Every parent can relate to having a toddler melt down at a birthday, an elementary kid feigning a stomach bug to avoid school, or a teen dropping out of a sport. When your child has atopic dermatitis (aka eczema), though, these instances can become the norm and a sign of bigger concerns.
Although eczema is a physical skin condition, it can weigh on a child’s mental and emotional health, too. Kids and teens living with the condition often face alienation and low self-esteem, which can impact their friendships, school performance, and even family dynamics. This goes beyond the typical hurdles of growing up and can stay with them into adulthood: Compared to the general population, people with eczema are 1.5 to 2 times more likely to develop clinical anxiety or depression.
Today, many providers realize this dynamic and build emotional support into a child’s treatment plan alongside topicals and other medications. This gives you the opportunity to partner with your kid’s care team to nurture their confidence, help them build healthy coping skills, and make sure their eczema is managed as effectively as possible.
Meet the Experts: Jennifer LeBovidge, PhD, a psychologist in the atopic dermatitis center at Boston Children’s Hospital; and Margaret Lee, MD, PhD, director of pediatric dermatology at Boston Medical Center.
“You can’t separate the physical effect from the emotional effect of eczema—it’s all intertwined,” says Margaret Lee, MD, PhD, director of pediatric dermatology at Boston Medical Center. The upside? “Once their condition becomes better controlled,” she says, “the child’s psychosocial health also tends to improve.”
Below, experts share practical ways parents can support kids living with eczema to help them cope with challenges, build confidence, and feel supported both physically and emotionally.
How eczema affects your child’s mental and emotional well-being
The itching, chronic discomfort, and resulting poor sleep associated with eczema can affect children in ways that go beyond their skin. Younger kids may seem more irritable, clingier, and prone to meltdowns, says Jennifer LeBovidge, PhD, a psychologist in the atopic dermatitis center at Boston Children’s Hospital. School-age children may seem impulsive and less able to focus, which can impair school performance.
Then there’s all the work of finding a treatment plan that manages the condition. When a child inevitably experiences flares, it can feel like they can’t control their eczema and will never get better, LeBovidge says. Many kids with eczema also feel embarrassed by their skin and struggle with negative body image and self-esteem. What’s more, kids with eczema—especially those with more visible or severe symptoms—are more likely to experience bullying than children without the condition. Factor in social media and the pressure many kids feel to fit in, and you can understand why children with eczema are at a higher risk of anxiety, depression, and suicidal behaviors.
How to talk to your child about their eczema
What you say, as well as what you don’t say, goes a long way in making kids feel heard and believed. At any age, listening is perhaps the best way to “talk” to your child—it shows support and helps validate what they’re going through.
As hard as it can be, LeBovidge says parents should try to avoid saying, “Stop scratching!”
“Eczema is really itchy, and the body’s natural response is to scratch,” she says. “The kid can start to feel like they’re doing something wrong, and then they feel further stressed,” which can worsen their symptoms.
LeBovidge recommends a few age-appropriate approaches to talking to your child:
Toddlers and preschoolers
With younger kids, keep explanations short and simple. Acknowledge what they’re feeling (“It doesn’t feel good when your skin is itchy”,) and focus on helping them feel better: “Thank you for telling me you feel itchy. Let’s get some cream so you can feel better. Then we’ll play blocks together.”
Elementary-age kids
LeBovidge suggests acknowledging worries about peers (“I can understand why you’re wondering if other kids will ask about your eczema during gymnastics”); helping kids understand how treatments work (“Your moisturizer helps keep your skin strong and healthy”); and recognizing the effort that goes into managing eczema (“It’s a lot of work to do your skincare each night. I’m proud of you!”).
Tweens and teens
Older kids often benefit from conversations that acknowledge their growing independence and identity. Validate their frustrations (“I know it’s not easy having eczema”); help them problem-solve around activities and school events (“I’m glad you want to travel with your team for the competition. Let’s think about what you can bring to feel comfortable”); and reinforce that eczema is only one part of who they are.
How to help your child navigate social situations
School, sports, and sleepovers can bring up a different set of challenges for kids with eczema. But don’t let that stop you from encouraging them to pursue hobbies, sports, extracurricular activities, and friendships since that can reinforce an identity beyond eczema. A little prep work can ease your child’s anxiety around these events and interactions.
LeBovidge suggests rehearsing common scenarios—such as questions from classmates, teasing from peers, or handling symptoms during activities—so kids feel more prepared in real life. You and your child can also come up with a signal for teachers or coaches when they need a break or time to care for their skin.
For extracurricular activities and social events, small adjustments can also help reduce anxiety. Help your child be comfortable in these situations by helping them dress in ways that will not irritate their skin. And prepare them with the know-how of handling flares if they occur during these events, whether that means speaking to a grown-up or having products they can use to soothe their symptoms on hand.
If your child is still craving friendship and understanding from their peers, consider this: Some kids may benefit from connecting with online eczema communities and hearing from peers who understand what they’re experiencing. You can help them find safe places for them.
Signs your child may need additional mental health support
No matter how much parent support they have, some children need professional help managing the emotional impact of eczema. Ask your child’s dermatologist or pediatrician for a referral to a mental health provider who works with children with eczema if you notice any of the following:
- Withdrawal from activities they enjoy
- Attempts to avoid school
- Changes in their friendships
- Sleep problems
- Increased negative self-talk
- Significant stress or obsessiveness around skincare
- Persistent sadness or hopelessness
- Heightened anxiety about appearance
Eczema can affect much more than just your child’s skin, but the right support can help them feel more confident navigating school, friendships, and everyday life—now and into adulthood.
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