Eczema is a common skin condition characterized by itchy, inflamed, and irritated skin. It can occur in people of all ages, but is most common in infants and children. Eczema is associated with dry skin and a compromised skin barrier that allows moisture to escape and environmental irritants to enter. While the exact cause of eczema is not known, it is thought to involve a combination of genetic and environmental factors.
What causes eczema?
The precise cause of eczema is not fully understood, but it is known to be related to the following factors:
- Genetic predisposition – People with a family history of eczema or other atopic diseases like asthma and hay fever are more likely to develop eczema.
- Immune system dysfunction – Eczema is linked to overactivity of the immune system and inflammation.
- Environmental triggers – Things like irritants (detergents, soaps), allergens (pollen, pet dander), microbes, dry air, and stress can trigger eczema flares.
- Impaired skin barrier – People with eczema have a defective skin barrier that allows moisture loss and entry of irritants and allergens.
In addition to these factors, hormonal influences like low estrogen levels have also been hypothesized as a potential cause of eczema, particularly in women.
Can low estrogen levels cause eczema?
Estrogen is one of the main female sex hormones. It plays an important role in maintaining healthy skin and regulating immune responses. Some research suggests that decreased estrogen levels may be linked to increased eczema risk in women, possibly due to the following effects:
- Impaired skin barrier – Estrogen helps promote skin barrier repair and integrity. Low estrogen may weaken the skin barrier, increasing water loss and entry of irritants.
- Dryness – Estrogen increases skin hydration and oil production. Low levels can cause dryness, increasing eczema risk.
- Inflammation – Estrogen has anti-inflammatory effects. Low levels may increase inflammatory responses involved in eczema.
- Immune regulation – Estrogen modulates immune responses. Decreased levels may contribute to the overactive immune responses in eczema.
Here is a closer look at some of the evidence linking low estrogen to eczema risk:
Age and gender patterns
Eczema often first appears during infancy when estrogen levels are low. It typically improves during puberty when estrogen levels rise. Women also tend to have higher eczema rates than men.
Pregnancy effects
Eczema severity often improves during pregnancy when estrogen levels are very high. Postpartum when estrogen levels crash, worsening eczema is commonly reported.
Menopause effects
Many women report increased eczema after menopause, when estrogen levels decline permanently.
Oral contraceptives
Some studies indicate that oral contraceptives containing estrogen can improve eczema in women with low estrogen levels.
Hormone therapy
Estrogen creams, pills, or injections may help alleviate eczema in some women, especially after menopause.
Overall, while these patterns suggest a link, more research is still needed to definitively confirm low estrogen as a cause of eczema flair ups.
Other hormonal factors
While much of the focus has been on estrogen, other hormonal influences may also be relevant in eczema. These include:
- Progesterone – Also decreases post-menopause and has anti-inflammatory effects.
- Androgens – Male hormones like testosterone also help maintain skin barrier function.
- Stress hormones – Increased cortisol/adrenaline during stress can worsen eczema.
- Thyroid hormones – Thyroid issues may increase eczema susceptibility.
- Melatonin – This sleep hormone also has skin barrier protective effects.
The influence of these other hormones on eczema is complex and interrelated with estrogen levels as well.
Who may be affected?
Women with chronically low estrogen levels may be most prone to developing eczema or experiencing worsening eczema from hormonal factors. This includes women:
- With premature ovarian failure or early menopause
- With hypothalamic amenorrhea (missed periods)
- Who are post-menopausal
- With hormone or endocrine disorders
- With very low body fat percentage
- Who excessively exercise, have eating disorders, or are under significant stress
- On hormonal birth control like Depo-Provera
However, even women with seemingly normal estrogen levels can experience cyclical eczema flares at different hormonal phases of the menstrual cycle. Monitoring cyclical symptoms can help identify a hormonal component.
Diagnosis and testing
If hormonal causes of eczema are suspected, a doctor may recommend:
- Blood tests to check estrogen and other hormone levels
- Allergy testing to uncover environmental triggers
- Analyzing symptoms in relation to menstrual cycle
- Reviewing medical history for other hormonal issues or risk factors
- Examining skin under a microscope to assess skin barrier damage
- Elimination diets to identify food allergies/sensitivities
Keeping a symptom and menstrual cycle diary for a few months can provide helpful information.
Treatments and relief options
If hormone issues are contributing to eczema, treatment approaches may include:
- Hormone therapy – Estrogen creams, pills, patches, or injections may help some women if appropriate.
- Addressing underlying issues – Correcting any thyroid disorders, chronic stress, or conditions causing hormone imbalances.
- Lifestyle changes – Such as stress relief, proper sleep, healthy diet, and regular exercise for hormonal balance.
- Moisturizers – Using gentle moisturizers can improve dryness and strengthen the skin barrier.
- Avoiding triggers – Preventing exposure to environmental irritants that provoke flares.
- Anti-inflammatories – Steroid creams, oral medications, phototherapy may ease inflammation.
- Immunosuppressants – Drugs like cyclosporine can reduce immune overactivity if severe.
Antibiotics, biologic drugs, PUVA, and alternative remedies may provide additional symptom relief in some cases.
Conclusion
In summary, while much remains unknown about eczema causes, emerging research suggests low estrogen levels may potentially contribute to eczema development or worsening of symptoms in some women. This seems biologically plausible given estrogen’s importance for skin health. Not all experts agree estrogen deficiency is a direct trigger, but it likely interacts with other genetic and environmental influences. More rigorous controlled studies are needed to clarify if hormonal therapies can treat eczema by correcting estrogen deficiency. Women with chronic or cyclical eczema flares should be aware of the potential hormonal link, especially those with identified hormone issues. Tracking symptoms while optimizing diet, stress levels, and lifestyle habits may help identify and alleviate hormonal factors involved in stubborn eczema cases.