Understanding Anxiety and Eczema

Eczema (also known as atopic dermatitis) is a skin condition that causes an inflamed, scaly, itchy rash. This can occur anywhere on the body, including the hands and face. Anxiety is a group of mental disorders with symptoms such as nausea, rapid heartbeat, and feelings of nervousness and panic.

In the United States, about 10.1% of the population will have eczema, and around 31.1% will have an anxiety disorder in their lifetime. While researchers have long assumed a correlation between the two, the extent to which the conditions are related is unknown. A 2022 review, however, revealed that eczema might increase the risk of developing anxiety by 68%.

This article discusses the link between anxiety and eczema, including diagnosis, treatment options, and more.

The Connection Between Anxiety and Eczema

Anxiety and eczema are two very different disorders. Eczema is considered a physical condition, with symptoms manifesting on your body as an itchy rash or scaly patches. In contrast, anxiety is a mental health disorder. Although anxiety can be felt physically (such as with nausea or sweaty palms), you cannot generally look at someone and see that they have anxiety.

Researchers theorize that eczema may increase the risk of developing new anxiety through these mechanisms:

• Social isolation
• Perceived social stigmatization
• Eczema on the face or hands (visible disfigurement can worsen social isolation and stigma)
• Stress
• Sleep disruption
• Itch and discomfort
• Shared inflammatory mediators
  

Latest Research

Research on the link between anxiety and eczema is ongoing. One 2022 systematic review found that having eczema increased the risk of developing new anxiety by 68%.

A 2020 study examined the relationship of eczema to both anxiety and depression. The study included data from over 520,000 adults with atopic eczema. Results showed that eczema increases the risk of both anxiety and depression.

Interestingly, the study found that the severity of eczema was not associated with anxiety. In other words, regardless of whether someone had a mild or severe case, they had the same increased risk of developing anxiety.

Diagnosis of Anxiety and Eczema

A mental health provider, such as a therapist or psychiatrist, generally diagnoses anxiety, while a dermatologist diagnoses eczema. However, your primary healthcare provider can also diagnose both.

There are no specific tests to diagnose eczema. Instead, dermatologists evaluate the signs and symptoms of an individual to make a clinical diagnosis.

Anxiety is diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) guidelines.

To be diagnosed with generalized anxiety disorder, a person must experience the following:

• Excessive anxiety and worry for the majority of days for at least six months
• Difficulty controlling their worry
• Three of the following symptoms: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
• Anxiety or worry that causes significant distress and impairment
• Anxiety or worry that is not due to substance use

Because anxiety is a mental disorder and eczema is a dermatological disorder, they are not mistaken for one another during diagnosis.

Scientists argue that future international guidelines on eczema need to address anxiety more clearly due to the growing body of research regarding the increased risk of developing anxiety in people with eczema.

Treatment of Anxiety and Eczema

Eczema is treated with a combination of the following:

• Lifestyle changes, such as moisturizing your skin and avoiding triggers
• Over-the-counter (OTC) therapies, such as hydrocortisone cream and antihistamines
• Biologics, such as Dupixent (dupilumab) and Adbry (tralokinumab-ldrm)
• Prescription medications, including topical steroids, topical calcineurin inhibitors (TCIs), oral steroids, antibiotics, and JAK (Janus kinase) inhibitors

Specialized procedures for eczema include phototherapy, immunotherapy, and wet-wrap therapy.

Anxiety disorders, on the other hand, are usually treated with a combination of psychotherapy (talk therapy) and medications.

Medications

It is important to make your primary care provider aware of what medications you're taking for each condition. Certain drugs or supplements may interact negatively with one another.

Though rare, certain psychotropic medications may cause eczema as a side effect. Such medications may include:

• Tegretol (carbamazapine)
• Lithium
• Barbiturates
• Clozaril (clozapine)
• Seroquel (quetiapine)
• Celexa (citalopram)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Zoloft (sertraline)
• Anafranil (clomipramine)
• Serzone (nefazodone)
• Effexor XR (venlafaxine)

Psychotherapy

If you have anxiety, your healthcare provider may refer you to psychotherapy or "talk therapy." Types of psychotherapy used to treat anxiety include:

• Cognitive behavioral therapy (CBT): Substantial evidence supports treating anxiety disorders with CBT. CBT involves challenging and changing thought patterns to change maladaptive behaviors (those that prevent you from coping).
• Psychodynamic therapy: This therapy focuses on understanding yourself, your emotional patterns, and the impacts of childhood events on your current emotions.
• Exposure therapy: This technique typically treats specific phobias, one type of anxiety disorder. It involves exposing a person to their feared trigger in a safe, controlled, and gradual way to reduce the fear response over time.

Psychotherapy may not treat your eczema, but it can help you deal with the stress and anxiety associated with this condition.

Coping With Anxiety and Eczema

If you have anxiety or eczema, discuss treatment options with your healthcare provider. In addition to medication and psychotherapy, it can be helpful to make lifestyle changes to better manage your symptoms.

Lifestyle Changes

Lifestyle changes for eczema management include:

• Identifying and avoiding your triggers
• Using eczema-friendly soaps, cleansers, and moisturizers
• Limiting sun exposure
• Soaking in a bath

Lifestyle changes for anxiety management include:

• Regular exercise
• Mindful movement (such as yoga or tai chi)
• Practicing mindfulness or meditation
• Sleep hygiene
• Journaling

Support Groups

Support groups are a way to connect with and learn from other people living with your condition. You can attend a support group in person or online.

Many national associations also offer other forms of support, such as one-on-one peer support or help connecting you with local resources.

Support groups for eczema include:

• National Eczema Association
• Asthma and Allergy Foundation of America
• My Eczema Team (online group)

Support groups for anxiety disorders:

• National Alliance on Mental Illness (NAMI)
• Mental Health America
• Anxiety & Depression Association of America
• The Tribe Wellness Community

Summary

Eczema can be a painful, disfiguring skin condition that can cause significant distress and anxiety. Research has found that eczema may increase your risk of developing new anxiety by 68%, primarily due to social isolation, stress, discomfort, and perceived stigmatization.

Eczema can be treated with over-the-counter (OTC) therapies, such as hydrocortisone or antihistamines, moisturizers, or prescription medication. Anxiety is typically treated with medication and psychotherapy. Be sure to speak to your healthcare provider about any medications you take for either condition, as some drugs may interact.

A Word From Verywell

Eczema is not only itchy and painful, but it can affect how you view yourself and how you believe others perceive you. You may find yourself increasingly socially isolated, worried, or anxious. When these feelings change from occasional emotions to daily distress, speak with your healthcare provider to get support and to learn about treatment options.