The Effect of Hormones on Eczema

Editor’s note: In this article, we use the words women and men to refer to people assigned female or male at birth who are affected by eczema This is both because the majority of them identify as women or men and because the research we cite refers to them as such. However, we recognize that eczema affects people with a diverse range of gender identities and hope all feel welcome here.

Atopic dermatitis (eczema) can be caused or made worse by a variety of things. Genetics, the environment, hormones, and more may be involved.¹

In kids, boys tend to have eczema more often than girls. But in adults, this trend is switched. Other atopic conditions, like asthma and allergies, have this trend too. While many factors might be at play, sex hormones may offer a clue about why this trend occurs.¹

Sex hormones and eczema

Sex hormones include estrogen, progesterone, and androgens. The body tightly controls the complex balance of these hormones. Sex hormones play a role in puberty, periods (menstrual cycles), pregnancy, and menopause. Eczema symptoms may differ in each of these phases of life.^1,2

However, every person’s body is different. Some people may be very sensitive to hormone changes. Others might not be impacted much at all.^1,2

The impact of hormones on the immune system

Sex hormones affect the immune system. Female sex hormones, like estrogen and progesterone, impact the balance of certain immune system cells. This can lead to more inflammation in the body, which often worsens eczema symptoms.¹

Androgens, like testosterone, have a different effect on the immune system. Androgens are more likely to suppress the immune system. While everybody has androgens, men tend to produce more of these hormones.¹

Hormones and the skin

Estrogen serves many roles. Along with impacting the menstrual cycle, it also helps strengthen the skin barrier. Estrogen plays a role in balancing oil, fat, and water in the skin.^1,3

On the other hand, progesterone and androgens are thought to weaken the skin barrier. Experts do not understand the exact ways in which these hormones impact the skin. More research is needed to understand these links.^1,3

In general, women have skin that is more hydrated than men’s. This is because men tend to lose water from the skin more easily. But during the days leading up to menstruation, increased progesterone can weaken the skin barrier. This period is called the luteal phase of the menstrual cycle.^1,3-5

This may be why some women experience a worsening of eczema symptoms right before their period starts. During this time, the skin may also be more sensitive to certain irritants, like nickel found in jewelry.^1,3-5

Sex hormones and itching

Estrogen and progesterone are also thought to increase the itch sensation. Estrogen specifically plays a role in the body’s response to allergens, which can further increase itchiness.^1,6

Scratching an itch can lead to further skin dryness and breakdown, making itching even worse. This is called the itch-scratch cycle. Any damage to the skin can lead to irritation and inflammation, worsening eczema symptoms even more.^1,6

Eczema and pregnancy

During pregnancy, the amount of each sex hormone in the body changes. This can lead some people to have worse symptoms during pregnancy. But for others, increased estrogen may actually relieve symptoms.^1,2,4

It is also possible to develop eczema for the first time during pregnancy. Eczema that starts during pregnancy is sometimes called atopic eruption of pregnancy.^1,2,4

Working closely with your doctor to manage eczema while you are pregnant is important. Some eczema treatments may not be safe to use while you are pregnant.^1,2,4

Eczema and menopause

A woman has reached menopause when she has not had a period for at least a year. Estrogen levels drop leading up to and during menopause. Skin dryness and eczema flare-ups can occur as a result of these hormone changes.^1,3,7

It is also possible for a woman to have eczema as a kid that goes away in adulthood but then comes back during menopause.^1,3,7

Stress hormones

Other hormones besides sex hormones play a role in eczema symptoms. A common trigger of eczema flare-ups is stress. When you are stressed, your body creates more stress hormones, like cortisol and adrenaline. These hormones have many effects on the body. For example, they tell your body to go on high alert or enter fight-or-flight mode.^8-10

Stress hormones also impact the immune system. High levels of cortisol, for instance, suppress the immune system and as a result, fire up inflammation in the skin and make eczema symptoms worse. Because of this, managing stress may help prevent flare-ups.^8-10