Living with eczema or psoriasis usually means getting to know your skin’s moods pretty well. For plenty of women, that includes noticing flares seem to show up at certain points: the week before a period, in the months after having a baby or somewhere along the road to menopause. Hormones may be a big part of the reason, according to Doral Fredericks, PharmD, MBA, global vice president of medical affairs and outcomes research at Organon, who recently spoke with Dermatology Times about what women with these conditions are up against.
Hormone levels rise and fall all month long, then shift dramatically during pregnancy, postpartum and menopause. Plaque psoriasis and atopic dermatitis (aka eczema) tend to move right along with them, which can change when a condition first shows up, how severe it gets and how often it flares.
“Women with these conditions report a disproportionately greater mental health and quality-of-life impact than men,” Fredericks says. That includes higher rates of depression, fatigue, loneliness, stress and stigma. Add a few nights kept awake by itching and it’s easy to see how a “skin thing” spills into everything else.
Starting a family brings its own set of worries. A quarter of women with psoriasis say they’ve put off motherhood because they’re afraid of passing the condition on, and some women with eczema scale back treatment while pregnant for fear of harming the baby. Inheritance depends on a lot of factors, Fredericks explains, and these are conversations to have with your provider early instead of quietly making the call on your own.
Ideally, your dermatologist is asking about more than your skin. Fredericks would like to see questions about mood, stress and sleep become a standard part of every visit (rather than something patients have to work up the nerve to bring up) with referrals to gynecologists, endocrinologists or mental health pros when it makes sense. And it’s backed by data: Research shows that combining dermatologic treatment with mental health support can calm inflammation, lower stress biomarkers and improve outcomes.
In the meantime, it’s worth paying attention to when your flares hit and mentioning any pattern at your next derm appointment, emotional stuff included. The National Eczema Association, National Psoriasis Foundation and Women’s Dermatologic Society all offer resources if you want to dig deeper.
