Hormones Drive Psoriasis and Eczema Flares Differently in Women

A quarter of women with psoriasis say they have postponed motherhood because they fear passing the condition on to a child, according to Doral Fredericks, PharmD, MBA, global vice president of medical affairs and outcomes research at Organon, who spoke with Dermatology Times about how eczema and psoriasis behave differently in women.

Hormones sit at the center of the difference. Hormone levels rise and fall across the menstrual cycle, then shift dramatically during pregnancy, postpartum and menopause. Plaque psoriasis and atopic dermatitis — the form of eczema at issue — tend to move with those shifts. The result: many women notice flares the week before a period, in the months after giving birth, or along the road to menopause. These hormonal swings can also change when a condition first appears, how severe it becomes and how often it flares.

What is the mental health gap?

The burden runs beyond the skin. "Women with these conditions report a disproportionately greater mental health and quality-of-life impact than men," Fredericks said. Women with plaque psoriasis and atopic dermatitis show higher rates of depression, fatigue, loneliness, stress and stigma than men with the same diagnoses. Nights lost to itching compound the effect, turning what patients often dismiss as a "skin thing" into a whole-life problem.

Why does family planning complicate treatment?

Pregnancy adds a second layer of decisions. Beyond the quarter of women with psoriasis who delay motherhood, some women with eczema scale back treatment during pregnancy for fear of harming the baby. Fredericks cautions that inheritance of these conditions depends on many factors, and she advises women to raise these questions with their provider early rather than quietly making treatment decisions on their own.

What should dermatology visits include?

Fredericks wants questions about mood, stress and sleep to become a standard part of every dermatology visit, rather than something patients have to work up the nerve to raise themselves. Where it makes sense, she said, dermatologists should refer patients to gynecologists, endocrinologists or mental health professionals.

Data support that integrated approach. Research shows that combining dermatologic treatment with mental health support can calm inflammation, lower stress biomarkers and improve outcomes.

For now, Fredericks points to a practical step: track when flares hit and mention any pattern — emotional factors included — at the next dermatology appointment. The National Eczema Association, the National Psoriasis Foundation and the Women's Dermatologic Society all offer patient resources on hormone-linked flares and mental health support.

If dermatology adopts routine screening for mood, stress and sleep, the mental health gap Fredericks describes becomes measurable — and treatable — at the point of care.