Atopic dermatitis

Atopic dermatitis (AE, atopic eczema, neurodermatitis) is a chronic recurrent skin disease. Atopic dermatitis is one of the most common non-communicable skin diseases. According to various sources, it affects up to 20% of children and from 2 to 8% of adults. As a rule, the disease develops in childhood, but about a third of cases begin in adulthood and are often associated with psychoemotional changes (depression, anxiety disorders).

Several specialists are involved in the treatment of patients suffering from this disease: allergists, dermatologists, therapists, geneticists. In recent years, psychotherapy has become increasingly important in helping with atopic dermatitis.

It is known that the triggers that cause exacerbations of atopic dermatitis, in addition to chemical agents, climate, infections, etc., include stress, changes in the emotional state. The stress factor is one of the leading factors in the exacerbation of the disease.  

Among the psychological factors that influence the course of atopic dermatitis, intra-family and interpersonal relationships are also described. Strained relationships with loved ones, difficulties in emotional contact with significant people, lack of comfort and understanding in the family - all this affects the frequency and nature of exacerbations. Especially in relation to children, when it is difficult to explain their experiences, there is only a reaction to the distance or vice versa overprotection on the part of the mother or a conflict in the relationship between the parents.

According to the European recommendations for the treatment of atopic dermatitis, the possibilities of psychological and psychotherapeutic assistance are on a par with medications. Interestingly, the range of assistance from psychologists and psychotherapists varies from psychological support and information to long-term psychotherapy.

A comprehensive approach to treatment with the inclusion of psychotherapy (at the level of parents of a child suffering from atopic dermatitis or an adult patient), according to several studies, has shown better results in terms of the frequency and severity of exacerbations compared to patients who do not receive psychotherapy.

Psychological support - when we talk more about the skills of self-regulation, relaxation, communication, control of skin damage (in relation to itching). This type of support is mandatory in the treatment package. The question of group or personal work with a psychotherapist is already decided individually with each patient.

The main goals of psychotherapy for atopic dermatitis are to reduce the level of anxiety, tension, and anxiety. An important part of the process is working with family relationships, because if we are talking about children, then building a more harmonious relationship, emotional contact is achieved through psychotherapeutic work with parents, primarily with the mother. For adolescents and adult patients, the relationship factor plays an important role. In the practice of a psychotherapist, we often see how misunderstandings, disturbing situations in relationships lead to an exacerbation of the disease. At the same time, it is not necessarily a disastrous situation (separation, loss) - in the structure of close relationships (couple, family), even a small degree of emotional contact can make a difference.

We see that today a holistic approach to the treatment of atopic dermatitis includes several specialists: a dermatologist, an allergist, a therapist, a geneticist, and a psychotherapist. Since only by simultaneously influencing the causes and manifestations of the disease can we achieve the desired results.

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GBUZ Moscow Clinical Scientific Center named after Loginov MHD