An Immunologist Explains The Link Between Eczema And Depression

While there are many different factors that may influence the development of depression in an individual, Dr. Jacqueline Eghrari-Sabet, allergist/immunologist with Allergy & Asthma Network, tells Health Digest in an exclusive interview that eczema may be one of them.

Characterized by inflammation, Dr. Eghrari-Sabet starts off by explaining the role that eczema, and other autoimmune disorders, may play in relation to depression. "Autoimmune disorders increase inflammation in your body system wide (not just linked to a particular organ like your liver or kidney or skin). Remember autoimmune disease means your immune system is attacking your own body," she states. "The inflammation from autoimmune disorders may well be a cause for depression. It is your brain's response to all the inflammation." However, Dr. Eghrari-Sabet shares that the relationship between eczema and depression is not necessarily a one-way street. "Studies have shown that depression shows a two-way association with systemic inflammation," Dr. Eghrari-Sabet says, referencing a 2017 study published in PLoS One. In essence, while inflammation may prompt symptoms of depression, in turn, depressive symptoms may also stimulate inflammation.

"We can look even deeper to see that depression itself is associated with an increase in [the] body's inflammatory response," she states. Offering a research example, Dr. Eghrari-Sabet further explains how this can also be true in the opposite direction. "When a study animal has an increase in inflammatory chemicals (called cytokines such as lipopolysaccharides (LPS) the animal has a cluster of symptoms overlapping with depressive symptoms."

Offering an alternate explanation for the link between eczema and depression, Dr. Eghrari-Sabet cites the emotional toll that eczema can take on a person. "Chronic disease is often a trigger for depression," she states. "Eczema in particular can be an isolating disease. Patients can be disfigured, have scarred or unattractive peeling, red raw skin, and do not want to go out in public." Symptoms of the condition, including fidgeting and itching, can also amp up anxiety and stress in patients, Dr. Eghrari-Sabet explains, which in turn, can increase itchiness. Furthermore, poor sleep patterns, often observed in those with eczema, can also contribute to heightened itchiness, moodiness, and irritability, as well as impact motivation and emotion regulation. Alternatively, Dr. Eghrari-Sabet notes that some depressive symptoms can be traced to the use of certain anti-inflammatory medications. "Some patients experience depressive symptoms because of medication side effects. Think Benadryl, which will help the itch, but makes some very sleepy, irritable, moody," she explains.

Referencing points from an alternate research article, Dr. Eghrari-Sabet states that depression may also exacerbate eczema flare-ups. "Mental health conditions such as stress, anxiety, and depression may cause an eczema flare-up or worsen existing symptoms," she tells Health Digest. In keeping with the nature of this reciprocal relationship, she adds that flare-ups can also amplify feelings of depression. "People with depression and eczema may feel embarrassed, ashamed, or hopeless about their situation, which can affect their mental well-being," Dr. Eghrari-Sabet explains. "They may also withdraw from or avoid social activities, relationships, or physical activities, which can exacerbate symptoms of depression."

Highlighting points from a recent video published by the Allergy & Asthma Network, Dr. Eghrari-Sabet states that tending to one's mental health is of the utmost importance. "Many people isolate themselves because of eczema, but you CAN lead a full and active life," she offers. "Some people struggle to the point of having suicidal thoughts," Dr. Eghrari-Sabet emphasizes. In such cases, she encourages individuals to speak to a mental health specialist or call the National Suicide Prevention Lifeline at 800-273-8255. Additionally, seek support and ask for what you need from your doctors, health insurance providers, and loved ones. Dr. Eghrari-Sabet concludes by encouraging individuals to focus on what is within their power. "Recognize what you CAN control: what you eat, what you put on your body, the environment in which you live, and how it affects your skin."