Understanding Eczema and Depression

Eczema, also known as atopic dermatitis, is an inflammatory skin condition that causes scaly, itchy, painful rashes and other symptoms. Depression is a mental health disorder that can include apathy, sadness, worthlessness, loss of interest, sleep disruption, and more.

A recent 2022 study found that people with eczema have a 64% increased risk of depression.

In this article, learn more about the link between eczema and depression.

The Connection Between Eczema and Depression

It makes sense that the painful and distressing symptoms of eczema and the social isolation and stigma that surround it could contribute to feelings of depression. The exact reasoning, however, is unclear and requires further research,

Some other possible links between eczema and depression include the following:

• Poor sleep quality: Eczema can be extremely itchy, keeping people awake. Poor sleep patterns can affect their quality of life and contribute to their risk of mental health disorders like depression.
• Eczema location: Eczema on your hands or face and other visible areas can be embarrassing, causing isolation and increasing the risk of depression and anxiety.
• Inflammatory mediators: Researchers suggest that there may be a biological mechanism behind the connection between eczema and depression via shared inflammatory markers (information and measurements from blood tests about various aspects of inflammation).

Latest Research

A 2022 systematic review and meta-analysis, which included data from over 140,000 patients with eczema, found that the condition increases the risk of developing new depression by 64%.

Another study completed in 2020 found a relationship between the severity of eczema and depression; as the severity of eczema increases, the risk of depression increases, too.

Interestingly, a 2019 study found that having eczema increases a person's risk of depression by about the same amount as having a history of cancer.

Complications of Eczema and Depression

Research shows that the chances of eczema causing depression are much greater than depression affecting or worsening eczema.

Still, people with depression may feel apathetic and find it challenging to follow through with daily routines. Self-care routines required for proper eczema treatment—moisturizing, bathing, medication management, and avoiding triggers—may feel more challenging to keep up with while depressed.

Diagnosis of Eczema and Depression

Eczema is diagnosed by a dermatologist, a healthcare provider specializing in conditions of the skin, hair, and nails. There are no tests to diagnose eczema. Instead, dermatologists use diagnostic guidelines in which a person must have at least three symptoms from two categories, both major and minor factors.

Depression is diagnosed by a mental health provider, such as a licensed therapist or psychiatrist, based on guidelines from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition  (DSM-5).

To be diagnosed with major depressive disorder, a person is required to have at least five of the below symptoms, including at least one of the first two listed, over two weeks:

• Depressed mood
• Loss of interest or pleasure
• Weight or appetite change
• Slow thoughts and movement
• Fatigue and loss of energy
• Feelings of worthlessness and guilt
• Indecisiveness
• Recurring thoughts of death or suicidal ideation

Treatment of Eczema and Depression

Eczema is treated with a combination of lifestyle changes, over-the-counter (OTC) therapies, prescription medications, and specialized procedures such as phototherapy (exposure to ultraviolet (UV) light), immunotherapy (allergy shots), and wet-wrap therapy (a wrap of bandages and topical medication that keeps affected areas moist). Moisturizing, avoiding triggers, and soaking baths can help alleviate eczema symptoms.

Depression is treated with a combination of lifestyle changes, psychotherapy, and medications

Medications

It is essential to let your healthcare providers know about all medications you are taking for depression and eczema, as there may be drug interactions.

Some psychotropic medications, including antidepressants, may also cause eczema as a side effect. This is rare and only occurs in less than 1% of cases. Still, it's important to be aware of if you have both eczema and depression.

Psychotropic medications that may cause eczema as a drug reaction include:

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

Alternatively, Dupixent (dupilumab), an injectable human monoclonal antibody used to treat eczema and other allergy-related diseases, may be particularly beneficial for people with eczema who also have depression. Two phase 3 clinical trials of dupilumab found that the drug improved signs and symptoms of eczema and improved symptoms of anxiety and depression.

Psychotherapy

Psychotherapy, or talk therapy, is a well-established treatment for depression. You may also find that talking through your feelings and experiences with a licensed therapist may help you process your emotions around having eczema, too.

Types of psychotherapy used to treat depression include:

• Cognitive behavioral therapy (CBT): CBT is considered the gold standard psychotherapy for treating depression and has the most evidence to support it. CBT helps you identify negative thought patterns and change thoughts and behaviors.
• Interpersonal therapy (IPT): IPT is a short-term talk therapy that focuses on your relationships with other people and how these are influenced by or may influence depression.
• Psychodynamic therapy: This approach is heavily influenced by Austrian neurologist and the founder of psychoanalysis Sigmund Freud and focuses on how past experiences from an early age affect your current emotions.

Coping With Eczema and Depression

Stress can negatively affect both eczema and depression, so you may find that adopting stress management techniques benefits both conditions.

Lifestyle Changes

Making lifestyle changes that can help reduce stress include:

• Journaling
• Daily exercise
• Gentle stretching, yoga, or tai chi
• Listening to music
• Meditation
• Opening up to loved ones, a mental healthcare provider, or a support group

Support Groups

Support groups can be a great option for coping with eczema or depression; you're often able to learn from healthcare professionals and form relationships with others living with your condition's unique struggles.

Support groups for eczema include:

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

Support groups for depression include:

• National Alliance on Mental Illness (NAMI)
• Mental Health America
• Anxiety & Depression Association of America
• Depression and Bipolar Support Alliance
• 7 Cups

Summary

Living with eczema can be stressful and painful, can affect your sleep, and even influence how you view yourself or interact with others. Having eczema can increase your risk of depression by 64%. Healthcare providers should be aware that people with eczema can develop depression and monitor mental health closely.

A Word From Verywell

If you have eczema, it may not surprise you to learn that you're at an increased risk for depression. Know that you're not alone if you have eczema and feel depressed. Speak to a trusted healthcare provider for support and to learn about treatment options.