It’s an unfortunate ripple effect: Chronic inflammation from AD drives a cycle within your nervous system that leads to the release of pro-inflammatory cytokines (immune system proteins that help fight germs).
That can affect the skin barrier, explains Amy Huang, MD, a dermatologist at Medical Offices of Manhattan in New York City. Cue the chronic itching, which contributes to psychological distress.
“This type of stress triggers the release of cortisol, the fight-or-flight hormone, which then increases systemic inflammation even more,” she says. “This perpetuates a cycle of scratching and AD lesions.”
Chronic stress also weakens your immune system, which causes flares to happen more frequently and makes symptoms more intense, says Elizabeth Geddes-Bruce, MD, a dermatologist at Westlake Dermatology in Austin, Texas.
“Patients often notice that their AD flares during stressful periods, and it’s because of this complicated interaction between the immune system, the nervous system, and the skin,” she says.
Another factor is sleep disruption, which is a common effect of itching and discomfort.
Sleep difficulties are closely linked to emotional health and resilience, and the ongoing sleep challenges caused by AD can further sabotage your mental health.