Research: Skin disorders can affect mental health of children, young people

Skin problems may have a severe impact on the physical and emotional health of children and adolescents, and while effective therapies are available, they are uncommon, according to experts.

The Medical Research Foundation has financed research to expand scientific understanding of these problems, which might lead to better assistance and treatment for children and young people with skin disorders in the future. Skin problems may have a significant influence on many parts of life, including education and relationships, as well as job and lifestyle choices. Adolescence, in particular, is a period of self-consciousness, self-doubt, and increased preoccupation with physical beauty and appearance.

It is a key phase in both physical and psychological development, which is why skin problems, which are widespread in this age range, may have such a long-term influence.

According to a 2020 poll conducted by the All Parliamentary Group on Skin, 98% of patients with skin disorders indicate that their disease has an impact on their emotional and psychological well-being, but only 18% have gotten some type of psychological care.

Scientists from King’s College London and Newcastle University will lead new study into two skin conditions in particular, eczema and ichthyosis, which are both known to have a significant impact on quality of life.

Understanding the relationship between severe itch, sleep disruption, and brain function in eczema – Professor Carsten Flohr, Chair in Dermatology and Population Health Sciences at King’s College London and Honorary Consultant in Dermatology at St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust Eczema is an inflammatory skin condition that affects 20% of children and 8% of adults. It has been related to serious negative effects on quality of life, as well as psychological and mental illnesses such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD).

Eczema frequently appears before the age of two, and afflicted babies may have bad sleeping patterns at a young age. Eczema can last into adolescence or adulthood in around 30% of instances, indicating that persons with eczema might have itchy skin and sleep disturbances for the rest of their life.

Poor quality sleep impairs memory, focus, and mood, and it has been linked to inferior educational results in healthy children and adolescents.

Importantly, children and young people with eczema who do not have sleep disturbance do not have a significantly higher risk of ADHD than the general population, whereas children and young people with eczema and sleep disturbance have a 40-50 percent higher risk of ADHD than those who do not have eczema.

However, experts are still learning about the connections between eczema, itching, and mental health disorders. Professor Flohr and colleagues hypothesise that persistent inflammation in the skin and blood, which leads to sleep disruption and inflammation in the brain, is a major contributor to these mental health concerns.

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Professor Flohr will compare teenagers with eczema to healthy adolescents and children and young people with ADHD in a study of patients aged 12-18 from the Paediatrics Severe Eczema Clinic at St Thomas’ Hospital and King’s College London.

The researchers will look at how sleep disruption and inflammation influence brain structure and function, as well as mental processes.

This involves sleep diary and gadget assessments, brain activity measures, and blood tests to determine changes in circadian rhythm (the natural body clock). Professor Flohr and colleagues will also investigate the lived experience of eczema-related sleep problems, as well as their cognitive and psychological effects.

Professor Flohr said: “We think the mental health issues seen in children and young people with eczema could in part be explained by chronic inflammation in the skin and blood, leading to sleep disturbance and inflammation in the brain.

Thanks to funding from the Foundation, we will be able to address this theory, with the long-term aim of developing strategies to help manage sleep disturbance better. Potentially, this could prevent the knock-on psychological effects we see in children and young people with eczema.”

Dr Neil Rajan, Senior Lecturer and Honorary Consultant Dermatologist at Newcastle University, is researching severe manifestations of the hereditary illness ichthyosis.

There are several kinds of ichthyosis, but they all include the formation of irritated, scaly skin.

Ichthyosis can be inherited or acquired throughout life. The hereditary types are uncommon, usually appear in infancy, and are usually lifelong diseases. Acquired ichthyosis can occur at any age as a result of a variety of medical conditions, including renal failure.

Unlike skin disorders such as eczema, which is spotty and comes and goes, ichthyosis is present throughout life and frequently affects the entire body.

Patients with ichthyosis may endure harassment, discrimination, and unpleasant symptoms that are frequently only eased by time-consuming therapies, all of which can have a significant influence on mental health.

Researchers know that hereditary ichthyosis can be caused by DNA mutations that impact skin cells, but they don’t know how these DNA changes cause the skin to become scaly and irritated. In rare circumstances, skin cells develop quicker than they are needed, and they accumulate on the skin’s surface, thickening it.

In some kinds, cells are created at the regular rate, but instead of brushing off as they reach the surface, they are unable to become disengaged from the cells underneath them, causing layers to accumulate (https://www.ichthyosis.org.uk/).

Dr. Rajan will investigate how skin cells in patients with severe ichthyosis differ from normal skin cells, and why the protective barrier in the skin is weakened, in collaboration with Professor Muzlifah Haniffa of Newcastle University and the Wellcome Sanger Institute, and Professor Edel O’Toole of Queen Mary University of London.

He wants to investigate at how the immune system reacts to this weakening in the skin barrier and how this varies across various layers of skin.

Improved Skin therapies

The researchers expect that by doing so, they would be able to detect abnormalities in the skin of ichthyosis patients that may be improved by novel therapies.

To test potential treatments, they will grow skin cells in the lab, which will allow them to see if such drugs are able to ‘treat’ ichthyosis in the lab.

Dr Rajan said: “Adolescence is a time of self-consciousness, self-doubt and exaggerated concern with appearance and physical attractiveness – all of which can make ichthyosis an especially painful experience for teenagers. By studying skin samples taken from ichthyosis patients, we’re hoping to reveal more about the genetics underpinning the condition, which is needed in order to develop much-needed new treatments for adolescents with ichthyosis.”

(This post has been published from a wired news agency with some modifications to the text and headline.)

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