What Is Atopic Eczema?

Atopic eczema, which is also called atopic dermatitis, is a chronic skin condition that causes dry, itchy, and cracked skin. It often presents as red, brown, brownish-gray, or purple patches of skin, raised bumps, or scaly patches. It can become swollen or infected if patients scratch it. This type of eczema can be localized or widespread, its manifestation can vary in severity over time, and patients often report considerable associated pain. The symptoms most commonly start in early childhood, but there is also adult-onset eczema.

An association between atopic eczema and allergies has been identified, with some eczema patients showing allergies to certain detergents, foods, or airborne particles like pollen. However, these allergies trigger more severe symptoms rather than being the underlying cause of eczema. Stress and other environmental factors are also known to trigger an increase in symptoms. The actual cause is probably genetic.

Can Atopic Eczema Be Cured?

There is no cure for atopic eczema, but it can be managed. Topical steroids (an artificial version of an adrenal gland hormone) are often prescribed when the symptoms are severe. However, most of the management falls on the patient, with recommendations including:

• Regular moisturizing of the skin.
• Identifying and avoiding the triggers of more severe symptoms, which may include soy, wheat, milk, or eggs; soaps, detergents, and other surfactants; or dust and pollen.
• Reducing the frequency of showers and baths and using only gentle soaps, to prevent drying the skin.
• Avoiding scratching or rubbing the skin, which includes being gentler when toweling off after a shower or bath.
• Reducing activities that cause you to sweat or ensuring that sweat does not stay on the body for long.
• Losing weight if recommended by a dermatologist, as people with eczema and obesity often show more severe symptoms.

What Is the Relationship between Atopic Eczema and Mental Health Conditions?

A significant percentage of patients with atopic eczema present with depression and anxiety. In the study reported in the paper “Depression, Anxiety, and Suicidal Ideation in Patients with Atopic Eczema in a Prospective Study in Leipzig, Germany”, the researchers worked with atopic eczema patients and control subjects to investigate any correlation between the severity of eczema and psychosocial conditions.

Participants in the study had their atopic eczema scored for severity by a trained dermatologist, who used objective indexes. They were also assessed for sleeping problems. They filled out a set of five standardized questionnaires to assess depression, anxiety, social network size, and quality of life. They also did a questionnaire about suicidal ideations, which was designed by the researchers.

The results showed that patients with atopic eczema:

• Show more signs of anxiety and depression than control subjects.
• Show more severe anxiety and depression if their eczema is more severe.
• Are more likely to have suicidal ideation if their eczema is severe.
• Are not at a higher risk for social isolation.

They also showed that sleep disturbance, which can be associated with atopic eczema, is linked to an increased risk of suicidal ideation.

The findings still require further validation with a larger group of subjects, but considered alongside the results of other studies on eczema and mental health, they show a clear signal about psychological conditions and skin health.

What Do the Results of the Study Mean for Patients?

If you or someone in your life has atopic eczema, it’s important to be aware of the link with anxiety, depression, and suicidal ideation. It’s also important to talk openly with your dermatologist and primary care physician about these findings, and about your own mental well-being. Mental health should never be ignored within the larger treatment plan.

Note: The authors of this paper make a declaration about grants received from pharmaceutical companies and memberships on the boards of such companies. It is normal for authors to declare this in case it might be perceived as a conflict of interest. For more detail, see the Conflict of Interest Statement at the end of the paper.