Eczema Awareness Month highlights condition’s burden
Eczema affects 10% of people in the United States, more than 31 million individuals, according to the National Eczema Association.
October, recognized as Eczema Awareness Month, is dedicated to informing those affected and their families, as well as spreading information regarding the condition to the general public.
Healio Dermatology spoke with Vivian Shi, MD, FAAD, associate professor of dermatology at the University of Arizona, about eczema, its burden, and what patients and providers should know.
Q. Why is it important to highlight eczema awareness?
A. I think it is important to highlight eczema awareness anytime, but October is Eczema Awareness Month, and many of us living in North America see the seasonal change. There is a lot of eczema flare at this time of year. In my clinic, we are getting a lot of flares because of dry skin, temperature change and different environmental triggers during this time of year. I think eczema awareness is important globally, not just in our country, because eczema is a heterogeneous disease. It is not a one-size-fits-all textbook atopic dermatitis. Eczema awareness is important to focus on how the disease presents differently in people of varying genetic backgrounds, and that allows us to have a better understanding of the cause and design targeted treatments for it.
Q. Who is most affected by eczema?
A. I wish we knew the root cause of eczema, but a person who is the poster child for eczema would have at least one first-degree relative who has eczema, asthma or hay fever. They may sometimes have a genetic mutation in a protein in their skin called filaggrin, which predisposes them to have drier skin and to be more eczema prone.
There are also people living in environments that have more allergens. To have eczema, you almost have to have the perfect storm. There are multiple factors contributing to it.
Some people have two out of three triggers and never get eczema, while some have one out of three, but they get eczema.
We think that genetics is only part of it. Epigenetics, an emerging field within eczema, is how our environment and how our lifestyle interferes with the expression of our genes. We cannot change our genetic make-ups, but we can change the expression of our genes to end up having a phenotype of eczema or no eczema.
Q. What should health care providers look for in terms of identifying and diagnosing eczema?
Health care providers in general, such as non-dermatologists, should look for the signs. It never hurts to ask because pediatricians, for example, are dealing with well-child exams and other medical problems. Many think eczema is just a skin disease, but it actually has a profound impact. As a pediatrician or front-line provider is seeing a patient for something other than eczema, it never hurts to ask, so it is on the radar of both the doctor and the family.
I think for dermatologists, if patients are not coming in for eczema but they are coming in for other skin diseases such as dry skin or hand rash, it is important to seek out other clues, such as a family history of eczema, asthma or hay fever, Dennie Morgan lines in the lower eyelids, and hyperlinear palms, which are hallmark signs of atopy. It could lead you to see why these other skin manifestations are happening. It could all be because the person has atopic tendencies.
Q. What should patients know in terms of treatment options?
A. Join the National Eczema Association. I think NEA is the center for eczema education and awareness. Finding the right support group is important, so they do not feel like they are alone. So, doing that and participating in NEA will allow them to be more immersed with the options and newest research on their disease. To be better informed means by the time they get to the doctor’s office, they are more prepared to advocate for themselves and ask the right questions. Also, it will help them to understand if their provider is doing the right thing for them and if a provider is the best fit in caring for their eczema.
All dermatologists treat eczema, but not all dermatologists specialize in eczema. So, sometimes knowing how to find the right provider for you and your family is also important. NEA can help provide that framework to find that provider.
Q. How can physicians keep up to date on the newest developments in eczema awareness?
A. There are patient-centered conferences such as the Eczema Expo, as well as other conferences dedicated to atopic dermatitis such as the Revolutionizing Atopic Dermatitis (RAD) conference. At the more general dermatology conferences, such as the American Academy of Dermatology, and the Society for Pediatric Dermatology, there are always symposiums and forums dedicated to atopic dermatitis.
Our physician assistants and nurse practitioners are also at the forefront partnering with dermatology to take care of these patients. There are dermatology NP and PA societies, which are good sources to learn more about eczema, too.