The emotional impact of eczema

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The emotional impactof eczema
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Impact and burden of eczema

• Eczema can have a significant impact on quality
  of life
• Sleep disruption is a common problem and can
  impact on school and work performance
• Social relationships and daily activities can be
  difficult
• Patients may suffer from anxiety, emotional
  distress and other psychological problems
• Eczema can place both an emotional and financial
  burden on families as a result of treatment costs
  and loss of earnings1

1. NICE (2007) Clinical guideline 57, London,
December 2007
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Eczema and negative feelings

• Living with eczema can evoke many negative
  feelings
• A patient with mild to moderate eczema may be
  just as badly affected
• The link between severity and impact is not
  necessarily direct
• Common negative feelings include
• Unhappiness
• Embarrassment and frustration
• Low self-esteem, stress and emotional distress

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Dealing with emotional distress

• Emotional distress is common among eczema
  patients, particularly during flare-ups
• Looking out for clinical depression, anxiety and
  stress is important as these can exacerbate
  eczema
• Diagnosis of clinical depression should be made
  by a trained specialist. However, treatment of
  depression can significantly improve a patients
  response to their eczema treatments

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Bullying

• Bullying is a problem for many patients with
  eczema
• Bullying comes in a variety of forms, e.g.
• Physical or verbal abuse
• Exclusion
• Healthcare professionals and parents should look
  out for signs of bullying
• Children who are suffering may display physical
  symptoms and/or behave out of character
• Encourage good communication between patients
  and parents

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Discrimination

• Many adult patients with eczema believe they
  have been subjected to discrimination at work1
• Employers may be inflexible about medical
  appointments and the need to have time off
• Colleagues may stare, make rude comments or
  exclude someone with eczema
• In extreme cases, eczema may limit a patients
  career opportunities

1. ISOLATE, National Eczema Society 2004
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Relationship problems

• Eczema can have a serious impact on a patients
  ability to form friendships or sustain
  relationships
• Patients often have feelings of social isolation
• During flare-ups, patients are more likely to
  avoid being seen in public, or being seen naked
  or touched by a partner or loved one

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Supporting patients

• Talking and listening to patients can help to
  identify those with emotional difficulties or
  facing challenging situations
• Touch is an important social and psychosocial
  sign of acceptance
• Using appropriate touch and contact with patients
  with eczema can be invaluable
• Consider whether wearing examination gloves may
  exacerbate feelings of exclusion and isolation
• You should always wear gloves when applying
  treatment for your own safety and protection

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Sources of help for children

• Enlisting the help of grandparents can be
  valuable - children are often easily ableto
  talk to them
• School nurses and teaching assistants can help
  with
• Daily treatment routines
• Educating classmates
• Child psychologists can help with children
  showing disturbed behaviour
• The Child Protection Service can help if family
  stress means a child is in danger of neglect or
  abuse

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Emotional support services

• Various services are available in the NHS
• When specialist advice and guidance could make a
  difference, referral to a counsellor may be
  appropriate
• Patients who seek independent support should be
  advised to check the credentials of any
  prospective counsellor
• Psychological support may be needed for those
  suffering from severe emotional distress

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Date of preparation March 2008 Code DIP/08-435