How Stress Hormones Affect the Eczema-Prone Skin Barrier

How Stress Hormones Affect the Eczema-Prone Skin Barrier

Stress and eczema can be closely connected. Stress does not cause eczema, but for many people living with the condition, periods of psychological or emotional stress can make itching and flare-ups more difficult to manage.

This connection is not simply about how stress makes us feel. When we are under stress, the body releases hormones and other chemical messengers that can influence inflammation, itching and the way the skin barrier functions.

Understanding this relationship can help explain why your skin sometimes seems to become more reactive during particularly busy, worrying or emotionally demanding periods.

What happens to your skin when you’re stressed?

When you experience stress, your body activates its stress-response systems. One of the hormones involved is cortisol.

Cortisol is an important hormone that helps the body respond to challenges. Short-term increases are a normal part of the stress response. However, ongoing psychological stress and prolonged activation of stress pathways can affect several processes within the skin.

Research suggests that psychological stress can interfere with the production of epidermal lipids and structural components needed for healthy barrier function.

This matters particularly for eczema-prone skin, where the skin barrier may already be compromised.

Stress, eczema and the skin barrier

Think of the outermost layer of the skin as a protective wall.

Skin cells form part of the structure, while lipids, including ceramides, cholesterol and fatty acids, help fill the spaces between them. Together, these components help keep moisture inside the skin while limiting the entry of irritants and other environmental substances.

Filaggrin is another important protein involved in the strength, hydration and function of the skin barrier. Changes in filaggrin function are associated with atopic dermatitis in some people.

Eczema-prone skin commonly has abnormalities in these protective barrier systems. Stress can place additional pressure on an already vulnerable barrier by affecting epidermal lipid production and other processes involved in barrier function.

Why can skin feel drier during stressful periods?

One effect associated with psychological stress is increased transepidermal water loss, often shortened to TEWL.

This is the process through which water passes from inside the body through the outer layers of the skin and evaporates.

When the skin barrier is not functioning effectively, more moisture can escape. The skin may then become drier, tighter or more easily irritated.

For someone living with eczema, this can contribute to a cycle where barrier disruption, inflammation and itching influence one another.

Stress can affect itching too

Sometimes the first sign that stress is affecting your eczema may not be a visible rash. You may simply notice that you are itchier than usual.

The nervous, immune and endocrine systems all communicate with the skin. During periods of stress, chemical messengers involved in these systems can influence itch and inflammation.

More itching can also mean more scratching. Scratching may provide temporary relief, but it can further damage the skin barrier and contribute to the familiar itch-scratch cycle.

This can make eczema increasingly difficult to settle.

Can stress cause an eczema flare?

Stress does not cause eczema itself. However, it is a recognised trigger for some people and can worsen existing eczema.

Not everyone will respond to stress in the same way. Some people notice a clear relationship between stressful periods and their skin, while others may find environmental conditions, illness, allergens, irritants or other individual triggers have a greater influence.

It can also be difficult to identify a single trigger because several factors may be occurring at the same time.

For example, a stressful week might also involve less sleep, changes to your usual skincare routine, more sweating or less time to moisturise.

Supporting your skin during stressful periods

You cannot always remove stress from everyday life, and trying to eliminate stress entirely is rarely realistic.

Instead, it can be helpful to support both your skin and your general wellbeing during particularly stressful periods.

Try to keep your eczema skincare routine consistent, even when life gets busy. Regular use of a fragrance-free moisturiser or emollient can help support the skin barrier and reduce water loss.

Sleep, regular movement and relaxation techniques may also help with general stress management. Some people find breathing exercises, mindfulness, time outdoors or simply making space for enjoyable activities useful.

The aim is not to suggest that eczema can be “thought away” or controlled simply by relaxing. Eczema is a complex inflammatory skin condition, and stress management is only one part of managing it.

Stress and eczema in children and teenagers

Children and teenagers can experience the stress-eczema relationship too.

School pressures, exams, changes in routine, friendships, sport and lack of sleep can all contribute to stress. At the same time, living with visible or uncomfortable eczema can itself be stressful.

Parents and carers may find it useful to look for changes in both skin and behaviour during particularly demanding periods.

Keeping skincare routines predictable, supporting good sleep habits and encouraging age-appropriate ways to relax can help. If eczema is worsening or affecting a child’s sleep, school, mood or everyday activities, speak with their GP, dermatologist or other healthcare professional.

Frequently asked questions

Can stress alone cause eczema flare-ups?

Stress does not cause eczema, but it can trigger or worsen symptoms in some people. Eczema is a complex condition influenced by the skin barrier, immune system, genetics and environmental factors, so it is rarely helpful to attribute a flare to one factor alone.

How quickly can stress affect eczema?

There is no set timeframe. Some people notice increased itching or skin changes during a stressful period, while for others the relationship may be less obvious. Keeping track of symptoms and potential triggers can sometimes help identify individual patterns.

Will reducing stress clear my eczema?

Stress management may help if stress is one of your individual triggers, but it should not replace appropriate eczema treatment and skincare. Continue following your eczema management plan and speak with your healthcare professional if your symptoms are persistent, worsening or difficult to control.

Can children and teenagers use stress-management techniques?

Yes. Age-appropriate approaches such as regular sleep routines, physical activity, breathing exercises, mindfulness and relaxing activities can support general wellbeing. If stress or eczema is significantly affecting a young person’s daily life, seek advice from an appropriate healthcare professional.

The takeaway

The relationship between stress and eczema is complex, but it is very real for many people living with the condition.

Stress can influence the skin barrier, water loss, inflammation and itch, potentially making already eczema-prone skin more reactive. At the same time, living with eczema can itself be stressful, creating a cycle that can be difficult to break.

Supporting your skin barrier with consistent eczema care while finding realistic ways to manage stress can form part of a broader eczema management plan.

If your eczema is becoming more frequent, severe or difficult to manage, speak with your GP, dermatologist or other qualified healthcare professional for personalised advice.

This information is general in nature and is not intended to replace individual medical advice. Always speak with an appropriate healthcare professional about your eczema or treatment.