Thirty-year-old Saanya Ali has lived with eczema for as long as she can remember, but a recent flare-up during a vacation on the Italian coast hit her differently.
“It was the worst eczema of my entire life,” she says, blaming the brutal combination of sun, salt, and stress. “My arms were scaling and flaking so badly that my brother told me if he were in my shoes, he would’ve gone home. It was just so, so bad.”
As her skin cracked and peeled, another old wound resurfaced: her relationship with food.
“The mental shift that often happens is like, ‘Well, if this is so ugly, how do I fix something else?'” she says. “I couldn’t control my arms, but I could control how I ate.”
The link between chronic skin conditions like eczema and disordered eating isn’t fully understood. But emerging research suggests the connection may be more common — and more psychologically complex — than anyone realized.
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Stevie Blum, LCSW, is a psychotherapist and relationship specialist.
What We Know About the Link Between Eczema and Eating Disorders
Eczema — also known as atopic dermatitis — is a chronic inflammatory skin condition that causes dry, itchy, inflamed patches of skin. It affects around 10 percent of the US population, often flaring in response to triggers like stress, environmental changes, and diet.
While a large body of research has linked eczema to mental health concerns like depression and anxiety — according to the National Eczema Association, two-thirds of people with atopic dermatitis say it has negatively impacted their mental health — its connection to eating disorders has only recently come to light.
A 2024 study out of Yale analyzed more than 250,000 electronic health records, including those of 12,000 patients with eczema, and found that people with atopic dermatitis were twice as likely to develop anorexia nervosa or bulimia nervosa, and three times more likely to experience binge-eating disorder.
The study, which is one of the first large-scale interdisciplinary analyses to examine this link, opens the door to a deeper understanding of how the body and brain interact. But it also leaves a major question unanswered: does eczema cause disordered eating or is it the other way around? In other words, it’s a classic chicken-or-the-egg scenario.
Researchers have proposed a few (admittedly imperfect) theories. One is behavioral: disordered eating may develop as a response to anxiety, depression, or the lack of control that comes with unpredictable eczema flare-ups. Another theory is biological: chronic low-grade inflammation (a hallmark of eczema) may affect the brain’s appetite regulation or mood pathways. A third possibility lies in the gut-skin axis, where a disruption in the microbiome called dysbiosis could influence both skin and mental health at the same time.
And then there’s the role of food itself. For many people with eczema, trying to manage flare-ups can lead to hyper-vigilance around eating, which can become a slippery slope.
“People assume dietary triggers that aren’t always medically confirmed and start eliminating entire food groups from their diet to manage flare-ups,” says psychotherapist Stevie Blum, LCSW. “Over time, that hyper-focus on ‘safe foods’ or ‘clean eating’ can trigger restrictive behaviors that spiral into a full-blown eating disorder.”
While more research is needed to fully understand the biological connection between eczema and eating disorders, the psychological link is coming into sharper focus.
The Psychology of Control
For many people living with eczema, the condition isn’t just skin-deep — it’s a constant reminder that their body is unpredictable and, at times, uncontrollable. That loss of agency can be deeply destabilizing.
“I use eczema as an analogy for the eating disorder itself: it feels like you always kind of have it and it flares up at certain times.”
Hally Leadbetter, 32, has dealt with both eczema and an eating disorder for nearly two decades. “When I have a flare-up, I feel like I’m out of control — annoyed at my body for doing whatever it’s doing,” she says. “I feel ugly and will find anything I can control, which is food.”
According to Blum, it’s not uncommon for people to use restrictive eating as a way to cope with eczema. “Because skin conditions are so visible and difficult to manage, individuals who struggle with them often feel a profound loss of control over their body,” she says. “This can cause them to become hyper-fixated on aspects of their appearance they can control.”
Given what we know about eating disorders, this tracks. Behavioral science researchers at The University of Massachusetts note that people with eating disorders often feel powerless in parts of their lives, and food becomes a domain where they can assert control. As the National Eating Disorders Association (NEDA) puts it, “restricting food intake may provide a sense of control in an otherwise chaotic world,” and eating disorders often “aren’t just about food, but about reclaiming control over one’s life.”
Ali knows this reality all too well. “If there’s a loss of control in one way, there’s a desperation for control in something else,” she says, adding that restrictive eating habits often emerge when she feels uncomfortable in her skin.
Leadbetter adds that she’s come to see her eczema and her eating disorder as more connected than she once realized, both in how they manifest and how she’s learned to manage them. “Even now, I use eczema as an analogy for the eating disorder itself: it feels like you always kind of have it and it flares up at certain times and you need to put in the necessary things to keep it at bay,” she says. “For eczema, it’s cortisone cream; for eating disorders, it’s therapy.”
Eczema, Appearance, and Identity
In a society that places an almost obsessive value on clear skin and thinness, it’s no surprise that dealing with both eczema and an eating disorder can create a feedback loop of shame, body dysmorphia, and self-surveillance.
“Living with eczema can really negatively affect your quality of life and body image, because of how uncomfortable you feel in your skin,” Blum says. “The pain and discomfort created by eczema can create a hyper-consciousness about your body and a fixation on every perceived flaw.”
For Ali, these feelings tend to peak during the warmer months. “My eczema and eating disorder are worse in the summer, because being out in the sun also means wearing fewer clothes and being more aware of your body, and everyone else’s,” she says. “There’s a lot of body dysmorphia. I’ll see photos of myself and be like, ‘That can’t be my skin. Whose is it?””
That disconnect between how she looks and how she feels often pushes her to find control in other, sometimes harmful ways, like restricting food. “This fixation and consciousness can make you more susceptible to disordered eating as a way of trying to regain control over your body,” says Blum.
Stress doesn’t help, either and for Leadbetter, it’s often the common thread. “Both are definitely stress-related — this one spot of eczema I get on my leg is definitely stress-related, and eating disorders can be very stressful,” she says. “I don’t remember ever being like, ‘They’re back at the same time,’ but stress triggers them both for sure.”
Both eczema and eating disorders are inside-out struggles — deeply physical, but also deeply emotional. And for those living with them, healing often requires more than symptom management. It takes a support system that sees the whole person.
The Bigger Picture
Given the link between eczema and various mental health concerns, it’s clear that it’s not just a skin condition. It’s a whole body and mind experience, and treating it effectively requires taking both into account.
“Dermatologists should screen patients with chronic eczema for disordered eating or body image concerns, since they’re often the first or only healthcare providers treating people with chronic eczema. They’re in a unique position to notice early signs of disordered eating or body image issues,” says Blum.
“Reminding myself that my love handles and my flaky skin are the least bad things going on right now is helpful.”
Even simple check-in questions like, “How has your skin impacted your relationship with your body or food?” can open the door to support, she adds. “Catching these issues before they escalate can make a big difference in their trajectory.”
Leadbetter agrees that treatment needs to be holistic and personalized. For her, it’s been a combination of the right dermatologist, medical-grade topical treatments, and a therapist she jokingly calls “the cortisone cream for my anorexia.”
“You have to be OK with getting help and be willing to put in the effort to find what works for you,” she says. “Don’t just go to Walgreens and pick out a random cream — go to someone who really knows what they’re talking about. That’s what made all the difference for me.”
Over time, she’s also learned to anticipate triggers. “I know that when I’m going to a dry environment, I’m going to have to be extra hydrated, and I know I might not feel great about myself,” she says. “So part of it is effort, putting systems in place, and part of it is building a toolkit. Like, ‘OK, when A happens, B is going to follow, and I can be ready for it.'”
For Ali, managing both conditions has meant learning to shift her perspective. “Reminding myself that my love handles and my flaky skin are the least bad things going on right now is helpful,” she says. “They’re uncomfortable, but there are so many other things to be upset about. If I’m opening up that box, they’re nowhere near the top.”
It’s a messy, imperfect process, but with the right support, awareness, and compassion, it’s one that can lead to healing from the inside out.
Zoë Weiner is a freelance beauty and wellness writer. Her work has appeared in Bustle, Byrdie, Cosmopolitan, PS, GQ, Glamour, Marie Claire, Allure, Self, Brides, and Teen Vogue, among others, and she was the senior beauty editor at Well+Good.
