Eczema, or atopic dermatitis, is a complex disease with many triggers, but no nailed-down cause. Genetics, the environment, and your immune system -- along with how hormonal changes affect it -- all might play a part, though.
Its Cause Remains Hard to Figure Out
Research hasn’t identified the exact cause of eczema. And studies don’t all agree. However, the way your hormones interact with your immune system during natural body changes over time or surges from stress, might be key to how you experience the disease.
Even a strong genetic link hasn’t been pinpointed, though the noncontagious skin condition tends to run in families and usually shows up in infancy or early childhood.
But hormones -- whether due to your gender or an emotional state like stress or depression -- might be behind eczema symptoms that appear “out of nowhere” or return after a long absence.
For example, hormonal changes can lead to moisture loss in your skin’s protective layer. This can cause intense itching, then scratching, and possibly pave the way for eczema to break out.
Sex Hormones and Eczema
Puberty
Some good news: Eczema goes away before adolescence in about three-quarters of people who are diagnosed in childhood. The remaining one-quarter have it throughout their adult lives or have a recurrence somewhere down the line.
Many factors figure into how and why eczema affects people in different ways. But your sex hormones have a big influence, especially if you’re female.
Slightly more boys are diagnosed with eczema than girls. But this turns around after puberty, when young people reach sexual maturity. For boys, this usually happens between ages 12 and 16; with girls, between 10 and 14.
Female estrogen and progesterone amp up the activity of certain cells in your immune system that affect your skin barrier. The reasons are complex, but the interaction can trigger eczema symptoms, a study in Japan theorizes.
Meanwhile, androgens -- male sex hormones such as testosterone, as well as progesterone -- seem to do the opposite. They suppress the reaction, so inflammation and other eczema signs don’t happen. This could explain how the numbers of girls with eczema might nudge ahead of the boys after puberty.
Hormone fluctuations during your period
About 47% of women who have eczema report their symptoms getting worse during the week before they have their periods, according to a London nutrition clinic. The sudden drop in estrogen you have before your time of the month can cause your eczema to flare. It shows how the changing level of the female hormone, not just the presence of it, matters most.
Estrogen surges in pregnancy
When you’re pregnant, your high estrogen levels shift your immune system’s focus. For the time being, it moves away from cells that protect you from outside invaders like bacteria and viruses. Instead, it wakes up cells in your immune system that stand guard over the fetus. These cells ward off toxins and harmful allergens outside your own cells.
This opens the door for old allergies -- and conditions like eczema -- to roar back into your life, at least during your pregnancy.
When eczema returns in menopause
Fluctuating hormones might be to blame for later-in-life eczema if you’re female. As you age, your eczema might return because your body’s immune system wears down. The same shift between immune cells happens as it does during pregnancy, but for different reasons. However, more research is needed to figure out how or if estrogen plays a role.
Stress Hormones
You’ve likely heard of “fight-or-flight” mode. It happens when you meet a stressful situation head-on. Your body kicks into action. It speeds up your heart rate, amps up your blood pressure, and releases stress hormones such as cortisol and adrenaline.
In doing so, cortisol suppresses your immune system. Meanwhile, “feel-good” hormones like endorphins tend to fade into the background. If you have eczema, the price for your body’s “emergency” response could be a flare-up and added stress.
The National Eczema Association is one source that can help you put more tools in your arsenal to fend off stress and eczema breakouts along with it.
Stress Hormones and Mental Health
There’s still a lot to learn about the link between eczema and mental health. However, the relationship is strong. A survey revealed more than 30% of people with eczema have been diagnosed with depression and/or anxiety.
A key might be in how your brain and body communicate during a bout with an inflammatory disease like eczema. Your skin has strong neural connections with your brain and the info exchange goes both ways. Some researchers believe when your skin is riled up, such as with an eczema outbreak, it can send messages to your brain that trigger depression, anxiety, or muddled thoughts. Those feelings can bring on stress, and the cycle repeats.
Lifestyle changes such as exercise, support groups, and relaxation techniques can help keep stress -- and breakouts -- at bay.