Myth: Eczema has a minimal impact on patients’ daily activities
Although eczema may be considered a relatively mild skin condition, the effects of the disease can be debilitating for many patients. Low quality of life (QoL) due to eczema flares and trigger avoidance can lead to decreased productivity in this population, and patients often report interference of the disease with participation in daily life, including activities at work and school.
In a series of patient satisfaction surveys administered by the National Eczema Foundation, 75% of adults with eczema said their disease interferes with their job and household chores. A study of 380 adult atopic dermatitis (AD) patients assessing the impact of the disease on QoL showed similar results, as 39.0% of participants said AD impacted shopping, home, and garden activities a lot or very much and 36.8% said it impacted these activities a little. Additionally, reports from caregivers of children with AD indicated that nearly 50% of children miss at least 1 day of the school year due to their disease, and 17% miss 5 or more days. Over time, these limitations can have a serious psychological impact in eczema patients of any age.
In the National Eczema Foundation survey, 71% of respondents said their disease also gets in the way of participating in sports or hobbies. Eczema patients may miss out on the physical and mental health benefits of activities associated with increased body temperature or prolonged contact with sports equipment, which can exacerbate symptoms. In general, outdoor activities in all seasons can be particularly troublesome in this population, as eczema flares can be triggered by cold or hot temperatures, humidity, wind, dry air, sun exposure, pollution, and contact with allergens like pollen or mold.
The impact of eczema treatments on patients’ daily activities also should be considered when evaluating QoL in this population, as it frequently takes considerable time out of a patient’s day to manage his/her disease. Control of symptoms often requires a multistep daily regimen involving medication, bathing, moisturizing, applying wet compresses, ridding the house of allergens, and/or cleaning sheets and clothing. According to the National Eczema Foundation survey, 1 in 3 respondents said it takes 1 or more hours per day to treat their disease. To encourage adherence and ensure optimal outcomes, physicians should work with patients to develop an eczema treatment plan that is both effective and manageable in terms of their daily routines.
Ultimately, the disease burden in eczema patients is multidimensional, extending beyond only cutaneous symptoms; therefore, it is important for clinicians to consider the impact on QoL when choosing treatments for patients with eczema and to initiate appropriate therapy at the onset of disease presentation to mitigate the effects of the condition on patients’ daily lives. Eczema management strategies should include QoL screening to ensure the disease has a minimal impact on patients' daily lives and preferred activities.