Inflammatory skin disease, known as Eczema, results in regions of dry, scaly, and itchy skin that is susceptible to cracking. Atopic dermatitis is the most frequent kind of dermatitis.
Atopic dermatitis is becoming more common across the world, with 15-30% of children and 2-10% of adults suffering from the condition.
There have been several studies that have discovered that eczema raises the risk of anxiety and depression, although estimates of the magnitude of the risk tend to vary greatly.
Analyzing the data
In an analysis of the best available data, researchers have discovered that having eczema increases the likelihood of acquiring either depression or anxiety by 63 percent, respectively.
According to the researchers, when they looked at these two mental health problems independently, eczema was connected with a 64 percent greater risk of depression and a 68 percent increased risk of anxiety.
The researchers compiled data from 20 studies that included a total of 141,910 people who had eczema and 4,736,222 persons who did not have the ailment in order to arrive at their estimations.
The findings were reported in PLOS ONE by the researchers from the Sixth Affiliated Hospital of Kunming Medical University in Yuxi, Yunnan, China.
Factors that might play a role
According to the authors, itching, sleep interruptions, and social isolation may all raise an individual’s chance of developing depression or anxiety.
As many patients experience their dermatitis on areas of their bodies that are visible to the public, such as the face, neck, and hands, social isolation and stigmatization can certainly occur. It may be challenging to negotiate intimate relationships as well.
Stress, according to Vivian Shi, MD, a dermatologist at the University of Arkansas for Medical Sciences in Little Rock, AR, who serves on the National Eczema Association’s expert panel, can cause flare-ups or worsen existing symptoms. “It is extremely important to address the mental health component of eczema because the stress can cause flare-ups or worsen existing symptoms,” she said.
“Treating the mental health component of eczema alongside the physical symptoms is crucial to maximize treatment benefits,” she continued.
The physiological side of it
The authors of the current study point out that the physiological processes that link eczema and mental health are still not fully understood.
However, they point to several intriguing research that imply that there may be common physiological reasons, such as oxidative stress and inflammation, among the two conditions.
It is also mentioned that a study conducted on a mouse model of eczema discovered that the animals exhibited anxiety and depression-like behaviour. The scientists who conducted this study discovered that the participants’ actions were related with alterations in the areas of their brains that are involved in reward processing.
According to the findings of another study, the antidepressant fluoxetine (Prozac) significantly decreased the symptoms of atopic dermatitis in mice while also alleviating their anxiety-like symptoms at the same time.
When it comes to psychological stress and inflammatory reactions, fluoxetine seemed to be particularly effective.
Clinical studies in humans have showed that a medicine known as dupilumab, which suppresses immunological signaling molecules, not only relieves eczema but also decreases anxiety and sadness in the patients who take it.
Stress and flare-ups are a never-ending cycle
In patients with eczema, there may be a cycle of psychological stress, increased inflammation, and skin flare-ups that they must break.
It has been reported that hormonal abnormalities linked with atopic dermatitis might influence the neurological and immunological systems, as well as the skin cells itself. According to the National Eczema Association, This causes inflammation to rise and the skin’s barrier function to be compromised.
Psychological stress, on the other hand, has been shown to impair skin restoration.
Those suffering with atopic dermatitis, particularly children and teens, believe they might be stigmatized by their classmates, according to the group.
Inflammatory chemicals such as histamines are produced in response to stress and worry, which can result in itchiness. Scratching can cause skin damage and irritation, which can worsen the situation.
The National Eczema Society in the United Kingdom conducted a poll in which 74% of respondents stated that eczema had harmed their mental health, with 66 percent stating that it had caused them to feel lonely and socially isolated.
The majority of these individuals stated that they had received professional psychiatric assistance to assist them in dealing with their problems.
Ask for help if needed
Children who suffer from eczema are more subject to social stigmatization, social isolation, and low self-esteem issues, among other things.
“It’s important that you talk to people about your skin if you are actually not feeling too great, if you are not in the best mood,” Daniel, a teenager who suffers from eczema, explained.
During a National Health Service (NHS) film on eczema and mental health in the United Kingdom, he stated, “It’s definitely important that you talk to people because they need to know that you’re not feeling great. If you surround yourself with positive people then you’re never going to hear a bad comment, you’re always going to have people looking out for you.
In addition to soliciting assistance from others, the National Eczema Association suggests maintaining a diary and engaging in stress-relieving activities such as walking, mindfulness, and yoga.