When atopic eczema continues into adolescence…

In 80% of cases, atopic eczema disappears around 7 or 8 years old. And yet there are still a number of children who don’t get lucky: 10 to 20% of adolescents are affected around the world. In France, 18% of 7 to 16-year-olds suffer from atopic dermatitis1. It’s also important to be aware that atopic eczema is a sign of a weakened skin barrier that stays with sufferers throughout life. It is, therefore, possible to stop having eczema flare-ups during several years and then see them reappear under certain circumstances, at any age.

 

1 https://www.resoeczema.fr/eczema-atopique-en-chiffres/

Why is eczema more complicated for a teenager?

Adolescence is a key moment in identity development. As with all visible skin diseases, atopic dermatitis can be difficult for teenagers to live with, as they are particularly careful about their image and what other people think of them. The phenomenon is similar to acne, except that atopic eczema is less well known.

To know more about eczema, read our article: "How do you distinguish the different types of eczema?"

  • Dr Magali Bourrel-Bouttaz, Dermatologist, France
    Dr Magali Bourrel-Bouttaz, Dermatologist.

    15 to 20-year-olds rarely consult. If they have had eczema relapse over a long period, they can feel discouraged. At an age where modesty becomes prevalent, they don’t want to be touched. They should be managing their own care, in particular by applying an emollient, but this doesn’t always happen. Even more so when teenagers do not always feel comfortable with their changing body. Between a visible skin disease and family relations that may be complicated, they can find themselves in a difficult situation.

    Dr Magali Bourrel-Bouttaz, Dermatologist.

→ Eczema is visible!

To start, skin is more porous than normal. It doesn’t fulfil its barrier function. Various factors can trigger an eczema flare-up (cold, cosmetics, rubbing, fabric, pollution, pollen, stress…). Red and thick eczema patches are also always very dry, and itching can be intense. Patches can be located anywhere, but during adolescence, they are most often found:

  • In the elbow creases,
  • Behind knees,
  • Around the neck,
  • On wrists and ankles,
  • On hands.

"My eczema is mostly on my elbows, inside and outside. It’s itchy and sometimes I scratch until I bleed."
Ethan, 16 years old

 

→ Tired of putting cream on all the time!

The other factor to take into account is that teenagers become more and more independent with respect to their parents.

"Ethan doesn’t like putting on cream. When he was little, I put all his cream on, everywhere. When he turned 10 years old or so, things started to get more complicated. As a pre-teen, I had to respect his boundaries. So it became more about motivating him to apply his cream himself. It was essential to explain clearly how important the cream routine is so that he understood why he should do it. Applying cream by himself is an important indication of him taking responsibility for his eczema."
Karine, 16-year-old Ethan’s mother

  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    There are normal steps in adolescent development: conflict, a need for independence, to do things themselves, etc. Parents may feel frustrated to see that while they followed medical advice for years, as a teenager their child doesn’t always want to continue with care. There is no point in forcing the issue: the more you insist, the less your adolescent will do it. At the same time, it’s important to highlight the moments where your teenager has followed his care routine. That’s motivating.

    Joël Pacoret, Psychologist.

→ Always that itch…

Itching is just as intense as it was during childhood. Teenagers can have trouble resisting and may sometimes feel ashamed at having to scratch in public. As well, adolescents often like using the same products as their friends and follow fashion trends seen on the internet or TV. Unfortunately, some cosmetic products aren’t at all adapted to atopic skin and can even trigger a new flare-up.

"Being able to use the same products as everyone else is important at this age. Ethan is paying attention to his image. He asked me to buy a shower gel targeted at men… He loves the scent. It’s true it can be frustrating to only be able to use perfume-free products. I tell him to do what his skin tells him."
Karine, 16-year-old Ethan’s mom

  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    Parents can suggest that recommended products are better quality and have been specially made to meet the needs of atopic skin. For teenagers, it’s a way of taking control over their care routine. This type of argument will become more logical for them with time.

    Joël Pacoret, Psychologist.

Adolescence is not an easy period when children are growing up, neither for the teenagers themselves nor for their parents. It’s true that eczema symptoms exacerbate all the usual problems of adolescence: sleep, mood swings, school problems, arguments with siblings, sometimes even rebellious behaviour. The most important thing is to show your teenager that you’re listening to her and that you understand her.

Psychological impact of adolescents with eczema

A day in the life of your teenager

1. Rebels and fatalists

Put yourself in his shoes: atopic eczema may have been part of his entire childhood. He may feel that this thing that makes him different is profoundly unjust – and don’t forget how sensitive adolescents are to injustice. Many accept the situation and their eczema without any trouble. Others don’t like showing it, and some may even turn inward and sadly accept their lot in life as fate. They even give up on the idea of their eczema disappearing one day, and don’t want their parents to worry. Others still get angry and rebel against everything, possibly leading to dangerous behaviour. None of these attitudes is healthy, neither for the teenager himself, nor his support network.

  • More than half of adolescents1 say they are embarrassed, unhappy or sad because of their atopic dermatitis.
  • Dr Magali Bourrel-Bouttaz, Dermatologist, France
    Dr Magali Bourrel-Bouttaz, Dermatologist.

    An individual’s development takes priority over caring for skin. Some adolescents refuse to accept their eczema and don’t take care of it. Others feel ashamed and hide their skin with long clothing, whatever the season. In both cases, let your teenager become responsible for her skin and understand what it needs in her own time.

    Dr Magali Bourrel-Bouttaz, Dermatologist.
  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    If you notice a lasting change in attitude in your child, don’t hesitate to start a conversation. Talking about it will helps him think of himself differently rather than focusing only on his atopic eczema. Show the value of his skills and abilities, the activities he likes and that bring him satisfaction. Show him that his eczema is not what defines him. There is much more to him that plays a much larger role in doing that.

    Joël Pacoret, Psychologist.

2. The impact of sleep

Any traditional sleep difficulties that adolescents may have been aggravated by itching. A lack of sleep on top of itching can make them irritable and moody. Chronic fatigue may also result in not being able to concentrate during class, leading to results that suffer.

  • 50%1 of adolescents with eczema don’t sleep well.

"Ethan scratched so much at night that it woke me up. At school, they told us he couldn’t sit still, but they didn’t necessarily link it to the itching he felt. With the benefit of hindsight, and after having spoken with a dermatologist, I think the trouble he had concentrating may have been the result of his need to scratch."
Karine, 16-year-old Ethan’s mom

Impact of eczema on sleep

3. Social relation consequences

Social relations and belonging to a group play a huge role during adolescence. Physical image is extremely important at this age, and even more so with social networks. Many say they have been made fun of or left out at some point during their school life. Parents must always remain aware and be sure that their child is surrounded by kind friends who look out for her so that she isn’t left isolated.

  • One in three1 teenagers admits they’ve been made fun of or left out of activities due to their atopic dermatitis
  • 50% of teenagers1 say they have missed school over the last 12 months due to their atopic dermatitis, averaging out to between 15 and 22 days of missed school per year.

"I scratched until I drew blood. I tried to hide it because I was a bit ashamed. When it bleeds, it’s always annoying. People look at me in a strange way. I’ve even had people say things to me like, “It looks like you have chickenpox."
Ethan, 16 years old

"When he was smaller, some people made comments about personal hygiene. They just don’t know what they’re talking about, that’s all."
Karine, Ethan’s mom

Social impact of eczema

Four pieces of advice from Joël Pacoret, psychologist

1. Don’t hesitate to talk about your child’s disease at an early stage at school, without turning it into a special case. Simply informing the teacher and the school nurse of eczema’s symptoms and related behaviour can be enough to develop an understanding relationship.

2. Adolescents with atopic skin often suffer in solitude because they are shut inside an idealised vision of their relationship with others, largely inspired by what they see on social networks. There is so much pressure to be well and happy. Parents must be ready to listen, without being intrusive, a balance that can be difficult to find. Teenagers often find more help outside the family circle, even if this can be hard to accept for parents. Someone who is having or has had the same experience can provide effective help, at a time when identifying with others is important.

3. A teenager is always more than simply her skin problem. She mustn’t be afraid of how people react to her skin. The objective is to understand what is wrong with her skin, what her skin needs, and accepts it. The more she feels comfortable with her skin, the more she’ll be able to think about other things and not feel the weight of other people’s looks and judgements.

4. Adolescents really need help with separating shame for their skin and feeling guilty. They don’t need to feel guilty about the state of their skin; they haven’t done anything wrong. As for shame, it’s a blend of several emotions (anger, fear, distress…) that are linked to how other people see them as well as how they see themselves. The better a teenager is at explaining why he feels ashamed, the more it will fall away. Don’t hesitate to ask a professional for help with your child.

Adolescent eczema is a family affair

Atopic eczema during adolescence is also difficult for the rest of the family to live with. Two parents out of five1 feel like their life is organised around their adolescent’s eczema. They can also feel alone in managing the dual problem of adolescence on its own and the requirements of a child with atopic skin. Constant negotiation so that basic care becomes routine is frequent: cleanliness, emollient cream, adapted clothing, diet…

Both they and their other children may feel that they are spending an inordinate amount of time and attention on the adolescent with atopic skin. Siblings may feel like itching, eczema flare-ups and dermatologist appointments are the only subjects of conversation, and legitimately feel that their own concerns do not receive as much rightly lose their patience when their own concerns do not receive attention. Again, a balance needs to be found.

  • More than a quarter of parents1 feel like they pay less attention to their other children due to their adolescent’s atopic dermatitis.
  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    Among siblings, conflict and feelings of jealousy are normal and necessary to learning how to be part of society. Parents must try to maintain an equilibrium in their relations with their children by spending quality time with each. Family events that everyone takes part in can also contribute to strengthening relationships. If necessary, seek outside help from a professional.

    Joël Pacoret, Psychologist.

1. Take care of eczema to reduce stress

Atopic eczema is a chronic skin disease that requires long-term care. Use cleansing and moisturising products that are adapted to atopic skin on a daily basis. Don’t hesitate to take charge of your teenager’s treatment and take them to see your GP or a dermatologist, even if they’re big. Atopic dermatitis requires medical care as this is the most effective way to reduce the number of flare-ups so that everyone lives in peace. You can also contact parent associations to share your experience and not be alone when managing problems. All solutions that preserve parents’ and teenagers’ serenity are recommended, from sport to meditation, sophrology, music and yoga.

Discover our solutions that make living with atopic eczema easier.

"Using topical corticosteroids is essential when there is a flare-up. It’s the only effective treatment. Daily application of an emollient cream complements the topical treatment in soothing skin. Cleanliness is also key. I noticed a real difference when we started using a shower oil."
Karine, Ethan’s mom

  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    There are so many solutions today for adolescent patients and their parents to help them avoid the feeling of solitude when dealing with their pathology: forums, online communities, meetings organised by associations, etc. They’re a great way to share your own experiences and get a wider perspective.

    Joël Pacoret, Psychologist.

2. Refuse feelings of guilt

Eczema is often genetic in origin, and it can run in the family. But this isn’t your fault! Anyone can be affected, at any age. Take some time to explain atopic dermatitis in detail to your teenager. Show her how great she is, give her confidence in herself and don’t become submerged yourself by feelings of guilt.

"It’s essential to educate your child: he needs to understand what he has and that it’s not serious. He needs to feel comfortable. When he was younger, Ethan used to say to me, “I want to be like everyone else.” But we’re all different. We just have to accept that. We have to be proud of who we are, of our difference. It’s not something that we should hide, but something that we learn how to live with and manage. It makes us mature faster!"
Karine, 16-year-old Ethan’s mom
 

3. Be together

Eczema should not isolate your teenager. Don’t hesitate to create moments that your family can all spend together, with your other children, so that they feel loved and supported. Shared activities let everyone relax together and distract everyone’s attention, too, so that you’re focused on something other than eczema.

 

4. Get your child to take responsibility

Adolescence is a key moment of transition, and teenagers should manage their treatment by themselves. After a certain age, you should no longer be doing this or spreading their cream for them. They need to learn what their skin needs and also understand how important it is to their comfort to apply an emollient cream. Pass on all the right reflexes for their skin, whether it’s which types of fabric to avoid, showering after sports or avoiding junk food.

  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    What is most important to remember is that teenagers have to take charge of their own skin, be aware of the benefits provided by their cream. They need to become independent. It’s a first and fundamental step toward adulthood where parents will no longer be there everyday to remind them about what they need to do.

    Joël Pacoret, Psychologist.

Teenagers with atopic skin are adolescents like any other, with strengths and weaknesses. A person is never just their skin problem or any other negative perception they have about their body. Every teenager has their own personality, strong points and talents that they can develop while they leave atopic eczema on their skin, where it belongs. Parents help their children to understand that atopic dermatitis is part of who they are and that it brings resistance, resilience and tolerance that will all be useful as they go through life.

  • Yes, they have to take care of themselves in the right way to reduce the frequency of flare-ups and live more comfortably.
  • No, they must not hide away and refuse contact with others. It’s still possible to laugh, have fun and be happy, even when eczema patches appear.

"There’s no need to overreact. Atopic dermatitis a skin disease that can be taken care of, and is neither contagious nor serious! The hardest time is at the beginning when you don’t know what to use. You need to find the right medical experts and the right products."
Karine, Ethan’s mom

All adolescents need to develop in their own way, without focusing on their weaknesses. Today, the #bodypositive movement on social networks has changed how we look at physical differences and shows the way. Whether affected by weight, acne, vitiligo or eczema, we’re seeing physical images in a different way and becoming more tolerant. So much the better!

"When you start looking into eczema and ask around, you realise that lots of people have it, near and far. Don’t hesitate to speak up and talk openly to everyone around you: family, teachers and the parents of other children. Ignorance leads to unkindness, intolerance and judgement. When people know what your child is going through, they understand and become far more empathetic and compassionate. The only way to make people think differently is to make sure they understand the pathology"
Karine, 16-year-old Ethan’s mom

  • Dr Magali Bourrel-Bouttaz, Dermatologist, France
    Dr Magali Bourrel-Bouttaz, Dermatologist.

    You have the solution in you, and it’s different at every age.

    Dr Magali Bourrel-Bouttaz, Dermatologist.
  • Joël Pacoret - Psychologist
    Joël Pacoret, Psychologist.

    Remember that all challenges have their positive sides. Children in this situation will acquire qualities and skills that others may never develop.

    Joël Pacoret, Psychologist.