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Eczema Woes Not Just Skin Deep

Eczema sufferers have terrible health habits and high risk of heart disease

CHICAGO --- Eczema wreaks havoc on its sufferers’ lives with health problems that are more than skin deep. Adults who have eczema -- a chronic itchy skin disease that often starts in childhood -- have higher rates of smoking, drinking alcoholic beverages and obesity and are less likely to exercise than adults who don’t have the disease, reports a new Northwestern Medicine® study.

These behaviors give them a higher risk of cardiovascular disease, including high blood pressure and high cholesterol as well as diabetes. They also have higher rates of insomnia. About 10 percent of adults in the U.S. have eczema. 

“This disease takes a huge emotional toll on its sufferers, like chronic pain,” said lead study author Dr. Jonathan Silverberg. “Because eczema often starts in early childhood, people are affected all through their developmental years and adolescence. It hurts their self-esteem and identity. That’s part of why we see all these negative behaviors.” 

Silverberg is an assistant professor of dermatology at Northwestern University Feinberg School of Medicine and a dermatologist at Northwestern Memorial Hospital. He also is director of the Northwestern Medicine Multidisciplinary Eczema Center.

Adding to eczema patients’ health woes is difficulty exercising, because sweat and heat aggravate the itching. “They will avoid anything that triggers the itch,” Silverberg said. “Patients report their eczema flares during a workout.”

The study was published Jan. 8 in the Journal of Allergy and Clinical Immunology.

“This opens our eyes in the world of dermatology that we’re not just treating chronic inflammation of the skin but the behavioral, lifestyle side of things,” Silverberg said. Dermatologists need to ask patients about their lifestyle habits such as smoking and physical activity so they can offer interventions.   

The study analyzed data for 27,157 and 34,525 adults aged 18 to 85 years from the 2010 and 2012 National Health Interview Survey. The Northwestern study reported patients with eczema had 54 percent higher odds of being morbidly obese, 48 percent higher odds of hypertension, up to 93 percent higher odds of having pre-diabetes and up to 42 percent higher odds of having diabetes. They also had 36 percent higher odds of high cholesterol.    

Silverberg said patients should be offered interventions for alcohol and smoking by their dermatologists. In addition, he is collaborating with colleagues in Northwestern’s department of physical therapy and human movement sciences to figure out how patients with eczema can exercise to improve their health without worsening their skin flare-ups.   

Silverberg also is an assistant professor in preventive medicine and medical social sciences.

Dr. Philip Greenland, the Harry W. Dingman Professor of Cardiology at Feinberg and a physician at Northwestern Memorial Hospital, was a coauthor on the study. Greenland also is the director of the Center for Population Health Sciences at the Institute for Public Health and Medicine at Northwestern.