The National Eczema Association (NEA), the leading private nonprofit funder of eczema research, has invested over $4 million in adult and pediatric eczema studies. As part of its ongoing commitment, the NEA presents “Under the Microscope,” offering an in-depth look at research funded by its grants. This initiative provides a closer look at groundbreaking studies, including those focused on the emotional and behavioral challenges faced by children with eczema.
Exploring the Link Between Eczema and Emotional Struggles
Children with atopic dermatitis, the most common form of eczema, often experience emotional and behavioral difficulties. However, the exact nature of this connection remains unclear.
Is the eczema itself—characterized by severe itching and disrupted sleep—leading to emotional problems in children? Could stress, a known trigger for eczema flare-ups, be responsible for exacerbating the condition? Or might children who are genetically predisposed to eczema also be more vulnerable to mental health issues?
Dr. Joy Wan, Assistant Professor of Dermatology at Johns Hopkins University School of Medicine, is leading a study to explore these questions. With a 2022 Catalyst Grant from the NEA, Dr. Wan’s research aims to better understand the mechanisms that link eczema with mental health problems in children.
“We need to understand the underlying mechanisms connecting atopic dermatitis and mental health issues,” Dr. Wan explained. “This will allow us to develop targeted interventions that can address both conditions effectively.”
The Research Approach: Examining Behavioral Issues in Children with Eczema
Dr. Wan’s research focuses on answering critical questions about the mental health challenges faced by children with eczema. Despite prior research, there is still limited understanding of the specific emotional and behavioral problems associated with the condition. Moreover, the impact of eczema severity on mental health outcomes remains unclear.
For the first phase of her study, Dr. Wan utilized data from a long-term study that tracked 1,000 children in the U.S. from birth to age 15. Among the children, 116 had been diagnosed with atopic dermatitis. The research found that these children were more likely to experience internal issues, such as anxiety and depression, as well as external challenges like aggression and interpersonal conflict. Interestingly, children diagnosed with eczema before first grade were found to be at an even higher risk for these emotional and behavioral problems.
In the second phase, Dr. Wan enrolled 47 children aged 2 to 17 with varying degrees of atopic dermatitis, ranging from mild to severe. The goal was to determine whether the severity of eczema correlates with the degree of emotional and behavioral issues. Dr. Wan used established evaluation systems and also assessed factors like sleep disruption and itchiness to explore their possible connection to mental health problems.
While Dr. Wan’s analysis is still ongoing, an early finding has already stood out: emotional and behavioral problems are prevalent among all children with atopic dermatitis, including those with mild cases.
“We initially thought that the difference would be more pronounced between children with mild eczema and those with severe cases,” Dr. Wan said. “However, behavioral issues were common even among children with mild eczema.”
Ongoing Research and Future Directions
Dr. Wan’s research continues, with further data collection and analysis in progress. She is particularly focused on investigating the role of sleep disturbances in the link between eczema and mental health.
“I hope to extend this research further and identify more meaningful connections that can inform the development of targeted treatment plans for children with eczema and associated mental health concerns,” she said.
While the research is still evolving, Dr. Wan’s findings thus far highlight a key takeaway: doctors treating children with atopic dermatitis should be aware of the increased risk for emotional and behavioral problems. Screening for these issues should be a routine part of care for children with eczema.
“More research is needed to understand the mechanisms at play, but it is essential that we begin screening children with eczema for emotional and behavioral issues,” Dr. Wan concluded. “This will help ensure that all children receive comprehensive care addressing both their physical and mental health needs.”
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