OBJECTIVES: Chronic skin diseases (CSD) may lead to productivity losses. This mixed-methods study investigated symptom severity, social challenges, need for workplace accommodation, sick leave, and their association with perceived impaired work performance (IWP) among workers with CSD. METHODS: Data were collected from April to June 2023. Participants (n = 102) completed an online questionnaire sent from the Institute for Occupational Safety and Hygiene and almost 20% were interviewed. The analyses included logistic regression and structural equation models and a thematic analysis. RESULTS: Of participants, 72.3% reported perceived IWP. The need for workplace accommodation and sick leave duration were directly associated with IWP. These findings were integrated with common themes based on a socioecological approach. CONCLUSIONS: By working together to address personal, interpersonal, organizational, and societal aspects associated with CSD, occupational physicians and stakeholders can alleviate perceived IWP.