Recent research and conversations shared at the National Eczema Association expo tackled the link between patient well-being and eczema.
The National Eczema Association (NEA) recently shared new findings from its real-world research focused on the intersection of eczema and mental health.1 These findings were recently published in the June 2024 edition of Skin Health and Disease2 and build on initial research published in Dermatitis in March 2024.3
Despite extensive research supporting the relationship between eczema and worsened mental health, there has been a gap in understanding the type of mental health support patients receive from their primary eczema care providers. The study surveyed adult eczema patients and the primary caregivers of children and teens with eczema, focusing on the relationship between eczema symptoms and mental health.
The findings reveal a concerning trend: 42% of respondents had never discussed mental health with their primary eczema care providers, and 50% reported never being asked about their mental health during medical visits. Furthermore, 64% of adult patients and caregivers indicated they had not been referred to mental health resources.
Those more likely to receive mental health referrals were children, men, individuals with limited education, and those seeing non-specialists. Common referrals included counseling services, alternative therapies like art or music therapy, cognitive behavioral therapy, and peer support groups. However, only 57% of those referred utilized the recommended services. Women, low-income individuals, and those seeing specialists such as dermatologists or allergists were among those less likely to discuss mental health issues with their care providers.
Discussing these findings and more, the NEA recently hosted its annual Eczema Expo in Denver, Colorado, from June 27-30. As part of the Expo, the NEA's Media Breakfast with the Ecz-perts featured insights from moderator Peter Lio, MD, and panelists Jennifer, a licensed clinical social worker at National Jewish Hospital; Jeremy, a patient with eczema; Amy, a caregiver for a child with eczema; and Wendy Smith-Begolka, MBS, Chief Strategy Officer, Research, Medical & Community Affairs, NEA.
Below, we review key questions posed during the panel session, as well as summarize the panel's answers and consensus.
A: Absolutely.
The connection between mental health and skin conditions is significant. Stress, anxiety, and poor sleep can directly affect the skin by driving inflammation, worsening itch, and damaging the skin barrier. For instance, a study involving college students who were deprived of sleep for one night showed that their skin barrier was significantly worse the next day compared to those who slept well. This cycle of poor mental health leading to worse skin conditions, and vice versa, is challenging to break. Improving mental health can lead to better skin outcomes.
A: Yes, definitely.
Improving sleep and reducing anxiety are crucial. When individuals sleep better, their skin condition often improves. Anxiety exacerbates the itch-scratch cycle, making it harder to manage. Behavioral strategies to reduce anxiety and stress can diminish skin problems. Moreover, when mental health is not well-controlled, individuals are less likely to follow their skincare routines, leading to worse skin outcomes.
A: It's a delicate balance.
There's a fear that patients might feel their concerns are being dismissed if mental health is brought up first. However, it's essential to communicate that mental health is a significant part of their treatment. Normalizing conversations about mental health and integrating them into the overall care plan can help patients understand its importance without feeling judged.
A: Residual mental health issues are common.
Even when the skin condition improves, the emotional trauma from the journey to better skin can linger. Sleep deprivation, social isolation, and other hardships don't disappear overnight. Patients often need time to emotionally unpack and heal from their experiences, regardless of their current skin condition.
A: Multidisciplinary care is key.
Incorporating mental health professionals into dermatology practices can significantly benefit patients. Even brief consultations can make a difference. Providing resources and referrals, asking key questions about challenges in managing the condition, and having prepared materials can help. Additionally, encouraging patients to come prepared with information about their symptoms and mental health can streamline appointments and make them more effective.
A: Creating comprehensive resources is essential.
There is a need for more organized resources that compile information on finding mental health support tailored to dermatological conditions. Existing resources for related conditions, such as food allergies, can sometimes be useful. Collaborating with organizations to create and disseminate such resources would be beneficial.
A: Simplifying care logistics can help.
Integrating multiple services into single appointments can significantly reduce the burden on families managing chronic skin conditions. This approach not only addresses the skin condition but also the associated mental health issues, reducing the overall strain on caregivers and patients alike.
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