Having Atopic Dermatitis (Eczema) during adolescence can be a daunting experience. This uncomfortable chronic skin disease can put a dampen on a teenager, especially at a time when many of them would rather focus on social interactions, sports, and extracurricular activities rather than put their attention to the constant management needed to control the triggers. The potentially disfiguring illness also incites bullying among a patient’s peers—a reason its effects are sometimes far worse in these teens mentally and emotionally.
It is, therefore, vital for parents and individuals involved to fully understand the knowledge and concerns associated with this disease in order to determine the best ways to help the young patients manage and deal with it as they go about their transitional phase of growth and development.
Atopic dermatitis, a form of eczema, is a chronic inflammatory disease with symptoms often appearing as a rash on the skin. It is caused, in part, by an underlying inflammation in the body that is believed to be driven by an overactive immune system. Moderate-to-severe atopic dermatitis is characterised by intense, persistent itching, skin lesions and skin dryness, cracking, redness, crusting and oozing. Experts point out that eczema isn’t the visual rash that appears – but rather the sensation of itch that the body experiences on and off.
In the UAE, data released by Dubai Health Authority (DHA) in 2016 showed that out of 20,788 patients who have skin-related diseases, 2,953 or 14.2 per cent of the total cases in the country were confirmed as cases of eczema. Initial symptoms appear around the age of five, with as much as 1 out of 4 children expected to experience atopic dermatitis.
Effects on teens
Unchecked atopic dermatitis can have a physical, emotional and psychosocial impact on children and adolescents, causing sleep disturbance, symptoms of anxiety and depression, as well as feelings of isolation.
In the Journal of Allergy & Clinical Immunology, experts believe eczema can greatly influence how an affected child perceives himself, impacting their psychological development and overall quality of life.
Among the psychological effects mentioned in the study are:
- Impaired emotional development
- Increased behavioural problems
- Sleep difficulties, which could interfere with the intellectual and social development of children
- Frustration on the part of the parents, resulting in lower social functioning, financial strain and reduced overall wellbeing.
- Embarrassment and anger about their appearance.
The study also added that with increased disease severity comes the greater impairment of quality of life in both social functioning and mental health—evident in both kids suffering from it as well as the parents. The energy to have the extra efforts required to care for the skin is in short supply especially with children wanting to focus more on their social and academic life.
Managing eczema for teens
Teenagers with atopic dermatitis often have a hard time managing the symptoms and flare-ups due to the less supervision from their parents. As a child, the parents were very much hands-on when it came to looking after their skin, but the responsibility now comes on them as they grow on to become adolescents. This is why for parents; it is important to cultivate in these kids a dedicated attitude towards their skin and overall condition. The goal is to allow them to uphold their lives with minimal disruption—including adequate sleep, focus on academics, and normal social interactions. With the correct approach, teens can control their eczema and have an uninterrupted life.
Focus on education
Parents and experts must properly educate their kids suffering from eczema in order to efficiently help them manage the disease and ingrain in them their needed treatment regime. Once the patients are successfully educated, the frequency of symptoms can be reduced, thereby decreasing the emotional and psychological stress to the patient and the family and improving their overall quality of life.
The study published in the Journal of Allergy & Clinical Immunology about the effects of childhood eczema on the quality of life said this can be done through problem-solving, role-play, computer-assisted instruction, short video clips, a checklist for therapy, or booklets.
In many cases, eczema often interferes more with mental health than with physical pain. This is why it is important to include psychological interventions so as to manage the disease well among teenagers.
Among these could include relaxation techniques, which teach patients to tense different muscles and then release that tension. There is also the use of imagery associated with calmness, which could stimulate the feeling in their own body; hypnotherapy, which creates a suggestible state for an individual; and caregiver training programmes, where caregivers will record and reward progress.
Another tremendously helpful intervention are therapies that focus on internal processes. These include cognitive behavioural therapy, counselling and family therapy.
Atopic dermatitis can be persistent and may return over the years, but they can be manageable with the right treatment for your skin.
The following are among some of the recommended treatment methods for eczema. It is important to consult with a doctor first before a patient pursues these approaches:
Creams and ointment – These products may be prescribed by the doctor to control itching and help repair the skin.
Drugs – Oral antibiotics and antibiotic creams are sometimes prescribed for a short time to treat the infection.
Oral drugs – Doctors sometimes recommend taking oral drugs for severe cases in order to control inflammation. However, these cannot be used long term due to potentially serious side effects.
New options for severe cases
Recently, Dr. Khadija Aljefri, a board member at the Emirates Dermatology Society and a lecturer at Dubai Medical College and consulting dermatologist at DermaMed Clinic Dubai and Dr. Anwar Al Hammadi, President of Emirates Dermatology Society, Adjunct Clinical Associate and Professor of Dermatology at MBRU in Dubai and a consulting dermatologist at DermaMed Clinic Dubai tackled an innovative therapy that is seen to significantly help address high unmet medical needs of adults and kids with AD—the Dupilumab – during the #LivingwithEzcemaNetwork Facebook online session that tackled insights and information surrounding the condition.
According to Al Hammadi, the therapy—developed by Sanofi and Regeneron under a global collaboration agreement—is a ﬁrst-in-class biologic medicine approved by the European Commission to treat adults with moderate-to-severe atopic dermatitis who are candidates for systemic therapy.
“For severe cases and persistent cases that didn’t respond to conventional therapy, we have what we call the injection of eczema. This is a newly introduced therapy, but it’s been in the market for four years,” he said.
After receiving a fast-track approval by the Ministry of Health and Prevention in 2018, the UAE has been one of the first five countries in the world to make Dupilumab available to patients. The others include North America, Japan, the Netherlands, and Germany.
The treatment includes injecting patients with the drug every two weeks, as per the recommendation of their doctor. It currently serves as a go-to medicine for patients whose bodies are unable to respond to therapy methods along with regular medications.
References available on request