leading canadian dermatologist identifies mental health struggles, equity concerns, as poorly understood impacts of atopic dermatitis

nearly one out of five canadians will suffer from atopic dermatitis (ad) — the most common form of eczema — at some point in their lives. yet considering how pervasive atopic dermatitis is, many canadians have a poor understanding of its effects. these effects go beyond discomfort and can lead to mental health problems and a slew of other issues that aren’t always obvious to the rest of us.  

dr. geeta yadav, a prominent toronto-based dermatologist, has spent much of her career treating patients with atopic dermatitis. “i think many people know that atopic dermatitis is a hereditary condition,” she says. “there is a complex genetic set of causes, and environment is certainly a factor. it’s more common in children.  and can resolve with age. but it can also onset later in life. i’ve had patients, who, for example, say ‘i’ve been wearing this mascara for my whole life and all of a sudden, it’s causing irritation.’”  

atopic dermatitis is also associated with other what are called “atopic” disorders, including asthma, food allergies, and seasonal allergies. “they tend to go together in a constellation of symptoms in a patient profile,” dr. yadav elaborates. “the analogy i like to use is like bricks and mortar. if the cells are the bricks, the mortar is the stuff in between. in this population, the mortar isn’t as cohesive, and the integrity isn’t as good. so, water can leak out and an irritant can enter.”    

beyond the best-known symptoms of atopic dermatitis — red, itchy skin — there is often confusion about its causes.   

“i sometimes wish i had a t-shirt that says, ‘it’s not your food,’” says dr. yadav. “one of the most common misunderstandings is the belief that diet causes flare-ups. there is no strong evidence to support that.”  

what can cause flare-ups are changes in climate — both humid air in the summer and drier air in colder months can be triggers.” what’s more, according to dr. yadav, the covid-19 pandemic “was a time with a lot of triggers for many sufferers, with excessive hand-washing and use of strong hand sanitizers.”  

the debilitating effects of atopic dermatitis can be serious. yet they’re also perhaps the least understood by people who don’t suffer from ad — or who don’t know someone who does.  

“we absolutely have to talk about the broader impact of atopic dermatitis,” dr. yadav says. “the eczema society of canada conducted a survey of 1,035 patients and caregivers across canada. it’s got some very eye-opening results even for physicians, let alone the general population.”  

called the “atopic dermatitis quality of life report,” the survey found that 39 per cent of respondents identified as having severe atopic dermatitis, and 49 per cent identified as having moderate ad. some of the most notable results were that a full 79 per cent reported loss of sleep, and 50 per cent of those experienced disrupted sleep more than eight days in a month.  

furthermore, 44 per cent said their atopic dermatitis contributed to depression, and 40 per cent said it contributed to avoiding intimacy. nearly one-third of respondents reported missing important life events or work.  

these responses reveal that the impact of atopic dermatitis goes beyond “just an itch,” and can have profound effects on mental health, relationships and more.  

there is another layer of complexity to ad dr. yadav believes is crucial for people to understand. “atopic dermatitis affects children disproportionately. but it also affects people with black and brown skin disproportionately,” she explains. “atopic dermatitis presents differently on different skin tones. as dermatologists, we always have to keep that top-of-mind, which makes the intricacies of treating those from various races and backgrounds a significant part of our job. ”  

despite the significant challenges facing those suffering from atopic dermatitis, dr. yadav is hopeful, and believes that hope is paramount for those suffering from ad. “a patient once gave me a little metal cup that was her mother’s,” she reflects. “when her mother was a baby, they tied the cup to her hand so she couldn’t scratch herself. now, options have come so far and there is so much we can do for patients.  

“i’d love nothing more than to have more people with atopic dermatitis coming to see dermatologists for open conversations. it’s an exciting time to be in the field, and i’m excited to give patients suffering from this complex and often deeply debilitating condition reasons to find hope.”  

this story was created by content works , postmedia’s commercial content division, on behalf of a canadian healthcare company.  

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leading canadian dermatologist identifies mental health struggles, equity concerns, as poorly understood impacts of atopic dermatitis

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