Children as young as three-years-old begin to notice differences about others (Chernyshov, 2016) and react to these differences. Sometimes, they are just curious and no harm is intended. Sometimes bullying follows. Bullying can occur in the form of verbal, physical, social or psychological taunts that are harmful, repetitive and involve an imbalance of power. It can occur directly or through electronic means in the form of cyberbullying. Teasing is generally described as more “playful” or “joking” but not necessarily any less hurtful than bullying (Magin et al, 2008).
Teasing/bullying often occurs when someone is viewed as appearing or behaving differently than their peers. Unfortunately, eczema is typically very visible and those with eczema may be identified as being “different” before one even gets to know them.
Many studies have looked at how teasing and bullying based on appearance affects people physically and mentally. Some show that bullying/teasing negatively impacts one’s level of self-consciousness, self-image, and self-esteem (Magin et al, 2008). Others identified reduced quality of life and more frequent depression (Halvorson et al, 2014). Still others showed increased anxiety levels and social phobias (Stawser, Storch, Roberti, 2005), feelings of loneliness, and decreased contact with friends (Forero et al, 1999). One study (Fattori et al, 2015) assessed bullying in the workplace and found a substantial impact on quality of life and productivity independent of the individual’s underlying medical condition.
Clearly, this isn’t true for every person with eczema. At least one study (Absolon et al, 1997) looking at stigmatization found that increased psychological disturbance rates were significantly higher only for the children with moderate and severe atopic dermatitis. Another (Halvorson et al, 2014) found that an association between atopic dermatitis and depression/anxiety/suicidal thoughts was only present when significant itch was also reported.
So what can be done?
- Don’t overlook the importance of consistent skin care to keep the eczema as well controlled as possible. This allows one to physically feel better, sleep better and itch less — all of which positively impacts mood and coping abilities. In addition, less visible eczema and scratching may help them stay off a bully’s radar.
- Model beneficial ways of engaging others (even when they are rude or insensitive).
- Practice scenario-based responses so that you/your child have the words/actions necessary to stand up to bullying.
- Don’t let eczema be the focus of your child’s identity. Help your child explore their strengths and become a well-rounded and confident person.
- Involve others. It’s never too early to start educating peers, neighbors, teachers and others, about eczema and how it impacts your child. Young children, while understanding differences, are much more accepting once they are educated. Therefore, the friendships established early on will often provide support, encouragement, and education to others throughout your child’s formative years. For older children and adults, you may find you have to repeat this in multiple situations; with new coaches, managers, or work teams.
- Ask your child directly if they have been teased, bullied, ostracized/left out, or hurt by others. Children often don’t report bullying so if you don’t ask, you may not know.
- Get involved with the school and their antibullying curriculum.
- Know your resources. Whether it’s accommodations through a 504 plan at school or workplace modifications through Human Resources (HR) there are services and supports available to help you be successful.
At National Jewish Health, we have found that using a multidisciplinary approach changes the focus to the “big picture” of physical health, emotional well-being and impact on family; which increases quality of life for all involved. Creating your own multidisciplinary care team for your child can be very effective. It’s important that this team communicate with one another and work together to treat you/your child with an integrated approach. This may take some extra work up front but is well worth it in the long run.
Jennifer Moyer Darr, LCSW is the Manager of Outpatient Behavioral Health Services at National Jewish Health in Denver, Colorado. For the past 12 years she has provided clinical services to children and families living with eczema, asthma, food allergies, and other chronic illnesses.
Absolon C, Cottrell D, Eldridge S, Glover M (1997) Psychological disturbance in atopic eczema; the extent of the problem in school aged children. Br J Dermatol. 137(2): 241-245
Chernyshov, P (2016) Stigmatization and self-perception in children with atopic dermatitis Clinical, Cosmetic, and Investigational Dermatology 2016:9 159-166
Fattori, L et al (2015) Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronical Medical Conditions. Re- search article Hindawi Publishing Corporation BioMed Research International; Vol 2015 Article ID 708908
Forero, R et al (1999) Bullying Behavior and psychosocial health among school students in New South Wales, Australia: cross sectional survey Br Med J 319: 344-8
Halvorson, J et al (2014) Suicidal Ideation, Mental Health Problems, and Social Function in Adolescents with Eczema: A Population-Based Study. Journal of Investigative Dermatology 132, 1847-1854
Magin, P et al (2008) Experiences of appearance-related teasing and bullying in skin diseases and the psychological sequelae: results of a qualitative study Scand J Caring Sci; 22; 430-436
Stawser M, Storch E, Roberti J (2005) The Teasing Questionnaire-Revised: measurement of childhood teasing in adults. J Anxiety Disord; 19; 780-92
First published in The Advocate Fourth Quarter 2016 (Volume 29 Number 4 Year 2016)