We all know that living with eczema is stressful and can impact our sleep, work, and relationships. There is also a long-held acceptance that stress can trigger eczema flares, and eczema flares can increase stress. This can be a vicious cycle! There is evidence now that supports this concept and highlights the neurological component of stress and eczema flares. The dermatology and psychiatry community are working to better understand the impact of stress on atopic dermatitis, the most common form of eczema.
ESC asked Edmonton-based dermatologist Dr. Marlene Dytoc to tell us more about the emerging field of psychodermatology. “Psychodermatology is an evolving area of medicine to help better address the needs of patients and reduce the psychological burden of living with such a challenging chronic condition.”
Stress hormones can activate immune function and drive inflammation. There is data to support the concept that stress drives atopic dermatitis flares on a physiological level. Adults with atopic dermatitis have a three-fold increased risk of experiencing anxiety and depression, and children with atopic dermatitis have a six-fold increased risk of experiencing anxiety and depression. Dr. Dytoc tells us, Psychodermatology “There are psychological therapies and mind-body techniques that can be very helpful. Dermatologists and specialists can refer patients for these types of support.”
Stress is only one piece of the puzzle. “In patients with atopic dermatitis, not only is their immune system playing a role, but their nervous system is also hyperactive, and therefore there is a neurological component of atopic dermatitis. There are now treatments that can target these pathways which can help to break the itch-scratch cycle.”
So, what can we as patients and caregivers do? Dr. Dytoc offers this guidance, “Atopic dermatitis should be optimally treated – and for some patients that may mean more aggressive medications such as systemic medications. Studies have shown that systemic treatment not only improves the signs and symptoms of atopic dermatitis but can also improve mental health and decrease the mental health burden of the condition. Patients can also ask for a referral to a mental health professional, and health care providers can screen for this as well.”
Eczema Society of Canada thanks dermatologist Marlene Dytoc, MD, PhD, FRCPC, for her voluntary contribution to this educational content.
Disclaimer: Information provided in this resource does not constitute medical advice and is not intended to be used as a diagnostic tool. The information is up-to-date at time of publication. All medications, interventions, and treatment plans have risks and benefits, and it is important that individuals discuss their or their child’s specific healthcare needs with a qualified healthcare professional.
June 2023
