It is 6 am. I’m getting up for the day. Its hard to make my feet move forward because all I want to do is crawl back into bed. I am so tired because I never sleep well. When I try to lay down my face feels like I am sleeping on broken glass. I stare into my closet then I look down at my arms which are so flared with eczema I just want to cry. I pick out a long sleeve shirt even though its going to be hot today. Better to be hot than have people ask me about my skin. I know I am depressed, but it is hard not to be when my skin always looks bad and I itch constantly. It is a cycle- the feelings of hopelessness and my physical symptoms of pain and itch- they feed each other and I feel like I never come out on top.
Is this the reality for you or someone you love? Unfortunately, this scenario is all too common. Multiple studies have shown that adults and children with eczema are likely to have higher rates of depression and anxiety. A recent meta-analysis found the global prevalence of depression among adults with atopic dermatitis to be 20% with anxiety coming in at 24%. For children, the same meta analysis found that 11% of children with atopic dermatitis had depression with 14% displaying anxiety (LeBovidge & Schneider, 2025). Another study looked at data from 526,808 adults with atopic eczema and 2,569,030 without. They found that having eczema was associated with a 14% increase in the risk of newly diagnosed depression and a 17% increase in the risk of a subsequent anxiety diagnosis (Schonmann et. al.). A systematic review conducted by Sandu,Thanh-Lan and Armstrong (2018) looked at 15 studies regarding suicide and eczema. They found that patients with eczema had a 44% higher likelihood of suicidal ideation and a 36% higher likelihood of attempting suicide than those without any skin disease.
Why does eczema affect mental health?
Eczema is a debilitating disease. Eczema often causes:
Itch
Pain associated with eczematous patches and cracking skin
Red, flaky, oozing patches that affect the appearance of the skin
Inability to sleep restfully due to pain and itch
Stress
All of these symptoms over time start to affect mental health, with rates of depression and anxiety increasing as the severity of the eczema increases.
A Special Note on Children
Childhood is an amazing time as children learn about and explore the world around them. However, for those with eczema, navigating childhood can be extremely hard. When children are faced with pain and severe itch, they can not focus on anything else. Learning about the world around them becomes second to the pain and itch that they can not control. They may scratch their skin until it bleeds, which often results in infection. They have difficulty concentrating at home and at school. For those who have hands affected, it may be painful to pick up and hold objects such as toys, pencils etc.
Sleep is critical for people of all ages, but especially so for children. Sleep plays an important part in growth, development and emotional regulation. When a child’s sleep is fragmented because they wake up due to itching or they never enter deep sleep because of eczema symptoms, all body systems are affected, including their mental health.
As the largest organ in the body, the appearance of the skin is important to all age groups. However, appearance is especially important to children who are trying to find out how they fit in to peer groups and society as a whole. Children with visibly flared areas are often teased or bullied at school and do not feel socially accepted. This has a dramatic impact on mental health for children of all ages.
Children are often not able to put these concepts into words. You can watch them scratch their skin open, but they may not have the ability to say they itch. They will not tell you they are tired because they did not sleep all night and they may or may not tell you they are being teased about the appearance of their skin. It is our responsibility as adults in their lives to look for these signs of poor eczema control and correct them before it starts to affect their growth, development and mental health.
How do I fix it?
Mental health is complex. There is often not one single cause for anxiety and depression. However, the first step in the journey to good mental health is identifying the triggers that have led to your mental health decline. If eczema is part of your struggle with your mental health, it is important you discuss this with your provider so that steps can be taken to better control the eczema and address your mental health concerns. At Monarch Medical, we understand that eczema affects more than just your skin and we are here to listen and take action to help you heal.
References
LeBovidge, J. & Schneider, L. (2025). Depression and anxiety in patients with atopic dermatitis
Recognizing and addressing mental health burden. Annals of Allergy, Asthma and Immunology.
134, 506-515
Sandu, J., Wu, K., Thanh-Lan, B., Armstrong, A. (2018). Association Between Atopic Dermatitis and
Suicidality. JAMA Dermatology, 155(12), 178-187. doi: 10.1001/jamadermatol.2018.4566
Schonmann, Y., Mansfield, K., Hayes, J., Abuabara, K., Roberts, A., Smeeth, L. & Langan, S. (2020).
Atopic eczema in adulthood and risk of depression and anxiety: a population – based cohort
study. Journal of Allergy and Clinical Immunology Practice (8)1, 248-257.
doi: 10.1016/j.jaip.2019.08.030
