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 Part of the problem may be that teens have little contact with
physicians and prefer to develop their own routines for using
medicines instead of following the directions on their
prescriptions, the study suggests. Another issue is perhaps not
surprising given their age: they want their medicine to instantly
clear up any patches of skin reddened by eczema.
"Adolescents may feel embarrassed by the appearance of this skin
(dry, red, inflamed), influencing their quality of life," lead study
author Dr. Richelle Kosse of Utrecht University in the Netherlands
said by email. "Adolescence is a life phase in which peers play a
more important role."
Eczema, also known as atopic dermatitis, usually develops in early
childhood and often runs in families. Scaly, itchy rashes are the
main symptoms. The condition can be treated using moisturizers;
avoiding certain soaps and other skin irritants; and prescription
creams and ointments containing corticosteroids to relieve itching.
While corticosteroids can be effective, results don't happen
overnight and these medications often have side effects like stretch
marks and thinning, thickening or darkening of the skin. Less often,
corticosteroids may also cause acne or infected hair follicles, and
can have more serious side effects in the eyes like glaucoma and
cataracts.
Much of the research to date on patients' perspectives on eczema
treatment has focused on parents of younger children, researchers
note in JAMA Dermatology.
For the current study, researchers held focus groups with 15
adolescents, ages 12 to 18, who had received at least one
corticosteroid prescription in the previous year.
Most participants had developed eczema as infants or during
childhood, but five of them didn't get the condition until
adolescence.
Roughly half had eczema on their head and neck, and more than half
had it on their arms - all areas that are likely to be visible to
classmates and friends.
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When teens deviated from prescribed treatment regimens, they tended
to use more corticosteroids than recommended or apply these topical
creams and ointments more often than they should in hopes of a
faster result. Sometimes, though, they skipped corticosteroids until
they had severe symptoms because they didn't want to use these
medicines every day.
Some focus group participants complained about the greasy feeling of
corticosteroids in their skin and the amount of time required to
apply it before school.
In some cases, teens didn't feel bothered by eczema, but in other
instances teens voiced frustration about eczema on their hands that
made it difficult and painful to hold a pen in class.
Beyond its small size, the study also didn't look at whether or how
teens' attitudes and beliefs about eczema treatment might influence
the frequency or severity of their symptoms.
Even so, the results offer fresh evidence that teens require a
distinct treatment approach that's not the same as what young
children or young adults would receive, said Dr. Saxon Smith, a
dermatology researcher at the University of Sydney in Australia who
wasn't involved in the study.
"For young children, their parents tend to be the key caregiver,
however, as children develop, they need to be brought into the
treatment process," Smith said by email.
"This can be through initially involving them in applying their
eczema creams with their care-giver, then applying their creams by
themselves with supervision, then ultimately taking responsibility
for the administration of their eczema creams alone," Smith added.
"This transition, which takes years, is a challenge for patient,
caregiver and doctor."
SOURCE: https://bit.ly/2Ih5BMJ JAMA Dermatology, online May 30,
2018.
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