Under the Microscope: Eczema in Hispanic Children in Texas

The National Eczema Association (NEA) is the largest private nonprofit funder of research for adult and pediatric eczema, investing more than $4 million to date. Ever wonder what exactly our research grant recipients are working on? Under the Microscope is where we provide an inside look at research from one of our latest grant recipients, including what they are studying and its potential impact on the eczema community.

Study unveils new (and surprising) finding about Hispanic children with eczema

There are notable differences in the way that children of different ethnic and racial backgrounds experience atopic dermatitis, the most common type of eczema. The average age of onset, severity of disease and persistence of the disease varies. And while doctors and researchers speculate that a number of socioeconomic and environmental factors may help explain these differences, not all of them have gone through rigorous study.

It was with this gap of understanding in mind that the National Eczema Association and the Pediatric Dermatology Research Alliance (PeDRA) awarded Emily Croce, PhD, a Childhood Eczema Challenge Grant to study the connection between atopic dermatitis (AD) and exposure to air pollution, one of the environmental factors that is suspected of playing a role in the differences between ethnic and racial groups.

Croce, a pediatric dermatology nurse practitioner at Dell Children’s Medical Center and a postdoctoral fellow at both the Dell Medical School and the School of Social Work at The University of Texas at Austin, conducted a year-long investigation of this connection in 2023, and what she discovered in her research was something of a surprise. A different socioeconomic contributor, known as acculturation, had a much larger connection to the rates of AD and severity of the disease, at least in this study population.

The children in Croce’s research all came from one region in central Texas, and while many different racial and ethnic groups were represented, about 55% of the children were Hispanic. Among the study participants, Hispanic children were most likely to have persistent AD.  

“Acculturation refers to the process of adapting to a new culture, and with acculturation comes acculturative stress” explained Croce. “The data showed that something about becoming acculturated to the United States makes eczema outcomes worse for Hispanic children.”

Acculturation is key factor for persistent eczema

Croce’s research was based on data collected from a study at Dell Medical School at The University of Texas at Austin, dubbed the TexHALE study. The study was recently launched to evaluate the associations between exposure to particulate matter in the air and asthma rates among 300 children of different racial and ethnic backgrounds.

The researchers involved in the study also asked questions about eczema, which is commonly found among children with asthma. According to Croce, she expected that acculturation would make a difference in the rates and severity of AD among some children, because stress is a known trigger for AD flares, but did not anticipate that it would rise to the top of the list of contributing factors in this study.

In a practical sense, acculturation stress can refer to many different physical and psychosocial stressors including changes in diet, the quality and location of housing, plus engaging and interacting with new people and customs.

“We expected psychosocial stressors to be a factor because that has been seen before,” said Croce. “But this points to the fact that acculturation and the connection to eczema really needs to be researched more completely.”

Following the data and new findings

Because her NEA-funded research revealed such a strong connection between AD and acculturation among Hispanic children, Croce plans to continue studying acculturation and is currently applying for funding from the federal government to take her research to a new level.

She expects that in the next phase of her research she will tease out more about which factors of acculturation seem to have the biggest effect on AD rates. Ultimately, she hopes that her research will reveal enough information for her to develop interventions that will help ease the eczema burden for this population of children.

“There is still so much more that needs to be understood, but the grant from the National Eczema Association helped reveal an important new avenue of exploration,” said Croce.

NEA grants and their impact

NEA is dedicated to increasing the number of scientists, research projects and research dollars devoted to eczema, in pursuit of better therapies, better care, better outcomes — and one day, potentially, a cure. Learn more about our eczema research grants, their impact and how you can get involved.