Unlike hormonal acne, eczema linked to hormonal change is often misunderstood. But both inflammatory skin conditions can arise at any age, either for the first time or following long-forgotten flares. “The postpartum period and the menopause transition are common times for eczema to appear or return,” says Dr Ellie Rashid, a consultant dermatologist practicing at Welbeck. For women, hormonal change can lower the skin's threshold for inflammation, while lifestyle factors – from poor sleep to stress and irritants – can tip it into a flare.
The link between eczema and hormonal changes
It boils down to that all-important skin barrier. “Oestrogen supports the skin barrier: it helps skin hold on to water and produce the lipids and ceramides that keep it resilient,” Dr Rashid tells HELLO!. “When oestrogen drops – as it does after birth and during perimenopause – skin becomes drier, loses water more easily, and is more reactive.” On top of that, “stress hormones like cortisol and poor sleep both worsen inflammation and itch, and scratching then damages the barrier further”.
But a skin flare doesn't always mean eczema. It may signal sensitive skin – a condition increasingly reported, although whether more people are biologically sensitive, or simply better able to identify it, remains unclear.
How to distinguish eczema from sensitive skin
Sensitive skin is largely a symptom, notes Dr Rashid: “Stinging, burning, tightness, or redness in response to products or the environment, often with skin that looks fairly normal.”
© Maja TopcagicEczema, by contrast, is a visible inflammatory skin condition. “You typically see dry, rough, itchy patches that may be red on lighter skin or darker brown, purple, or grey on deeper skin tones, sometimes with small bumps, weeping, or thickened skin from scratching.”
Although there is considerable overlap – and eczema-prone skin is often sensitive – itching is one of the most useful cues, she says. “If you have persistent itchy patches, sleep disturbed by itching, or broken or weeping skin, that points to eczema rather than simply sensitive skin, and it is worth getting it medically assessed.”
How to track whether skin changes are linked to hormones rather than coincidence
Because several factors can converge in a skin reaction, tracking symptoms may help reveal a pattern. Dr Rashid recommends keeping a simple diary for at least two to three months and taking it to your GP or dermatologist: “Note your cycle days (or HRT and IVF dates), how your skin looks and itches on a scale of zero-to-10, your sleep, stress levels, and any new products, detergents, or foods,” she says. “And take a photo in the same light once a week.”
A hormonal contribution is more plausible when the same pattern repeats, she continues, “for example, flares that reliably appear in the week before a period, or that started within months of stopping breastfeeding or entering perimenopause”. If the episodes are random and track more closely with a new product or a stressful work week, hormones are less likely to be the main driver.
What to do during a skin flare-up
Here, Dr Jonathan Guckian, consultant dermatologist at Belfast Skin Clinic, says to first respond by simplifying your routine: “Use a gentle cleanser, apply a fragrance-free moisturiser and pause products that consistently sting or irritate.”
During any periods of irritation, forgo exfoliating acids and scrubs and potentially irritating anti-ageing actives such as retinoids on affected skin, he says, even if you previously tolerated them. Also avoid fragrance and essential oils. “Switching to ‘natural’ products does not necessarily help, as natural fragrances can cause problems too.”
With eczema, inflammation needs addressing. “Regular emollients help support the skin barrier, but moisturising alone may not be enough to settle a flare,” Dr Guckian says. “A topical steroid of the appropriate strength, used as directed and supported by your doctor, is often needed to bring that inflammation under control. Other prescribed treatments can be helpful for recurrent eczema, particularly on delicate areas such as the face.”
How to adopt a barrier-first skincare approach
For anyone experiencing eczema or sensitive skin, the experts recommend adopting a barrier-first skincare approach. “This means choosing a routine that helps the skin hold onto moisture while reducing exposure to things that irritate it,” Dr Guckian explains. “It does not need to involve lots of products, and does not need to be complicated.”
Keep showers short and lukewarm, he continues, avoiding ordinary soaps and fragranced shower gels, and gently pat the skin dry. Apply an emollient cream immediately afterwards, and reapply throughout the day as needed – particularly after washing your hands.
When it comes to specific products, Dr Guckian recommends the QV Gentle Wash, and the QV Moisturising Cream, but “if you're tackling more sensitive skin versus eczema, QV Skin Lotion is a lighter option”. For the face, also choose fragrance-free formulas designed for sensitive skin, such as those from Skn To Skn, which were created with hormonal life stages in mind. And don’t forget SPF – the Green People Scent Free Mineral Sun Cream is ideal.
Crucially, avoid repeatedly changing products in search of a quick fix. Resist the temptation to try lots of new “soothing” products at once; when the skin has settled, add anything new gradually, one product at a time. “Consistency is usually more useful than a complicated routine,” Dr Guckian says, “and for someone with eczema, caring for the skin barrier works alongside treating inflammation when it flares”.
