What to Know About Eczema and COVID-19

Eczema is the name for a group of conditions that cause the skin to become dry, red, itchy​, or inflamed. In some cases, the skin can also blister and weep. There is no evidence suggesting that people with eczema are more likely to develop COVID-19 or experience a more severe form of the condition if they catch it.

However, there is some concern that people taking oral immunosuppression medication for eczema may be at increased risk of COVID-19, although this is not fully known.

Managing the risk of COVID-19 through handwashing and mask-wearing can cause eczema symptoms to flare up. Stress also impacts eczema symptoms, and many people are finding living during a pandemic particularly stressful. 

Research regarding eczema, COVID-19, and related medications is ongoing as scientists continuously learn more about the disease. This article will discuss how having eczema affects your risk of catching COVID-19 and complications from the infection, how eczema medications may affect those risks, and how to stay safe.

Eczema and COVID-19 Risk

Medical professionals advise that having eczema alone is probably not a significant risk factor for getting sick with or having a more severe case of COVID-19. The general thinking seems to be that even in severe eczema, the immune system is disordered but not compromised.

A cross-sectional research study carried out in the United Kingdom found that atopic eczema and psoriasis were not associated with an increased risk of testing positive for COVID-19. Researchers advised that these two conditions should not be considered risk factors for contracting COVID-19.

However, it is not fully understood how COVID-19 affects people with eczema or if certain types of eczema medication may affect their response to the virus.

Although people with eczema are not considered as high risk for contracting or developing severe symptoms of COVID-19, it is still essential to keep eczema symptoms under control to prevent flare-ups.

Complications of Eczema and COVID-19

To help prevent the spread of COVID-19, regularly washing hands with soap and water (to remove germs and viruses from the skin) is recommended. However, frequently washing hands with soap can cause problems for people with eczema, worsening symptoms.

To help lessen the effect of handwashing and sanitizing gel on your eczema symptoms, you can apply the following tips:

• Once you have thoroughly washed your hands with soap and water, you can rewash them with your usual emollient to protect the skin.
• Use moisturizer after washing hands and when the skin feels dry, cracked, or sore.
• Pat your hands dry rather than rubbing them to avoid irritation. 
• Put an ointment or moisturizer on your hands and cover them with clean cotton gloves overnight to rehydrate hands if they are sore and dry.
• If you need to use a sanitizing gel, apply your usual emollient once the gel is dry. 
• If you are using cleaning products, disinfectants, or washing dishes, wear gloves to protect your skin and avoid further irritation. 
• If your eczema worsens or you suspect your skin is infected, then contact your healthcare provider for advice.

Stress can also exacerbate eczema symptoms through its effects on immune response and skin barrier function. It's essential to be aware that the impact of COVID-19 on your life could be increasing your stress levels. Therefore, to help prevent eczema flare-ups, you can practice techniques to reduce stress levels. 

Tips for managing stress and eczema include:

• Try and identify what your stressors are, and make lifestyle changes to reduce or remove them. If you can't identify particular stressors, try a general approach to overall stress reduction. 
• Interventions known to lower stress include modifying lifestyle factors, managing emotions, getting adequate sleep, eating a healthy diet, and exercising regularly. 
• Try implementing relaxation techniques into your daily routine such as meditation, visualization, deep breathing, or progressive muscle relaxation (tensing and then relaxing the different muscle groups throughout the body).
• Being socially isolated due to the pandemic can be a cause of stress. Try to stay in touch with your friends and family in a safe, socially distanced, or virtual manner.

There have been anecdotal reports that the COVID-19 vaccine has worsened eczema symptoms or caused a flare-up in some patients. However, the National Eczema Society states that there is no robust evidence to show that the COVID-19 vaccine will worsen eczema.

If you believe the COVID-19 vaccine has exacerbated your eczema, speak to your healthcare professional and discuss whether it needs to be reported to the Vaccine Adverse Event Reporting System (VAERS). 

Eczema Treatments and COVID-19

Some people with eczema take systemic treatments that affect the immune system. Examples of these medications include prednisone, cyclosporine, methotrexate, Imuran (azathioprine), and Cellcept (mycophenolate). 

When taking systemic medication, it is advised that you avoid live vaccines. None of the COVID-19 vaccines authorized for use in the United States contain a live virus. Therefore, if you are taking a treatment that affects the immune system, it is advised that you can safely receive the COVID-19 vaccine. 

Even though it is considered safe to have the COVID-19 vaccine, clinicians advise they still do not know whether being on an immunosuppressant or biologic treatment will reduce the vaccine's effectiveness. Research is still ongoing in this area.

If you take immunosuppressants, systemic, or biologic medication for your eczema and are concerned about whether you are more at risk from COVID-19, then speak to your healthcare professional for support and advice. 

Some clinicians advocate taking extra safety precautions (such as shielding from groups of people) to reduce the risk of contracting COVID-19 if you are on multiple medications or have additional underlying health conditions.

Frequently Asked Questions

I have both eczema and allergies. Is it safe to take the COVID-19 vaccine? 

Most people with eczema and allergies can have the COVID-19 vaccine. The Centers for Disease Control and Prevention (CDC) recommends that people get vaccinated even if they have a history of severe allergic reactions not related to vaccines or injectable medications—such as foods, pets, or latex allergies.

They advise that the only people at risk with allergies are those that have had an immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components, including polyethylene glycol (PEG).

Are there any eczema treatments that might interfere with the COVID-19 vaccine? 

Experts advise that there is no increased risk of side effects from the vaccine when taking any type of medication for eczema. 

It is thought that some immunosuppressive treatments might reduce the effectiveness of the vaccine, but this is theoretical. At present, there is no definitive data to confirm this. Researchers continue to investigate this.

Wearing a face mask is worsening my facial eczema. What can I do to help prevent it from getting worse?

Try these suggestions:

• Try to wear a face mask made from 100% cotton that is soft on the skin.
• Ensure your face mask is clean, and wash masks regularly in detergent that does not irritate your skin.
• Face masks with cloth ear loops are less likely to irritate the skin than elastic ones. 
• Masks that tie around the back of the head or have a headband and button option might help reduce irritation.
• Avoid applying moisturizer to the face just before putting on a mask, as it might make a face hot and sweaty. Instead, put moisturizer on when you remove your mask, and you have time to let your skin breathe.

How To Stay Safe

The best way to stay safe with eczema during the pandemic is to follow public health guidance to lower the risk of catching COVID-19:

• Continue your eczema medication as prescribed.
• Take steps to avoid and manage flares during the COVID-19 pandemic. 
• Support your health by reviewing eczema care basics.
• Take steps to reduce stress, manage itching, and improve your sleep hygiene.
• Wash your hands regularly, avoid close contact with others, and socially distance where possible. You can rewash your hands with your usual emollient to protect the skin and use moisturizer after washing hands and when the skin feels dry, cracked, or sore.
• When washing your hands, wash with soap and water for at least 20 seconds. 
• If soap and water are not available, use a hand sanitizer containing 60% alcohol. Apply moisturizer to your hands once hand sanitizer is dry if it is causing our eczema to worsen. 
• Wear a face mask in public settings and where social distancing is not possible. Once you are fully vaccinated, wearing a face mask is optional.
• Avoid crowded situations.
• Avoid unnecessary travel.
• Practice self-monitoring.
• Avoid contact with people who are unwell.
• If someone in your home becomes unwell, follow medical guidance and isolation advice to reduce the risk of spreading the virus in your home.

Summary

Having eczema does not place a person in a high-risk category to become infected with COVID-19 or have a severe case or complications. If you take medications that affect the immune system, it isn't yet known how that may affect your risks or impact your response to COVID-19 vaccines. Discuss this with your healthcare professional.

Your eczema symptoms may worsen with frequent handwashing and wearing a face mask, so you will need to use tips to prevent this. Once you are fully vaccinated, wearing a face mask is optional. COVID-19 vaccines may be taken safely unless you have had an allergic reaction to the vaccine or one of its components.

A Word From Verywell

Having a condition like eczema may make you feel worried during the pandemic, especially if you are taking medication that suppresses your immune system. However, experts advise that it does not put you at a higher risk of COVID-19 or more severe symptoms.

Nevertheless, the added handwashing, wearing of face covers, and stress can exacerbate eczema symptoms. This is why it is vital to take care of yourself and take measures to protect your skin and reduce stress levels.

If you have concerns that your eczema is getting worse then contact your healthcare professional immediately for advice and support. 

The information in this article is current as of the date listed. As new research becomes available, we'll update this article. For the latest on COVID-19, visit our coronavirus news page.