A rash can start as an itch that never quite goes away, or a redness can suddenly appear on your leg. It can become better with treatment or get much worse with a trigger, but it is still quite present in your life. When most individuals see a child suffering from the extensive discomfort of eczema, they can sympathize living with an itchy, bothersome rash. These onlookers, however, often fail to grasp the emotional toll of the disease on the family, particularly the parents.
What Is Eczema?
Eczema is the more common term for the skin condition, atopic dermatitis. Atopic dermatitis is a chronic, recurrent skin disease that usually affects children and presents as itchy, red rashes that appear commonly on the inside of elbows, knees, wrists, ankles, neck and other areas of the body. The irritated rashes are usually managed with the consistent use of moisturizers as well as topical steroids, antihistamines, and sometimes even light therapy and strong systemic medications that suppress the immune system.[2-5]
How Common Is Eczema?
Atopic dermatitis is very common in developed countries, affecting up to 25% of children and 2-3% of adults. In about 60% of cases, the disease appears around age three to six months. Children have a higher likelihood of developing the disease if one or both of their parents also suffered from the disease.
Psychological Effects of Eczema
For patients suffering from eczema, the disease not only causes physical and emotional distress but also can interrupt sleep, as up to 60% of children with eczema have sleep disturbance. This lack of sleep can lead to potential behavioral deficits during the daytime; children and teenagers suffering from eczema are at an increased risk of developing attention-deficit hyperactivity disorder.[6,8] However, a child’s eczema can disrupt the sleep of parents and other care givers as well, as they are often the ones applying the appropriate cream or ointment to help soothe the child.
As parents are frequently required to assist in the treatment of their child's eczema, their confidence as well as their ability to adhere to treatment plans including special clothing, bedding, and ointment application can significantly affect a child's improvement outcome. In an Australian study, caregivers spent approximately 1.5 to 3 hours a day treating a child suffering from atopic dermatitis. The extra time needed to care for a child suffering from atopic dermatitis can cause parents to miss work or even avoid working altogether; a caregiver’s social life can also be strained by the time required for treatment. Mothers of children suffering from eczema expressed more feelings of stress in parenting. Many of these parents often avoided conflict with their children to avoid distressing the child and further exacerbating emotional symptoms, such as scratching and worsening the eczema. In a study examining the family impact of skin diseases in general, there was no significant difference between male and female caregivers. The stress on parents, as well as lost work opportunities, are even clearer in lower-income families that may lack social support to help care for children suffering from eczema.
The cost of treatment can be a large financial burden, with treatments costing from 100 dollars to more than 2,000 dollars per patient per year.[13,14] In a study of caregivers, when a dermatologist or another specialist saw the child, the burden of the disease on the family decreased when compared to the burden on families prior to receiving specialist care. Discussing the family burden of the disease with care providers can help alleviate the stress, as your care provider can discuss treatment options and plans that work well not only for the child but also for the entire family unit.
* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.
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Lewis-Jones S, Mugglestone MA. Management of atopic eczema in children aged up to 12 years: summary of NICE guidance. Bmj.2007;335(7632):1263-1264; PMID: 18079551 Link to research.
Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol.2014;71(1):116-132; PMID: 24813302 Link to research
Sidbury R, Davis DM, Cohen DE, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol.2014;71(2):327-349; PMID: 24813298 Link to research.
Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol.2014;70(2):338-351; PMID: 24290431 Link to research.
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Carroll CL, Balkrishnan R, Feldman SR, et al. The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol.2005;22(3):192-199; PMID: 15916563 Link to research.
Balkrishnan R, Manuel J, Clarke J, et al. Effects of an episode of specialist care on the impact of childhood atopic dermatitis on the child's family. J Pediatr Health Care.2003;17(4):184-189; PMID: 12847428 Link to research.