Whats the Link Between Eczema, Antidepressants, and Depression? 6 FAQs

Antidepressants are prescription psychotropic medications that treat several mental health conditions, including:

  • depression
  • anxiety
  • obsessive-compulsive disorder (OCD)

Yet while antidepressants help relieve symptoms of the above conditions for many people, they can also cause a range of side effects, such as:

  • nausea
  • headaches
  • dry mouth
  • difficulty sleeping
  • sexual side effects
  • weight gain

Another potential side effect you might experience? Eczema: a condition in which your skin becomes dry, itchy, and inflamed.

The relationship between depression, antidepressants, and eczema can be confusing, in part because in some cases, antidepressants can help treat symptoms of eczema. What’s more, evidence also supports a strong link between eczema and depression.

Below, find out what experts currently know about the link between antidepressants, eczema, and depression, plus get answers to your questions about managing eczema symptoms while taking antidepressants.

1. Can antidepressants cause eczema?

According to a 2014 review of clinical trials, eczema can happen as a side effect of the following drugs:

  • citalopram (Celexa)
  • fluvoxamine
  • paroxetine (Paxil)
  • sertraline (Zoloft)
  • clomipramine (Anafranil)
  • venlafaxine (Effexor XR)

According to the review, most people taking antidepressants don’t experience any skin-related side effects. Even if you do, you’re more likely to experience excess sweating or acne.

If you do develop eczema, it will probably appear in the first few days after you start the medication. Skin reactions typically go away on their own, so you don’t necessarily need to stop your medication to get rid of eczema.

Older tricyclic antidepressants (TCAs) tend to cause more side effects than the newer selective serotonin reuptake inhibitors (SSRIs). According to 2014 research, roughly 1 in 1,400 people taking TCAs report skin changes, compared to about 1 in 2,000 people taking SSRIs.

2. Why does eczema happen?

Science isn’t entirely sure why antidepressants trigger eczema symptoms for some people. Current theories focus on two possible mechanisms: sweat and serotonin.

Sweat

Both too little and too much sweat can contribute to eczema.

Citalopram, paroxetine, and sertraline can all dry out your skin and decrease the amount of sweat you produce. This process, called anhidrosis, may damage your skin and make it extra sensitive.

But excess sweating, or hyperhidrosis, tends to happen more commonly as an antidepressant side effect than a lack of sweat. If perspiration sits on your skin for too long without getting cleaned off, the chemicals in your sweat could irritate your skin.

Serotonin

According to another theory, antidepressants may increase the amount of serotonin circulating in your skin.

In one 2015 study, mice scratch their skin much more frequently after SSRI injections, which suggests they feel itchier. However, humans usually take SSRIs in pill form, not directly in the skin via needle.

Unusual activity in your nerves’ serotonin receptors has been shown to cause itching in humans as well as in mice. That said, only one case report, from 2004, found evidence to suggest oral antidepressants may affect human skin serotonin levels enough to cause symptoms.

Future research involving humans may offer more support for this theory.

3. How do antidepressants treat eczema?

The atypical antidepressant Mirtazapine (Remeron) is sometimes prescribed off- label to address severe nighttime itching caused by eczema.

A doctor or other clinician may also prescribe other antidepressants, such as fluoxetine and sertraline, to help reduce itching and inflammation.

Experts have yet to determine exactly how antidepressants provide relief from eczema symptoms. Possible mechanisms include:

Reducing peripheral inflammation

When your immune system senses your skin is being attacked, it sends microscopic agents to fend off the invader. The ensuing inflammation can create tender bumps and hot rashes that characterize eczema. Inflammation may also send itching signals as an alarm bell to tell your brain that something is wrong.

SSRIs can also reduce inflammation on the edges of your nervous system, including your skin. Once your immune system settles down, your eczema symptoms should too.

Dampening your perception of the itch

As mentioned above, serotonin circulating in your skin can contribute to itchiness.

Oral antidepressants mostly raise the serotonin levels in your central nervous system (CNS), not the nerves on the surface of your skin. But antidepressants can also prompt your CNS to suppress the itch signals coming in from your skin. Your brain lowers the strength of the itching — something like turning down the volume on a radio — so it doesn’t overwhelm you.

SSRIs seem particularly good at prompting this process.

Lowering stress levels

Stress can raise your cortisol levels and cause inflammation all across your body. It’s a well-known trigger of eczema episodes.

Antidepressants, however, can lower your cortisol, which can reduce inflammation, in turn.

To put it another way, antidepressants don’t just combat inflammation. They can also help prevent it from happening in the first place.

4. What’s the link between depression and eczema?

According to a large 2020 study, adults with eczema are 14% more likely to develop depression than people without eczema. The more severe your eczema, the higher your depression risk:

  • Mild eczema: 10% higher risk
  • Moderate eczema: 19% higher risk
  • Severe eczema: 26% higher risk

You might get a diagnosis of eczema before a diagnosis of depression, but that doesn’t automatically mean eczema came first. Unlike an eczema rash or dry skin, symptoms of depression may be less recognizable, especially when they first appear.

Other potential explanations

It’s also possible both eczema and depression might relate to a third factor, such as:

  • heightened stress levels
  • lack of sleep
  • chronic inflammation

Some eczema cases which show up early in antidepressant treatment may actually happen as a result of these underlying factors, not as an antidepressant side effect.

Just as eczema can have many triggers, a range of factors typically contribute to depression.

For instance, the physical changes often caused by eczema, including rashes and scarring, may also affect self-image and self-esteem — both of which can play a part in depression.

5. What are other common eczema triggers?

Of course, in many cases, eczema may have nothing to do with depression or antidepressant treatment.

Eczema can have many environmental triggers, including:

  • hot or cold weather
  • pollen
    • mold
  • tobacco smoke
  • scratchy or synthetic fabrics
  • scented soaps, lotions, shaving gels, and other personal care products
  • preservatives in cleaning products

Some non-antidepressant medications can also cause eczema, including:

  • immune checkpoint inhibitors, which treat cancer
  • interleukin (IL)-17 inhibitors, which treat psoriatic arthritis
  • peginterferon and ribavirin, which treat hepatitis C

How do you know if your eczema is caused by antidepressants or something else? To get more insight, you can try keeping a record of when your eczema appears.

For example, if your eczema always gets worse after laundry day, you may want to consider changing detergents. But if your eczema episodes happen regularly, regardless of your schedule or external factors, it likely relates to something internal, such as medication or chronic stress.

Another good option involves reaching out to a doctor or dermatologist for allergy testing. They’ll place tiny amounts of allergens into a tool that lightly scratches your skin. If your skin reacts to the exposure, then your eczema may relate to an allergy.

6. What treatments can relieve eczema symptoms?

You don’t have to stop taking antidepressants to get rid of your eczema. Your psychiatrist may be able to switch you to a similar medication that doesn’t affect your skin.

Basic self-care practices can also go a long way toward reducing symptoms of both eczema and depression. If you have both eczema and depression, the National Eczema Association recommends:

  • taking time to relax
  • sleeping 7–8 hours each night
  • getting regular physical activity, if able
  • eating an anti-inflammatory diet

Here’s how to build a self-care checklist.

For eczema-specific relief, consider these remedies:

  • Moisturize your skin 2–3 times a day.
  • Apply topical steroids to lower inflammation.
  • Take antihistamines to decrease itching.
  • Trim your fingernails or wear gloves to reduce any damage from scratching.

If you have severe, persistent eczema that doesn’t respond to over-the-counter (OTC) treatment, a good next step might involve connecting with a dermatologist.

They can prescribe medications that modify your immune system, provide wet wrap therapy, and offer guidance on other treatment options.

The bottom line

Antidepressants may occasionally cause eczema symptoms for some people. Scientists still don’t know exactly why this reaction happens, particularly because antidepressants can also be used to treat eczema and general itching.

Generally, drug-induced eczema remains fairly mild and responds to OTC remedies and treatments. If you experience lingering itching, irritation, and other skin discomforts while taking an antidepressant, it may be worth asking your psychiatrist or doctor about trying another medication.

Consulting a dermatologist about your symptoms and potential triggers could also be beneficial since your eczema could have an entirely different cause.