Menopause and Eczema: The Surprising Connection

Hot flashes, mood swings, disrupted sleep—menopause can seem like the gift that keeps on giving. But did you know that menopause can also cause skin changes, too, including worsening eczema? It’s true: The changing hormones that come with the end of your menstrual periods can also affect your skin and contribute to eczema flares.

“Changing hormones during menopause can impact many aspects of skin health,” says Alexandra Flamm, M.D., a dermatologist at NYU Langone in New York City. “Some may notice that their skin is drier and is more likely to get irritated. Other changes can include increased redness or flushing of the skin.”

Eczema, also called atopic dermatitis, is a chronic inflammatory condition of the skin that causes symptoms like dry, red, and itchy skin. If you’re living with this condition, you’ll want to know how menopause can cause eczema to flare, the role hormones and your immune system play, and what you can do to manage your symptoms—from medications to daily tips.

Perimenopause is the time in your life where your ovaries begin to stop working, eventually leading to an end to your menstrual periods and a change in your body’s hormones overall. During this life stage, levels of the hormone known as estrogen plummet—which can spell trouble for your skin and contribute to eczema. Similarly, other times of life when hormones are going through dramatic shifts—like pregnancy—can also cause eczema flares, according to the American Academy of Dermatology (AAD).

Estrogen plays a key role in skin health by helping skin retain moisture. It does this through promoting the production of sebum (an oily substance), increasing water retention, and improving barrier function of the outermost layer of skin, according to one study. As estrogen wanes at menopause, so do these skin benefits—leading to increased dryness.

“Those who have eczema are already prone to dry and irritated skin,” Dr Flamm says. “So these changes [at menopause] can lead to worsening of a person's baseline eczema.”

In addition to eczema, other skin-related changes you may notice at menopause include signs of sun damage, thinning skin, and changes in hair growth patterns, according to the AAD.

Your immune system plays a key role in the development of eczema, and similarly, it plays a role in new or worsening flare-ups of eczema during menopause. Picture the immune system as having two sides, explains Jenny Murase, M.D., an associate clinical professor of dermatology at the University of California, San Francisco, and director of medical consultative dermatology at Palo Alto Medical Foundation in Mountainview, CA. One side is called Th1, which is your cell-mediated immunity that helps fight off things like bacteria and viruses; the other side is called Th2, which is the “allergic arm” of the immune system that plays a role in allergen-sensitive diseases like atopic dermatitis and asthma.

As you get older, “your TH1 cell-mediated immunity goes down, and your Th2 increases and you become more Th2 dominant,” Dr. Murase explains. As a result of this immune system shift, there are a host of different changes you may notice in your skin, she says, from increased itchiness to conditions like Grover’s disease (red, itchy bumps across the chest, abdomen, and back) and, you guessed it, different types of eczema.

“You can get different forms of eczema [including atopic dermatitis] during this time because eczemas for the most part are Th2-dominant conditions,” she says. That includes atopic dermatitis as well as other types of eczema, such as asteatotic eczema (“dry skin eczema”) and nummular (coin-shaped) eczema.

“People with atopic dermatitis have a skin barrier defect, meaning the skin barrier is not as strong, and they also create a lot of allergic inflammation,” Dr. Murase says. “These atopic conditions can occur in childhood but go away and then recur in adulthood or when we go into menopause because of that shift where we become more Th2 dominant.”

That’s why you may start to notice eczema flare up again as you reach this stage of life. “You may notice new rashes develop or older rashes come back again,” Dr. Flamm says.

Think your skin changes during menopause could be related to eczema? Here are the symptoms of eczema to watch for, according to the National Institute of Health (NIH):

• Dry, red patches of skin

• Itchiness

• Rashes that may ooze clear fluid or bleed if you scratch them

• Swelling

• Thickening of the skin (crusting or scaling)

Eczema symptoms can affect many different areas of the body—some people have eczema in multiple areas at once, while others repeatedly get eczema in the same places. Those with darker skin tones may also notice darkening or lightening of the skin in areas with eczema, per the NIH.

No matter your age, treating your eczema starts with gentle skin care at home. But in some cases, medical treatment may be necessary. “If someone has a concern that their eczema is worsening, it is important to be seen by their doctor and in particular a board-certified dermatologist,” Dr. Flamm says. “A dermatologist can do a full evaluation of your eczema and give recommendations on what over the counter or prescription treatments may be helpful.”

Eczema medications are not known to interact with hormone therapy during menopause, but just to be safe, it’s always good to tell your dermatologist or primary care doctor which medications you’re currently taking.

These are some of the treatment options—from at-home care to topical therapeutics and systemic drugs—that you and your doctor may discuss.

Home Remedies for Eczema

Practicing gentle skin care and working to avoid triggers is key when you have eczema—especially during menopause, when estrogen is declining and your skin’s protective barrier is reduced. The following steps may be helpful:

• Lock in moisture. “Moisturizing is very important,” Dr. Murase says. She breaks down the different options into three consistencies, ranging from lotions (which tend to have the most water in them and can be drying) to creams to ointments (the thickest, “strongest” option). “I recommend you use a cream in the morning and an ointment at night.” You can get ointments like Aquaphor or Vaseline over the counter at your local pharmacy.

• Bathe wisely. “Avoid using soap all over the body—just the armpits and groin. Especially as you get older, using a body wash all over can strip your skin of its natural oils,” Dr. Murase says. In the shower or bath, use lukewarm water rather than hot water, and keep it to 10-15 minutes to avoid irritating and drying your skin out further, per the National Eczema Association. Don’t forget to slather on your moisturizer afterward!

• Try itch-relief remedies. Applying a cool compress can sometimes soothe itchy skin when you have eczema, according to the AAD. You may also try a colloidal oatmeal bath.

• Choose gentle products. “It is important to treat your skin gently,” Dr. Flamm says. ”Try to use cleansers formulated for those with eczema or sensitive skin. Moisturizing often with gentle moisturizers for eczema or sensitive skin is also important for keeping the skin barrier intact and healthy.” Using a fragrance-free moisturizer can also help reduce irritation for sensitive skin during menopause, per the AAD.

Topical Treatments for Eczema

Sometimes, you need extra help to manage your eczema during menopause. Several medications can bring relief, starting with topical creams or ointments available by prescription. These may include the following, according to the AAD:

• Topical steroids. Steroid creams may be helpful for mild to moderate cases of eczema. They work by reducing the inflammation in the skin to bring symptom relief.

• Topical calcineurin inhibitors (TCIs). These topical drugs are also for mild to moderate cases of eczema, but they are not as harsh as steroids so are typically prescribed for thinner-skinned areas like your face. This can be especially helpful during menopause, when the skin naturally begins to thin with the changing hormones. Your doctor may also suggest a TCI if you have already tried a topical steroid and it stopped working or failed to work, per the AAD.

• Topical phosphodiesterase 4 (PDE4) inhibitors. Eucrissa (crisaborole) and Zoryve (roflumilast) are a prescription ointment and cream that contain PDE4, an enzyme that works by stopping the immune response to reduce inflammation and itchiness in mild to moderate eczema.

• Topical Janus kinase (JAK) inhibitors. A JAK inhibitor cream called Opzelura (ruxolitinib) is available for mild to moderate eczema and works by targeting the inflammation at the root of the disease.

Systemic Treatments for Eczema

If you have more extensive eczema—for example, if it’s severe or covering a large area of your body—your doctor may recommend a systemic medication to help treat it. Systemic drugs work throughout the body, unlike a topical drug that mainly works in the area it is applied. The following are systemic drugs that may be prescribed for eczema, per the National Eczema Association:

• Biologics. Biologics are targeted medications created from living cells that work by blocking inflammatory pathways in your body to reduce inflammation, typically given as shots. Biologics available for eczema include Dupixent (dupilumab), Adbry (tralokinuab-Idrm), and Ebglyss (lebrikizumab-Ibkz).

• JAK inhibitors. JAK inhibitors are also available as oral tablets. Both Cibinqo (abrocitinib) and Rinvoq (upacitinib) are JAK inhibitors approved for eczema treatment.

• Immunosuppressant drugs. More traditional immunosuppressant drugs like cyclosporine and methotrexate may also be used for eczema in some cases, according to the AAD—that said, they are less common now with the introduction of newer drugs like JAK inhibitors and biologics.

• Phototherapy. Sometimes, phototherapy may be recommended for moderate cases of eczema. Your skin is exposed to a narrow band of UV light for several minutes a few times a week over the course of one to two months; it works by suppressing the immune system to reduce inflammation.

Another promising drug may also be soon available for eczema, Dr. Murase says, and she’s already seen it work well for people in her own clinical practice battling itch: Nemluvio (nemolizumab) is a monoclonal antibody drug (a type of biologic) approved by the Food and Drug Administration (FDA) to treat itch for people living with the skin condition prurigo nodularis and is currently under study for use in people with atopic dermatitis with promising results, per a 2024 article in The Lancet.

Hormone Therapy During Menopause

If your eczema is flaring during menopause alongside other menopause symptoms, you may wonder whether hormone therapy typically prescribed for menopause symptoms may also help reduce your eczema. If you are also experiencing menopause symptoms like hot flashes, vaginal dryness, insomnia, or mood swings, it’s worth discussing hormone therapy with your health care team as a potential option for you, as these treatments can help bring you relief, per the Cleveland Clinic.

That said, if you are looking for relief from eczema specifically, your dermatologist will likely focus on tried-and-true methods for eczema like the topical and systemic drugs discussed above. “[Hormone therapy] is not generally prescribed for treatment of eczema worsening in the setting of menopause,” Dr. Flamm says.

If your eczema is getting worse around menopause—or if your childhood eczema has suddenly made a midlife resurgence—it’s not uncommon. That’s because changing hormones and shifts in the aging immune system create an environment in which the condition can flare. Thankfully, there are strategies to help manage your symptoms, from at-home steps to prescription medications.

“It is important to be evaluated by your dermatologist as eczema can be caused by multiple different factors, and your doctor can ensure you are getting the best treatment for your eczema.” Dr. Flamm says.