If you have eczema – aka atopic dermatitis – you already know the immediate impacts of your chronic skin condition: the patchiness, itching, redness and discomfort or even pain. But eczema can also have deeper long-term effects. My dermatological patients know I like to keep it positive, and effects vary from person to person in both type and severity. Some of these effects will sound scary, but knowledge is power when it comes to your health. Knowing the potential long-term effects of eczema can help you better manage, minimize or even prevent these effects in the future with a proactive treatment plan. ATOPIC CONDITIONS While the medical community hasn’t been able to firmly establish the reason behind the connection, Eczema patients are at an increased risk of developing allergic disorders like asthma, hay fever and food allergies. While I’m going to keep my focus on the specific type of Eczema that is Atopic Dermatitis, it’s important for me to point out that folks with Eczema who don’t get treatment for their rough patches, and instead scratch to the point of gouging their skin could see that area of their skin become permanently marked even after the condition has cleared up. INCREASED INFECTION RISK Atopic dermatitis compromises the skin barrier and affects the immune system. So in the long term, eczema patients are more prone to developing bacterial skin conditions like impetigo and cellulitis. Some studies also show that systemic infections of the heart, brain, GI, and bone are higher compared to those without atopic dermatitis. This is a major reason why we doctors emphasize the need for good, consistent self-care that helps protect your skin barrier and overall health profile. The care isn’t merely for immediate symptom relief but for long-term protection. Just knowing your body may have a propensity for these infections will keep you aware and in touch with what your body is telling you, helping to keep any future infection from spiraling. MENTAL HEALTH Another reason I emphasize the importance of self care is for the patient’s overall sense of happiness and well-being. I can’t overstate the long-term impact of Eczema on a person’s mental health, particularly if they have a moderate to severe case. Patients and their families can experience considerable emotional distress. Parents and caregivers of children with atopic dermatitis report feeling embarrassed over their child’s appearance as well as frustrated, helpless, sad and guilty about their child’s disease. Caregivers may experience stress, anxiety and sleep disturbances as they help their affected child. Eczema can become a family affair, and it helps to understand and appropriately address the mental health of the entire household as you move through the rough patches. Depression and anxiety are more common in individuals with eczema, and patients of all ages may experience discrimination, social isolation or struggle with their sense of worth and self-esteem. Rather than shutting themselves away, I encourage patients to be open about their diagnosis in order to educate others and find understanding and support among their peers. This is keenly important among kids and adolescents, who studies show often feel isolated from their peers due to disease-related lifestyle restrictions. Studies show pre-teen and teenaged girls may take a stronger hit to their self-esteem, reporting more problems with clothing choices than boys. Parents have to also be aware that heightened anger and embarrassment is something they may have to help their child control. And if you’re an adult with eczema reading this, anger and embarrassment may be happening to you, too. Without sounding like a broken record, this is why I want you to practice self-care, not just for symptom relief but for your mental well-being and acceptance as you learn to manage a life-long condition. It’s also good to know that while eczema may make you feel isolated, you are not alone. SLEEP DISTURBANCES By now, you’ve surmised sleep disturbances can be a long term effect of eczema. Itching often feels worse at night for patients, and disturbed sleep can set off a cycle that aggravates eczema symptoms while also disturbing your mood/state of mind and equilibrium. Sleep disturbance occurs in approximately 60% of children with atopic dermatitis, and parents of children with AD are four to eight times more likely to average less than six hours of sleep per night compared with caregivers of healthy children. In fact, insomnia and fatigue are often rated as the #1 or #2 most burdensome symptom of eczema. I like to recommend a soothing pre-bed ritual of bathing in warm water, using a pure eczema body wash, and applying eczema relief creams that are gentle, protective and just feel good. LIVING WITH THE LONG TERM EFFECTS OF ECZEMA Anyone living with a chronic condition of any kind is at risk of facing many of these issues at some point — whether it be anger or depression or fatigue and an affected lifestyle and even productivity cut short. As a doctor, it’s deeply vital I convey to you that you not feel alone or helpless. While there are things you won’t be able to control, there are things you can. There are tools – use them. There are products such as dermatitis cream – try them. And take a sense of control back by actively participating in the creation of a treatment plan with your doctor. There’s a world of information out there, all designed to help you not just cope, but thrive.