Introduction
Eczema, also known as atopic dermatitis, is a common and chronic skin condition that tends to flare up from time to time. It is known to cause your skin to be itchy, red, and dry. It can also have an impact on your mental health. One of the biggest myths about eczema is that some people might think it is contagious.
What is eczema?
Eczema is a common chronic skin condition that causes parts of the skin to be itchy. It is usually a cause of dry skin, rashes, scaly patches, blisters, and some other skin infections. There are different types of eczema, such as; atopic dermatitis, which is found to be common, contact dermatitis, nummular eczema, dyshidrotic eczema, seborrheic dermatitis, and stasis dermatitis.1
Eczema could range from mild to severe and can begin during early childhood, adolescence, or adulthood.1
Symptoms
It is quite important to note that the severity and symptoms of eczema vary with different people. ‘Itching’ is a must-have symptom of eczema. Other symptoms include:
- Scaly skin or scaly patches
- Dryness of skin
- Areas of swelling
- Crusting of skin
- Inflamed, discoloured skin1
Effects of eczema on mental health
Often mental ups and downs are correlated with flare-ups of eczema.
There is a well-known association between eczema and mental health disorders such as depression and anxiety, but the nature of this association is quite unknown.
Eczema is an inflammatory skin disease that causes intense itching and discomfort. This causes sleeplessness and may result in disfiguring lesions. These lesions are a contributing factor to social embarrassment whilst impairing the quality of life of the sufferers and their families.2
Mental health disorders are one of the leading increased causes of morbidity and mortality worldwide, with depression and anxiety together accounting for more than half of that burden.2
Depression is a mood disorder that manifests as a persistent feeling of sadness and loss of interest and enjoyment in ordinary things and experiences. This condition affects approximately 4.4% of the global population; anxiety disorders, characterised by excessive fear, anxiousness, or avoidance of perceived threats, affect approximately 3.6% of the global population. Eczema is associated with common mental disorders such as depression and anxiety and increased suicidal ideation.
A research study shows that individuals affected with eczema are more likely to develop depression and anxiety, regardless of the severity of their eczema.2
The main cause of eczema remains unknown. The American Academy of Dermatology (AAD) describes eczema as a complex skin disease caused by an interaction between a person’s environment and genes.3
The tendency to have an overactive immune system that responds to topical irritants or allergens by producing inflammation is common with sufferers of eczema.
A person sometimes suffers flare-ups when their skin comes in contact with specific materials or products that triggers eczema, this usually triggers a kind of eczema called, contact dermatitis.3
Living in an environment that is either very cold and damp or hot and swampy poses a risk for eczema flare-ups.
Food allergies and hay fever can also cause eczema to form, manifesting itchy skin, dryness, red, inflamed skin, etc.
A weak immune system increases the susceptibility of eczema and triggers eczema flare-ups.3
Although mental health conditions do not directly cause eczema, they do aid in increasing flare-ups which causes more anxiety and more eczema- seems like a vicious cycle that never ends.5
Stress in particular can trigger eczema, this is because when the body encounters a stressful situation, there usually is a physical reaction. This physical reaction causes inflammation in the body, and inflammation is one of the known causes of eczema. Other mental conditions that cause an inflammatory reaction include depression and post-traumatic stress disorder etc.
Increased prevalence of anxiety and depression
Depression and anxiety disorders are among the most common illnesses in primary health care. Patients with depression often have symptoms of anxiety disorders, and those with anxiety disorders commonly also have depression. Both disorders may occur concurrently, meeting the criteria for both. It can be quite difficult to differentiate between the symptoms of anxiety and depression, but it is quite important to differentiate both illnesses and give the appropriate treatments, as they are associated with significant morbidity and mortality.4
Flare-ups and social anxiety
Social anxiety disorder is a common type of anxiety disorder, which could be described as an intense, persistent fear of being watched and judged by others. Sufferers of social anxiety disorder experience fear in situations where they may be scrutinised, judged, or evaluated by others. For example, speaking in public, or when making new friends.
Studies of social anxiety disorder in primary care settings find the disorder to be common in patients, but only a fraction of cases are diagnosed by general practitioners.
The brain communicates inflammation of the skin via sensations of pain, heat, itch, and general discomfort. All these make one feel anxious, depressed, tired, and foggy thinking, so it is very credible that anyone with a chronic inflammatory condition is at an increased risk for depression based on that inflammatory immune stimulation alone.6
Decreased self-esteem
Eczema flare ups make the suffers very self-conscious and cause reduced self-esteem. This is largely due to our society where 'the perfect skin' is idealised.8
The problem of sociocultural idealism
We live in a society where beauty is defined as symmetric large evenly spaced eyes, white teeth, a well-proportioned nose, and a flawless complexion. The global cosmetics industry is worth billions. These industries are built on self-consciousness, whose goal is to market a certain ‘ideal beauty’, people who are unable to meet up with this ‘ideal’ tend to suffer from low self-esteem, depression, and anxiety.8
If you’re worried about your or your loved one’s mental health
Today, mental health disorders remain one of the most underdiagnosed health issues. Most people with any of these disorders will not see a health practitioner for their issues.
If you are worried about your or your loved one’s mental health, learn about the warning signs and treatment options. There is nothing wrong with seeking help, try speaking with an understanding close friend or family member. If you think that a friend or family member may be struggling with a social anxiety disorder, make some time to talk with them to express your concern and reassure them of your support.
Discuss your concerns with a healthcare provider about your mental health.
Summary
No doubt, eczema is a pain. It is chronic and gives rise to sleeplessness due to its itchy nature. Most individuals with eczema have weakened immune system too. Unsurprisingly, there is a huge connection between eczemas and mental health disorders like anxiety and depression.
These disorders are know to be a cause of mortality worldwide. There is no known cure for eczema but living a healthy lifestyle and staying away from triggers would certainly bring an eczema-healthy life.
References
- National Eczema Association [Internet]. What is Eczema?; [cited 2022 Nov 21].
- Schonmann Y, Mansfield KE, Hayes JF, Abuabara K, Roberts A, Smeeth L, et al. Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. The Journal of Allergy and Clinical Immunology: In Practice [Internet]. 2020 [cited 2022 Nov 21]; 8(1):248-257.e16.
- National Eczema Association [Internet]. Eczema Causes and Triggers; [cited 2022 Nov 21].
- Tiller JWG. Depression and anxiety. Medical Journal of Australia [Internet]. 2013 [cited 2022 Nov 21]; 199(S6).
- National Eczema Association [Internet]. Eczema and Emotional Wellness; [cited 2022 Nov 21].
- National Eczema Association [Internet]. 2017. The Connection Between Eczema and Depression: It’s Not Just In Your Head; [cited 2022 Nov 21].
- Stein MB, Fuetsch M, Müller N, Höfler M, Lieb R, Wittchen H-U. Social Anxiety Disorder and the Risk of Depression: A Prospective Community Study of Adolescents and Young Adults. Arch Gen Psychiatry [Internet]. 2001 [cited 2022 Nov 21]; 58(3):251.
- Sinclair R. Beauty is skin-deep: why our complexion is so important to us. The Conversation [Internet]. [cited 2022 Nov 21].