Eczema, which is more prevalent in Black children, doesn't just irritate kids' skin. The often disfiguring condition may also be tied to depression, anxiety and sleep difficulties, new research warns.
A study of more than 11,000 British children and teens found that those with severe eczema were twice as likely to become clinically depressed as eczema-free kids.
"Eczema is an itchy red skin disease," study author Dr. Katrina Abuabara, an associate professor of dermatology at the University of California, San Francisco says.
But it's complex.
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"The disease course and severity can be quite variable," Abuabara explains. "It often presents in early childhood, but can occur at any age. It tends to be episodic, flaring up, then remitting, but these cycles can be chronic over years.
"For many children, the disease seems to improve by their teen years, but we've found that some continue to have episodic disease into adulthood," she adds.
The risk goes up among those with a family history of the disease or related conditions like asthma and allergies. And the condition "is quite common. According to the National Eczema Association, 20.2% of Black children in the United States have some form of eczema.
READ: Eczema More Common Among Black Children
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Among the children she and her colleagues started tracking in 1991, the annual prevalence of eczema -- also known as atopic dermatitis -- ranged from 14% to 19% between the ages of 3 and 18.
Roughly 22% to 40% developed a moderate or severe form of the disease; the rest of the cases were mild.
In addition to being linked to a doubling of depression risk, severe eczema also doubled the risk for the kind of depressive and/or anxiety-linked behaviors that typically
indicate underlying emotional and psychological difficulties. Severe cases also drove up the odds for sleep troubles.
The depressed children were more likely to be female, and from a higher social class, the authors found.
Mild and moderate eczema was not linked to a higher risk for childhood depression, the team stresses. But among children as young as 4, even less serious cases of eczema were associated with a 29% to 84% spike in the risk for internalizing behaviors.
That's concerning, Abuabara and her colleagues note, because children who struggle with depression and/or brewing emotional turmoil may face a higher risk for depression, anxiety and poor overall health as adults.
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"Many parents of children with eczema will tell you it can be a deceptively devastating disease," Abuabara shares.
"Eczema has long been known to cause sleep disturbances which impact the whole family," she adds, "and certainly can take a toll on emotional well-being. Increasingly, studies are revealing that some types of eczema are more than 'skin deep', and can impact overall health in a variety of ways."
In general, "skin disease is well known to affect patients' quality of life and cause depression," Dr. Robert Kirsner, chairman of the department of dermatology and cutaneous surgery at the University of Miami Miller School of Medicine says.
Children are often thought to be relatively
resilient in that respect, according to Kirsner.
But "understandably, severe eczema, even in children, can cause depression and associated internalizing symptoms such as low self-esteem, fear and worrying," he says.
It is worth noting that even "less severely affected patients apparently are emotionally affected by the disease and may internalize their feelings and manifest symptoms," Kirsner says.
This suggests "more aggressive, expert treatment for even mild eczema might improve the lives of children and have the potential for long-term mental health benefits," he adds.
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What can parents do?
Abuabara says they should strive to get the best care possible, not only for eczema itself but for the emotional hardship it may trigger.
"If you have a child with eczema that you're concerned about, it is important to talk to their doctor about optimizing their eczema treatment and to ask about behavioral screening and support through their clinic and/or school," Abuabara says.
Eczema may affect your child's mental and physical health but with the right regimen of bathing, moisturizing and medication, your child can be comfortable. There is no "right" treatment for eczema so work with your child's doctor about the best treatment/combination of treatments for your child's condition.
