Hormones and Atopic Dermatitis: What’s The Connection?

Allergens. Harsh soaps. Bacterial infections. Eczema has many triggers.

But did you know your own hormones could play a role, too? If your eczema flares seem to follow a pattern, changing hormone levels might play a part.

Dermatology resident Angela Wei, MD, explains why hormones can impact eczema and what to expect from future flares.

How do hormones affect eczema?

Think of hormones like your body’s version of dimmer switches. When hormone levels turn up or down, it can affect:

• Oil production
• Moisture retention
• Inflammation
• Immune system activity
• Skin sensitivity

These shifts in hormones can sometimes weaken your skin barrier or make eczema symptoms — like itching, dryness and irritation — more likely to flare.

“Research shows there may be more of a connection between hormones and eczema than we once thought,” says Dr. Wei.

Dr. Wei explains more about how hormonal changes affect eczema and what to expect.

Sex hormones

Sex hormones are mainly responsible for your sexual and reproductive health. But they also help with other things, like growth and development.

There are three primary sex hormones that everyone has on some level:

• Estrogen: Primarily produced in the ovaries, this hormone helps regulate the menstrual cycle and plays a vital role in pregnancy. Men have estrogen, too, though usually in smaller amounts than women.
• Progesterone: In women, this hormone helps prepare the lining of the uterus for implantation and supports pregnancy. In men, it serves as a building block for creating other hormones, including testosterone.
• Testosterone: For both men and women, this hormone drives energy levels, muscle strength and bone density, and plays a vital role in male puberty.

“The levels of these sex hormones rise and fall during your lifetime,” says Dr. Wei. “When those levels change, they can make eczema symptoms worse or even trigger eczema for the first time.”

It’s common to experience these changes during:

• Puberty
• Menstrual cycles
• Pregnancy
• Perimenopause and menopause

Puberty

After puberty, eczema tends to be more common in females than in males. Researchers believe this is because shifts in estrogen and progesterone influence inflammation and the skin’s ability to protect itself against irritants and infections. When your skin is weak or inflamed, eczema symptoms can flare or get worse.

In comparison, some studies suggest that men may be less likely to get eczema after puberty because testosterone might help suppress inflammation.

But that’s not to say men don’t get eczema later in life or that women can’t get it earlier in life. There are several factors at play, and hormones affect everyone differently.

“It’s hard to predict exactly how puberty will affect an individual’s eczema,” notes Dr. Wei. “It can get better or worse — but either way, changes in hormones have been linked to changes in eczema.”

Menstrual cycles

You might notice eczema symptoms in the week or so before your period begins.

“A few days before the start of your period, estrogen levels drop,” explains Dr. Wei. “This sudden change can trigger an eczema flare and worsen symptoms.”

Estrogen has positive effects on skin health by:

• Increasing hydration
• Increasing collagen production
• Improving skin barrier function

So, when estrogen drops, it’s common for your skin to become:

• Drier
• More sensitive
• Prone to irritation
• More inflamed

And again, it’s not just about estrogen.

“Progesterone also fluctuates during your menstrual cycle and can shift your immune system in ways that may contribute to eczema flares,” she adds.

Pregnancy hormones

Eczema is one of the most common skin conditions during pregnancy. The reason? It’s likely because of a surge in key hormones, such as estrogen and progesterone. These hormones shift your immune system to help protect the fetus — but that same shift can trigger eczema.

“More than half of pregnant women with a history of eczema will get a flare during pregnancy, though some actually improve,” shares Dr. Wei. “Others can develop eczema for the first time, usually in the first or second trimester.”

Perimenopause and menopause

As you get older, your body makes fewer and fewer sex hormones.

For women, this starts during perimenopause, when your body starts to produce less estrogen in preparation to end your menstrual cycle (menopause). This drop can lead to changes like:

• Thinner skin
• Drier skin
• Slower wound healing

“Those changes in your skin can worsen eczema or trigger a first-time flare,” says Dr. Wei. “Other changes, like hot flashes and disrupted sleep, can also make itch worse.”

Stress hormones

When you’re stressed or anxious, your body kicks into high gear and starts producing higher levels of cortisol.

For a short time, an increase in cortisol can help reduce inflammation. But long-term stress can disrupt the way cortisol works, throwing your immune system and skin barrier out of balance. As a result, your skin can become:

• Drier
• More sensitive
• More likely to have an eczema flare

“Managing stress and getting enough sleep can improve or reduce the chances of future flares,” advises Dr. Wei.

Managing hormonal eczema

Self-awareness is key when managing a chronic condition like eczema.

“If you can predict it, you can get ahead of it,” encourages Dr. Wei. “If you know you tend to get flares at certain times, it helps to plan ahead by moisturizing and avoiding potential triggers or irritants in the week or two leading up to those periods.”

If you recognize any patterns in when and how your eczema flares, bring that information to your dermatologist or primary care physician.

“We can evaluate whether hormonal changes or other underlying conditions may be contributing to your symptoms,” she adds.

Hormone replacement therapy can help treat symptoms of menopause and may improve skin dryness. But it’s not considered a primary treatment for eczema.

You can also use prescription treatments and topical ointments to help relieve some of the itching, swelling and burning that comes with eczema if and when it flares.

“The important thing is being mindful,” says Dr. Wei. “Recognizing your triggers and taking care of your physical and mental health can help prevent future flares, even if your hormones are a factor.”