What Parents Need to Know About Eczema and Kids’ Mental Health

Eczema and children’s mental health

There are strong links between eczema and mental health challenges in children of all ages. According to a systematic review and meta-analysis from 2019, children and adolescents with eczema faced a significantly higher likelihood of experiencing any mental health condition compared with their peers without the condition.

The American Academy of Dermatology (AAD) says that eczema can often affect the moods of babies and young children. They may be:

• restless
• irritable
• fussy
• clingy

Some kids with eczema may also associate scratching with getting attention from a parent or caregiver, per the AAD. That, in turn, can make scratching a habit and lead to a cycle that continues to impact both their emotional well-being and their skin.

Older kids with eczema, including adolescents and teens, also have a higher risk of mental health conditions. A 2021 study, which analyzed survey data from a nationally representative sample of U.S. children up to age 17, found that twice as many kids with eczema had a mental health disorder that impacted their lives, compared to those without the condition.

Compared with other kids, the participants with eczema were also more likely to express that they:

• worried often
• felt unhappy or depressed
• had trouble paying attention
• experienced difficulties managing emotions, behavior, or getting along with others

There isn’t a simple explanation for the link between eczema and mental health. Instead, it may be the result of a variety of factors, each of which can impact children in different ways.

Some kids may feel frustrated from dealing with perpetually itchy skin and missing out on other activities while at doctor’s appointments or treating flares.

The physical appearance of eczema patches may also make them feel like they don’t “fit in” with other kids. They may deal with low self-confidence and isolation. Some kids with eczema may also be bullied, which could contribute to mental health problems.

In some cases, medication may impact kids’ mental health as well. For example, if your child is taking montelukast (Singulair) for asthma (which is more common in people with eczema), they may experience mental health side effects, like anxiety and depression.

Can anxiety cause eczema?

Anxiety, along with stress, can trigger eczema flares. They put the body into fight-or-flight mode, leading to a surge of cortisol (a stress response hormone). That, in turn, can cause an inflammatory response in the skin, according to the National Eczema Association.

While there’s a link between anxiety and skin flares, it’s unclear whether anxiety can be a root cause of eczema. Researchers think that eczema may be caused by a combination of genetics and environmental triggers, but more studies are needed.

Eczema and depression

Children with eczema may potentially face a greater risk of depression than those without the condition, but research is ongoing. This is more likely to be true among those with severe eczema.

A 2021 study on more than 11,000 children in the U.K. found that those with severe eczema had twice the likelihood of experiencing symptoms of depression. However, it did not find the risk of depression to be higher among those with moderate or mild eczema.

That research built upon a 2017 study from Korea, which included data on more than 72,000 middle and high school students. It found that students with eczema were significantly more likely to report feelings of depression, as well as suicidal ideation, planning, and attempts.

There’s no single reason why a child with eczema may be more likely to experience depression. It may have to do with the way the body communicates with the brain during an inflammatory response, according to the National Eczema Association. There is still much to learn about the connection between eczema and mental health.

Eczema and your child’s behavior

Eczema symptoms can impact your child’s behavior and performance at school in a variety of ways.

A 2021 study on more than 2,700 people found that children ages 3 to 10 who had eczema were more likely to have conduct problems, inattention or hyperactivity, and emotional challenges.

Sleeping issues from eczema may contribute to behavioral problems, as well. Around 30 percent of children with eczema have sleep disruptions 5 or more nights each week, per the National Eczema Association. That can lead to irritability, daytime drowsiness, and trouble paying attention.

Research from 2016, which evaluated survey data from more than 354,000 U.S. children, found that those with eczema were more likely to have attention deficit disorder (ADD) or ADHD. Kids with severe eczema also faced much higher odds of ADD and ADHD when they didn’t get adequate sleep at least 4 nights a week.

Those conditions, as well as coping with red and itchy skin, can affect how well a child can regulate their emotions and behavior.

How does eczema affect emotions?

Eczema can have an emotional impact on children. In a 2020 study, researchers analyzed interview transcripts from 28 adolescents and young adults. They found that participants:

• worried that itching would wake them up in the night
• felt their symptoms were not taken seriously by others
• were frustrated by unsolicited advice
• tried to cover up their skin in order to “fit in”
• avoided certain social situations (like sleepovers) out of fear of judgment
• dealt with self-esteem issues

While the size of that study was too small to generalize the results to a larger population, the emotional response to eczema or any other chronic disease is unique to each individual. Eczema may have a much bigger effect on some children’s emotions than others.

What to do for your child

With the right support, children with eczema can learn to manage the disease, as well as its impact on their emotional and mental health.

Keeping up with eczema treatments, such as medications, topical treatments, and moisturizing, can help reduce symptoms that might otherwise affect a child’s behavior and feelings. Younger children may need a parent or caretaker to directly manage their treatment. As kids get older, regular reminders might be enough to keep them on track.

Parents and caregivers can also step up in a few other ways, including:

Making kids feel understood

Eczema is sometimes dismissed as a disease that’s easy to manage and doesn’t have a huge impact on a person’s life.

However, for people with the condition, it can feel like the opposite. Asking your child about their well-being and acknowledging that managing eczema can be challenging and frustrating may help them feel like someone else gets what they’re going through.

Focus on normalizing but not pointing out or avoiding conversations about flares when your child is dealing with them. Make sure they know that it isn’t something to be ashamed of and talk with them about being open with their friends about their condition.

Supporting kids at school

At the beginning of the school year, talk with your child’s teacher about their eczema. That way, they can provide additional support in the classroom.

You may want to ask the teacher to avoid telling children with eczema not to scratch. Instead, they can encourage students to find other ways to relieve the itching, including:

• gently rubbing or pinching the skin
• applying moisturizer
• pressing a cool cloth on the skin
• drinking a glass of cold water

You and your child’s teacher should also look for signs of bullying related to the condition. Putting a stop to early teasing and bullying before it turns into a larger problem can help prevent serious mental health issues later on.

Teaching them coping strategies

Stress — whether from eczema or any other source — can never be permanently prevented, but it can be managed. Teach children coping strategies for stress, such as:

• exercising
• spending time outdoors
• mediating and breathing exercises
• journaling or drawing
• talking about it
• progressive muscle relaxation
• practicing mindfulness

Getting them mental health support

If your child is showing signs of depression, anxiety, or another mental health condition, connect them with professional support. Pediatric psychologists and therapists are trained to identify mental health disorders in children and help them develop personalized tools for managing symptoms.

In some cases, medication may also be used to treat certain mental health disorders in kids.

Takeaway

Eczema can take a toll on children and adolescents emotionally and socially. Research shows that children with eczema may be at a higher risk of depression, anxiety, and other mental health problems. Some kids may also be bullied for their condition, leading to social withdrawal and self-esteem issues.

If you take care of a child with eczema, ask them about what they’re going through and avoid minimizing their experience. It’s important that kids feel understood by those around them.

You may also need to help your child develop stress management techniques. That might mean meditating, breathing exercises, playing outside, or something else entirely. Try a few different strategies to see which works best for your child.

Finally, keep an eye out for signs of mental health conditions in your child. You may need to connect them with a mental health professional for additional support.

Remember: Eczema might only look like a skin condition, but it can have a big impact on a child’s emotional well-being. Try to find strategies to address all the ways in which eczema can affect their lives.