How stress causes an eczema flare up

How stress causes an eczema flare up

By Miryam Naddaf & Nature magazine

Stress often exacerbates eczema, leading to more intense and itchy rashes for those affected. However, the connection between stress and skin inflammation has remained somewhat undefined.

Recently, scientists have identified specific neurons that respond to stress by activating immune cells in the skin, thereby intensifying eczema symptoms.

According to a recent publication in Science, these results were derived from research using a mouse model of atopic dermatitis (AD), a chronic form of eczema impacting over 200 million people globally.

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The study illustrates “how a feeling, such as psychological stress, can translate into a biological event, namely inflamed skin,” explains Shenbin Liu, a neurobiologist at Fudan University in Shanghai, China.

Allergic skin conditions like AD result from hyperactive immune responses that target the body’s own skin cells. In some individuals with AD, there is an accumulation of immune cells known as eosinophils in the affected skin, which worsens inflammation. The mechanism driving these cells to the skin and activating them in AD had been elusive.

Itchy cells

An analysis of skin biopsies and blood samples from 51 individuals with AD revealed that high stress levels were associated with more severe skin inflammation and increased eosinophil counts compared to those with lower stress levels.

To delve deeper into this inflammatory process, researchers developed a mouse model of AD that exhibited skin redness, itching, and inflammation. When subjected to psychological stress, these mice showed intensified AD symptoms, including increased itching. The biopsied skin from stressed mice contained four times as many eosinophils as that from non-stressed mice.

By examining neural signals that link stress and inflammation, researchers identified neurons in the skin activated by stress. These neurons received signals from the central nervous system related to stress responses and produced inflammatory proteins that attracted eosinophils to the skin.

Stimulating these neurons significantly increased eosinophil levels in the skin of AD mice, while blocking them prevented stress-related symptom worsening. Liu suggests these findings could lead to targeted treatments, such as inhibiting stress-responsive nerves or the inflammatory molecules they release.

Wolfgang Weninger, a clinical dermatologist at the Medical University of Vienna, describes the research connecting stress and eczema as “an important piece to the puzzle,” but emphasizes that further research is necessary to apply these findings to humans.

This article is reproduced with permission and was first published on March 19, 2026.

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