The itching … It can drive you to distraction and keep you (and your loved ones) up all night and unable to focus in school or on the job.
The rash…It can leave you feeling self-conscious and scared to put yourself out there and force you to cover up even in summer.
This is just a snapshot of what it’s like to live with eczema gleaned from Eczema Experience: Stories Itching to Be Told. Held during National Eczema Awareness Month in New York City and presented by AbbVie, the pop-up event immersed visitors in the emotional, physical, and social realities of living with eczema through a multisensory experience narrated by actress and eczema advocate Tia Mowry and Evan Rieder, MD, a dermatologist and psychiatrist at 36 North Moore Dermatology in New York City.
Dr. Rieder talked to The Dermatology Digest about the new immersive exhibit and how eczema can affect quality of life.
TDD: How does eczema impact a patient’s mental health?
Dr. Rieder: “Eczema really affects mental health in terms of social stigma and self-perception. Eczema is associated with decreased quality of life, decreased sleep (for the whole household), depression, and anxiety. In addition, eczema and body dysmorphic disorder (BDD) can be connected. Eczema is much more than a skin disease. It takes over every aspect of your life, from grooming and work to romance and sleep.”
TDD: Is the eczema the chicken, the egg, or both when it comes to mental health conditions?
Dr. Rieder: “There are many different theories. Sleep loss can be a cause of mental health effects. Stress hormones, like cortisol and epinephrine, can cause or worsen eczema. Inflammatory mediators in eczema may contribute to depression. We have more inflammatory theories worked out for psoriasis than eczema, but we know that there is an association. We just don’t have all the inflammatory pathways mapped out in eczema yet. There are more simplistic ways the two are linked as well. If a person feels judged for their skin condition, they may limit their social interactions and become or remain isolated.”
TDD: What do you hope people take away from this immersive experience?
Dr. Rieder: “My hope is that visitors understand what it is like to live in the body of a person with eczema on a daily basis.”
TDD: How can dermatologists better capture anxiety, depression, or BDD in their eczema patients?
Dr. Rieder: “It would be really great if everyone screened for depression in the eczema clinic. We have all gone through a psychiatry rotation in medical school, but [such screening] isn’t always feasible. Poor eye contact, impoverished speech, and impoverished movements, can be non-verbal clues of an underlying depression or anxiety. These conditions can even occur when the patient’s skin is clear. I ask, ‘How has your mood been over the last two weeks?’ to get a better idea of how they are doing mentally.”
PHOTO CREDIT: Christopher Lynch on behalf of AbbVie.
