Ahead of Eczema Awareness Week, newly released research by Typharm has revealed how this chronic inflammatory skin condition negatively impacts mental and physical health. In this feature, skin expert and GP Dr Nisa Aslam from Skin Life Sciences Foundation provides extra insight into the struggles facing millions with the condition.

Eczema is on the increase,[1] and that’s a worry because it is far more than simply a skin condition. Eczema increases the risk of depression, anxiety and thoughts of suicide.[2] It disrupts sleep, which is associated with higher rates of obesity, heart disease and diabetes.[3] And it has a toxic impact on quality of life.[4]

The UK has some of the highest rates of eczema in the world, and according to the Global Burden of Disease Study, only Sweden has higher rates of disability and negative health outcomes as a result of this chronic inflammatory skin condition.[5]

Now, new research[6] has been commissioned for Typharm, which produces a range of prescription-only skin therapies, detailing the year-round struggle millions of eczema sufferers are enduring.

Almost two-thirds (63%) confirm that their eczema directly impacts their mood and behaviour, with one in five (21%) saying this is often the case.

Low mood and fatigue
More than half (54%) experience low mood, and other mental and physical health impacts include:

  • Increased fatigue: 40%
  • Impatience: 39%
  • Mood swings: 37%
  • Increased anger: 23%

This aligns with multiple studies, including research by the National Eczema Association, which found that 30% of people with eczema have also been diagnosed with anxiety or depression.[7] The All-Party Parliamentary Group on Skin also heard evidence that 85% of dermatology patients believe the psychological impact of their skin condition is a major component of their illness.[8]

Dr Nisa Aslam, a GP with a special interest in skin and an adviser to the Skin Life Sciences Foundation, says, “It’s worrying that the new Typharm data reveals such high levels of fatigue as this is a common symptom of depression.

The intense itching associated with eczema can also make sleep difficult — and this alone is a serious concern as we know that prolonged sleep disruption increases the risk of heart disease, diabetes, obesity and many other serious health conditions.”[9]

It also maps the corrosive effect eczema has on self-esteem, with four in five (79%) sufferers reporting that their eczema undermines their confidence, with more than a quarter (28%) saying this is often the case:

  • 68% feel embarrassed
  • 42% keep their distance from people in the hope that others will not notice their skin
  • 28% avoid social situations
  • 23% feel isolated
  • 22% have become more quiet
  • 20% have become more withdrawn

Dr Nisa Aslam continues, “Far too many people underestimate the psychological impact of skin conditions. If eczema is poorly controlled, this can spill over into sleeplessness, anxiety, depression, reduced confidence and self-esteem, and other mental health problems.”

Eczema is a chronic inflammatory condition which affects one in five children and one in 10 adults. Skin becomes cracked, red and sore, and so intensely itchy that people sometimes scratch until they bleed. Allergies, household chemicals and other irritants, clothing and even the weather can trigger flare-ups.[10]

The National Institute for Care and Health Excellence (NICE) recommends a stepped approach, where treatment can be stepped up or down according to the severity of symptoms.[11]

Dr Nisa Aslam says, “It’s very important to speak to your GP if your eczema is not under control, apart from emollients, there are prescription-only steroid creams and ointments, and also Fludroxycortide tape — which many patients find very useful on areas such as the hands and elbows which are highly mobile. There are also oral medicines for extremely severe eczema.”

Hands up
The Typharm research shows that hands are the most common site for eczema to strike, with 28% of those surveyed saying they are affected. Other high-risk skin sites are:

  • Arms: 24%
  • Face: 22%
  • Elbows: 20%
  • Scalp: 17%
  • Fingers: 13%
  • Stomach: 9%

Dr Nisa Aslam adds, “The fact that hands are the most commonly affected areas affected by eczema presents a major challenge because our hands are not only highly visible, they are also in constant use and are frequently exposed to irritants and allergens.

“As many eczema sufferers know all too well, creams and emollients often provide poor symptom control when the hands are involved because these treatments are easily rubbed or washed off. They also do little to prevent further damage, or reduce the risk of infections, when the skin barrier has been compromised.”

A far more effective solution is a steroid, waterproof tape, which is a prescription-only transparent adhesive tape impregnated with the steroid fludroxycortide. It is ideal for areas such as the hands, which are always moving and always in use.

Understanding the issues
The new Typharm research details the deep distress associated with eczema. Most (57%) think people don’t recognise it as a medical condition, yet one in four (25%) has suffered such a severe flare-up they have had to take time off work.

Given the lack of understanding that exists around skin conditions, it’s perhaps not surprising that only a quarter (25%) are up-front about the reason for their absence. In addition to time off, 21% of people with eczema confirm it has reduced their productivity or the quality of their work.

Two-thirds (67%) of people with eczema think it’s impossible for those who have no first-hand experience of the condition to appreciate the impact it has — and this even extends to family and friends. Only three in 10 people (28%) with eczema feel their friends are always supportive, and only 38% say their family is fully supportive of their condition.

Conversations with health professionals can be difficult, too. More than a quarter (28%) will only discuss their condition with their GP or a pharmacist if they are asked about it, and almost a third (30%) of people with eczema are not receiving advice on how to manage their symptoms from any health professional.

Dr Nisa Aslam notes further, “This is a major missed opportunity as there are lifestyle changes which can help to reduce flare-ups and manage symptoms and, as NICE recommends, therapies can be stepped up when symptoms worsen.

“If your skin condition is not under control, it’s important to speak to a health professional about adjusting your treatment and skincare routine. Skin conditions are often complex, and there are no magic bullets, but taking a proactive approach to treatment can make a big difference in terms of both symptom control and psychological well-being.

“There is also a desperate need for better awareness of the therapies such as medicated tapes, which are available. A recent evidence review pointed out, “Whilst a steroid-impregnated tape such as Fludroxycortide tape has been available in the UK for several decades, they are not as widely used as steroid creams and ointments due to health care professional lack of awareness and knowledge.”[12]

Despite its proven effectiveness and a number of advantages over creams and emollients, including the fact that it does not moisturise the wound bed, 67% of patients have never used or been prescribed a tape inclusive of the steroid compound – fludroxycortide.

Proven solutions
Typharm, an innovative life-science company based in the East of England, has a portfolio of prescription-only therapies which can help patients take control of their eczema. Their treatment options include:

FLUDROXYCORTIDE TAPE is a transparent medicated surgical tape impregnated with the steroid Fludroxycortide. When applied to the skin, it helps reduce redness, swelling and itching and contributes to wound healing.

It is used to help treat difficult cases of dermatitis and eczema, especially when the skin is dry and scaly. It can also be used in wound care to help prevent the overgrowth of granular tissue, which can hinder wound healing. The prescription-only tape is waterproof and can be used for up to five days by children under 18 years of age.

Fludroxycortide Tape is a Prescription Only Medicine. Prescription-only medicines must be prescribed by a qualified health professional. This may be a GP, hospital doctor or prescribing pharmacist, for example.

Active ingredients: Fludroxycortide 4 micrograms per square centimetre tape. Always read the label.

Fludroxycortide Cream is a prescription-only white cream which helps reduce redness, swelling and itching. It is particularly useful if the skin is moist or weeping. It should be applied sparingly, two or three times a day. Like other topical steroids in the Typharm range, it can be used for up to five days by children under 18 years of age. The active ingredient is Fludroxycortide 0.0125%.

For more information, go to www.typharm.com or www.slsf.uk.

References:

[1] https://onlinelibrary.wiley.com/doi/10.1111/cea.13783

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947493/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056590/

[4] https://onlinelibrary.wiley.com/doi/10.1111/ijd.14763

[5] https://pubmed.ncbi.nlm.nih.gov/33006135/

[6] Perspectus Global; omnibus survey of 531 adults with eczema; August 2023

[7] National Eczema Association. Eczema and Emotional Wellness. https://nationaleczema.org/eczema-emotional-wellness/. 2017.

[8]

[9] https://www.heart.org/en/health-topics/sleep-disorders/sleep-and-heart-health

[10] https://eczema.org/information-and-advice/#:~:text=What is eczema?, ten adults in the UK.

[11] https://cks.nice.org.uk/topics/eczema-atopic/prescribing-information/stepped-approach-to-treatment/

[12] IMPACT OF ECZEMA AND OTHER DERMATOSES ON MENTAL AND EMOTIONAL HEALTH. THE ROLE OF STEROID TAPE IN ECZEMA MANAGEMENT; Dr Nisa Aslam.

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