As many as 3% of the world's adults suffer from eczema, also known as atopic dermatitis.
Eczema is a chronic inflammatory skin condition that causes extremely dry, rough, and itchy skin.
There is currently no cure for eczema. While there are medications that can help treat the symptoms of the disease, experts say the persistent itching and visual aspects of the disease can take a toll on a person's quality of life.
Previous research has shown that atopic dermatitis can have a negative impact on a person's mental health and psychological state.
Now, researchers at the National Eczema Society report that 72% of people with eczema experience adverse mental health symptoms for one to 10 days per month, with 17% experiencing adverse mental health symptoms for more than 11 days per month.
Results of the study were recently presented at the 2024 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting.
Is there a link between eczema and mental health?
National Eczema Society research supports this link.
A study published in January 2020 reported that adults with eczema were more likely to develop new diagnoses of depression and anxiety, and that depression was related to the severity of the eczema.
Additionally, research published in March 2021 reported that significantly more people with atopic dermatitis said they suffered from depression than those without the condition.
Unmet need to address mental health issues
For this study, 23% of people surveyed were currently seeing an allergist for treatment of eczema. Through survey data, researchers found that 72% of respondents reported experiencing adverse mental health symptoms on 1 to 10 days during the month. Another 17% said they experienced more than 11 days of negative mental health conditions.
This prevalence is concerning rather than surprising, as numerous studies have shown a link between atopic dermatitis and poor mental health, particularly among those with moderate to severe atopic dermatitis. There is a huge unmet need to more effectively address mental health issues in patients with atopic dermatitis.
Eczema requires holistic care
The team also found that 35% of respondents had never raised mental health concerns with their allergist, and 57% said their allergist had never asked them about their mental health concerns.
The significance of these findings is that they indicate the need for holistic care of atopic dermatitis.
While focusing on reducing skin symptoms is important, it clearly ignores other issues that are important to patients. Because the connection between atopic dermatitis and mental health is exacerbated by the presence of other specific comorbidities, allergists are in a unique position to reduce the emotional burden associated with symptoms. However, there is an opportunity to raise the standard of care by inviting patients to have discussions around mental health that go beyond the impact on their skin and increase awareness and willingness to refer to mental health resources and other healthcare professionals who can help.
Since appointment times are limited, general inquiries about mood, mood, sleep, and frequency of symptoms can provide a starting point for educating patients about their mental health. Also consider using a focused mental health assessment tool, such as the Patient Health Questionnaire, or assessing subelements of other patient-reported outcome tools, such as the Atopic Dermatitis Control Tool (ADCT), which takes one to two minutes to complete and includes information about sleep and Emotional issues.
How eczema affects mental health
The sensation of itching is carried by the same nerve fibers as pain, so it can be extremely disruptive both day and night for people with skin conditions like atopic dermatitis. Because itching is usually worse at night and can interfere with sleep. Poor sleep may cause difficulty regulating emotions, which may make a person more susceptible to depression. Additionally, depression is associated with sleep difficulties, such as shortening the amount of restorative slow-wave sleep a person gets each night.
This study reinforces the vicious cycle that patients with this disease find themselves in. The more anxiety they feel, the worse off they will be, as stress is a common trigger for atopic dermatitis flare-ups.
The results of this study help advance the conversation. Now there is concrete data that can be cited to advance mental health conversations with patients.
