Atopic Dermatitis Management Beyond Skin Symptoms in Primary Care

Even when formal referral isn't immediately needed, primary care clinicians can incorporate mental health awareness into routine atopic dermatitis (AD) management. Small changes in approach can make patients feel seen and supported beyond their skin symptoms.

In Your Practice

Normalize the mental health conversation

• Frame questions about mood and functioning as routine parts of AD care, not "extra" concerns
• Use language like "Many patients with skin conditions experience..." to reduce stigma
• Screen for emotional wellbeing regularly, not just at initial diagnosis

Validate patient suffering

• Acknowledge that AD is more than a cosmetic problem
• Recognize the burden of daily skin care routines
• Express empathy for sleep disruption and social challenges
• Avoid minimizing comments like "it's just eczema" or "at least it's not..."

Set realistic expectations for treatment

• Explain that AD is a chronic condition requiring ongoing management
• Discuss that treatment aims for control, not cure
• Prepare patients for the possibility of flares despite good management
• Frame setbacks as normal rather than treatment failures

Follow up on psychosocial impact, not just skin clearance

• Ask "How is this affecting your daily life?" not just "How does your skin look?"
• Track functional outcomes (work/school attendance, sleep quality, social participation)
• Celebrate improvements in quality of life even if skin isn't completely clear
• Revisit mental health screening and consider referral if disease worsens or treatment changes

Resources to Share

For Patients and Families

• National Eczema Association - Patient education, support groups, treatment information
• Global Parents for Eczema Research - A virtual organization created by and for parents of children with moderate to severe eczema. Focuses on promoting evidence-based medical decision-making and advocating for better treatments.
• International Society of Atopic Dermatitis - Provides resources and educational sessions for healthcare providers and patients, including clinical resources and listings of atopic dermatitis guidelines from around the world.
• American Academy of Dermatology - Provides comprehensive patient information about atopic dermatitis, publishes clinical guidelines, and offers Camp Discovery summer camps for children with skin conditions.
• American Contact Dermatitis Society - Professional organization dedicated to advancing the care and understanding of dermatitis and allergy through education, research, and advocacy.

NEXT: Mental Health Matters in Atopic Dermatitis: Priorities for Primary Care

The lists of small actions taken in primary care that can help change a patient's emotional experience of atopic dermatitis are based on Patient Care© conversations with and research conducted by:

Mona Shahriari, MD

Assistant clinical professor of dermatology at Yale University School of Medicine in New Haven, CT and co-founder of Central Connecticut Dermatology in Cromwell, CT

Jennifer LeBovidge, PhD

Attending psychologist in the division of immunology at Boston Children's Hospital and assistant professor of psychology in the department of psychiatry at Harvard Medical School, in Boston, MA

Jonathan Silverberg, MD, PhD, MPH

Associate professor of dermatology, and director of clinical research and contact dermatitis at The George Washington University School of Medicine and Health Sciences in Washington, DC