condition to manage, as each individual’s response can vary. 

Symptoms: Adults with eczema experience dry, itchy, and scaly skin, particularly on areas like the face, hands, neck, and inside the elbows and knees. Scratching can worsen symptoms, potentially leading to bleeding, cracking, and skin infections. These symptoms often disrupt daily life, affecting comfort, sleep, and self-esteem.

How does it affect quality of life? Atopic eczema in adults can have a substantial effect on mental and emotional well-being:

• Sleep Disruption: Severe itching often disrupts sleep, causing frequent awakenings that lower sleep quality. Daytime fatigue, irritability, and decreased cognitive function are just some of the results.
• Social and Emotional Impact: Visible eczema symptoms can lead to feelings of embarrassment or self-consciousness. Some individuals may experience anxiety in social or professional settings, feeling uncomfortable about their appearance.
• Reduced Physical Comfort: Persistent itching, dryness, and irritation can make everyday activities challenging. Everything from work productivity to physical exercise are affected.

Medical Implications: Chronic eczema also raises risks for additional health issues. Adults with atopic eczema are more prone to skin infections due to frequent scratching and weakened skin barriers. Studies have shown that adults with eczema are more likely to have comorbid conditions such as asthma, hay fever, and even cardiovascular disease, likely due to systemic inflammation associated with the condition.

What Did the Study on Eczema and Mental Health Discover?

Research is increasingly showing that atopic eczema also has a profound mental health dimension. In a recent matched cohort study conducted using data from the UK Clinical Practice Research Datalink, researchers examined the link between atopic eczema and mental health, specifically focusing on depression and anxiety in adults. 

What Was the Study’s Objective and Methodology?

The study’s primary goal was to clarify the association between atopic eczema and mental health by examining how the condition relates to new instances of depression and anxiety in adults. 

This connection has been observed before. However, the exact nature of it — whether eczema directly increases mental health risk or if other factors come into play — has been less understood. To address this, researchers used a strong approach. Analyzing routinely collected health data over an extended period (1998-2016) to establish a clearer temporal relationship between eczema and mental health outcomes.

The study examined a substantial sample: 526,808 adults with atopic eczema, compared to a control group of 2,569,030 adults without eczema. Researchers matched participants based on age, sex, diagnosis date, and general practice to ensure accurate comparisons. 

They applied a stratified Cox regression method to consider additional factors that could affect mental health outcomes. Factors included are socioeconomic status, obesity, smoking, harmful alcohol use, and glucocorticoid treatments, which can impact both skin and mental health. This allowed the study to provide a nuanced look at the connections between eczema and mental health factors.

What Were the Key Findings on Depression and Anxiety Risks?

The results were conclusive. Adults with atopic eczema face a higher risk of developing depression and anxiety compared to those without the condition. 

• Increased Risk of Depression: Eczema was associated with a 14% increased risk of new-onset depression. This figure, expressed as a hazard ratio (HR) of 1.14 with a 99% confidence interval (CI) of 1.12-1.16, shows a statistically significant link between eczema and depression risk.
• Increased Risk of Anxiety: The data also revealed a 17% higher risk for new cases of anxiety in individuals with eczema, with an HR of 1.17 (99% CI, 1.14-1.19). This suggests that the presence of eczema has a meaningful impact on anxiety onset as well.

How Does Eczema Severity Affect Depression and Anxiety Risk?

One of the study’s most compelling findings was the correlation between eczema severity and depression risk. As eczema severity increased, so did the likelihood of depression, indicating a dose-response relationship. Specifically:

• Mild Eczema: Patients with mild eczema had a 10% increased risk of depression (HR 1.10).
• Moderate Eczema: Those with moderate eczema showed a higher risk. A 19% increase in depression incidence (HR 1.19) was found.
• Severe Eczema: The risk rose even further for those with severe eczema, showing a 26% increase in depression likelihood (HR 1.26).

Severe eczema can strain mental health due to physical discomfort and social challenges. Together, these effects often increase stress and impact well-being.

For anxiety, however, the dose-response trend was less consistent. While moderate eczema cases showed a 21% increased risk for anxiety (HR 1.21), the anxiety risk for severe cases actually showed a slight decrease (HR 1.15) compared to moderate cases. So, while eczema severity clearly influences depression risk, the connection to anxiety may involve additional factors beyond physical severity alone.

Why Might Eczema Increase the Risk of Depression and Anxiety?

Understanding why atopic eczema raises mental health risks involves examining the daily struggles and physiological impacts of the condition:

• Physical Discomfort: Persistent itching, soreness, and inflamed skin can take a toll on mental resilience, leading to increased stress and frustration.
• Social and Emotional Impact: Visible symptoms may cause individuals to feel self-conscious, impacting social interactions, self-esteem, and overall confidence.
• Sleep Disruption: Eczema often disrupts sleep due to itching, which can lead to chronic fatigue—a known risk factor for depression and anxiety.
• Immune System Interplay: Eczema is an inflammatory condition. And chronic inflammation has been linked to an increased risk of mood disorders, possibly due to the body’s prolonged stress response.

These factors combined create a challenging environment where individuals with eczema may be more prone to emotional stress, anxiety, and depression.

What Do These Findings Mean for Eczema and Mental Health Care?

A comprehensive approach to treating atopic eczema should address both physical symptoms and mental health needs. For healthcare providers, this study emphasizes the importance of monitoring not only skin symptoms but also mental health, particularly in moderate to severe cases. 

Mental health screenings are a valuable addition to patient care, along with access to appropriate support. Educating patients about the psychological impacts of eczema may help reduce associated mental health risks. These combined efforts aim to improve overall quality of life for those managing eczema.

What Lifestyle Changes Can Help Reduce Eczema Flare-Ups and Improve Mental Health?

Managing eczema involves more than just topical treatments. Small lifestyle changes can significantly reduce flare-ups and support mental well-being. Here are a few practical adjustments:

• Moisturize Regularly: Hydrating the skin daily is essential. Use fragrance-free, thick emollients to lock in moisture, especially after bathing. This helps strengthen the skin barrier, reducing itchiness and irritation.
• Avoid Triggers: Identifying and steering clear of personal triggers, such as certain fabrics, allergens, or harsh soaps, can prevent flare-ups. Keep a journal to pinpoint patterns and eliminate these triggers from daily life.
• Manage Stress: Stress is a common flare-up trigger. Practice stress-reducing activities, like mindfulness meditation, yoga, or breathing exercises, to lower stress levels and ease eczema symptoms.
• Follow an Anti-Inflammatory Diet: Eczema is an inflammatory condition, so adding foods rich in omega-3 fatty acids, such as salmon, walnuts, and flaxseed, may help reduce inflammation. Avoid highly processed foods and limit sugar intake to further support skin health.
• Sleep Well: Sleep quality can impact both skin health and mood. Aim for 7-9 hours nightly to support immune function and reduce inflammation, which may lessen flare-ups and boost mental resilience.

Experience Expert Support at the TMS Institute of Arizona

The TMS Institute of Arizona understands how overwhelming it is to manage the mental health challenges that come with chronic conditions. 

Our team specializes in treating depression, anxiety, and other mental health conditions through advanced, evidence-based TMS therapy. 

With compassion, we provide the support and care you need to feel confident and capable in handling life’s challenges. Contact us today to learn how we can help you find relief and regain balance. We’re here for you—every step.

References

Raj Chovatiya. (2023). Atopic Dermatitis (Eczema). JAMA, 329(3), 268–268. https://doi.org/10.1001/jama.2022.21457

Schonmann, Y., Mansfield, K. E., Hayes, J. F., Abuabara, K., Roberts, A., Smeeth, L., & Langan, S. M. (2020). Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. The Journal of Allergy and Clinical Immunology: In Practice, 8(1), 248-257.e16. https://doi.org/10.1016/j.jaip.2019.08.030

‌Silverberg, J. I. (2019). Comorbidities and the impact of atopic dermatitis. Annals of Allergy Asthma & Immunology, 123(2), 144–151. https://doi.org/10.1016/j.anai.2019.04.020

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This content is designed to provide general information and is not a replacement for professional medical advice. Always consult a qualified medical professional for your healthcare needs.