Severe eczema is an inflammatory skin condition that causes many unpleasant symptoms, including very itchy skin, dry skin, rashes, and skin discoloration, according to the National Eczema Association (NEA).
In addition to being a physical problem, these symptoms can also contribute to emotional issues. According to an analysis of previously published studies in the February 2022 issue of the journal PLoS ONE, people with eczema may be at 63 percent higher risk for developing anxiety and depression compared with those who don’t have eczema.
This is likely because severe eczema doesn’t just affect your skin but can impact your quality of life as well.
How Severe Eczema Can Impact You Emotionally
Relentlessly itchy skin can make it difficult to sleep, which makes it hard to function during your waking hours.
“People who don’t get a good night’s sleep are often more depressed, more anxious, and unable to focus on their tasks during the day, ” says Suzanne Friedler, MD, FAAD, a clinical instructor of dermatology at Icahn School of Medicine at Mount Sinai and a dermatologist at Advanced Dermatology in New York City. “When you have eczema, it can also be hard to focus during the day because you’re distracted by the itching. ”
In addition, the embarrassment of having large, noticeable patches of red or discolored skin can start to have an emotional impact on people as well.
“If somebody has eczema on their arms, hands, or face, it is more obvious to others, and then this can cause more anxiety and self-esteem issues, ” says Mohammad Jafferany, MD, executive director of the Association for Psychoneurocutaneous Medicine of North America (APMNA) and a psychodermatologist in Saginaw, Michigan. “And people who feel more depressed may opt to be by themselves.”
Signs of Depression and Anxiety
According to Dr. Jafferany, you may be depressed if you‘re:
- Feeling empty and down. “We’re talking about feelings of sadness, tearfulness, hopelessness, helplessness, and emptiness, as well as frustration and anger in some cases,” he says.
- Losing interest in things you normally enjoy. You might not relish hobbies you used to love, or you struggle to partake in fun activities, Jafferany explains.
- Experiencing sleep disturbances. This one can be tricky since eczema itself can impact sleep. “Sometimes a person sleeps a lot, but sometimes they just can’t sleep and toss and turn on the bed,” Jafferany says. “Consequently, they can feel really tired and have a lack of energy.”
- Experiencing changes in weight. For some people, this might mean not eating as much and losing weight, while others may gain weight from stress-eating, according to Jafferany.
- Having difficulty concentrating. “This might include ruminating on the past — a person cannot make decisions or remember things, because they can’t focus,” he says.
- Having thoughts of suicide. This could mean thinking you don’t deserve to live, or imagining ways to die, Jafferany explains.
The symptoms of anxiety can be similar to the symptoms of depression, he adds. People with anxiety may also overthink and envision worst-case scenarios, obsess over situations, feel restless, or feel agitated and have trouble relaxing, according to the Cleveland Clinic. “In addition, a person may be worried about their physical look and appearance … so they might try to hide or isolate themselves,” Jafferany explains.
It’s also possible to experience both anxiety and depression at the same time, he adds.
How to Treat Anxiety and Depression When You Have Severe Eczema
The good news is that anxiety and depression are both highly treatable conditions, and addressing them can also help you live better with eczema — and vice versa. Here are some tips for managing these common mental health disorders if you have severe eczema:
- Get the right treatment for your eczema. “Make sure you’re seeing a dermatologist and learning the right skin-care habits, because your behaviors really do influence the health of your skin,” says Dr. Friedler. “Treating the itch of the eczema is really important for quality of life.” This includes taking short, warm (but not hot) showers with soap for sensitive skin and moisturizing afterward, as well as taking appropriate medications to control itching, such as antihistamines and steroids, among others. If you’ve tried all this and still haven’t experienced any relief, Friedler says, there are more potent medications available for severe eczema, including oral or injectable biologics like Janus kinase (JAK) inhibitors.
- Talk to a therapist. Talk therapy can help you cope with depression and anxiety, since a therapist can give you tools to help you deal with your emotions. Others may also need to add an antidepressant medication to their treatment plan, along with therapy. Fortunately, antidepressants shouldn’t cause any issues when taken with eczema treatments, according to both Friedler and Jafferany. In fact, for some people with eczema who scratch themselves when they get anxious, “[certain] antidepressants can actually help with the compulsion to scratch, as well,” says Friedler.
- Consult with a psychodermatologist. Psychodermatology is a new field that focuses on how the mind and skin impact each other. A psychodermatologist is generally both a dermatologist and a psychiatrist, and as such, they can treat your skin while also teaching you how to manage stress, according to Jafferany, who specializes in the field. If you want to focus more on how your skin is impacting you emotionally, a pscyhodermatologist can be a good person to add to your treatment team. You can search for a psychodermatologist on the APMNA website.
- Get support from others. It can feel isolating to live with eczema, especially if you don’t know others who have it. Ask your doctor to refer you to a local support group or find others who have eczema by visiting the National Eczema Association (NEA). The NEA also hosts an annual Eczema Expo for people with the condition. In addition, you can also join online communities such as AltogetherEczema.
- Follow a healthy lifestyle, including meditation and exercise. According to a review published in 2020, meditation may reduce the urge to itch in people who have chronic itching. Exercise can also lower stress and improve your mood, which is good for your skin. It’s a good idea to experiment with different exercise routines to see which help you get a workout without aggravating your skin, according to the NEA. Per the NEA, that might include low-impact exercises like yoga.
“Relieving stress and helping with your anxiety or depression will play a positive role in the management of eczema,” says Jafferany. “It’s good for your overall well-being and health.”