17 September 2025
Global study links atopic eczema to elevated suicide risk
The findings presented at EADV Congress 2025 uncover the hidden mental health toll of AE.
Adults with atopic eczema (AE) are significantly more likely to experience suicidal thoughts, according to new data presented at the European Academy of Dermatology and Venereology Congress 2025.
The international “Scars of Life” study, one of the largest of its kind, surveyed 30,801 adults across 27 countries in 2024.
Of these, 15,223 had physician-confirmed current AE and 7968 without AE served as controls.
Participants with current AE were grouped by age of AE onset – childhood, adolescence or adulthood – and completed a detailed online questionnaire capturing sociodemographic information, self-reported suicidal ideation, severity of itch and skin pain, AE severity and experiences of skin-related stigmatisation.
Findings revealed that 13.2% of adults with AE reported suicidal ideation, compared with 8.5% of adults without AE.
All AE subgroups – whether the condition began in childhood, adolescence, or adulthood – were at increased risk, underscoring the widespread mental health burden.
Several factors stood out. Younger adults under 30 (odds ratio [OR]=1.60) and individuals with obesity (OR=1.29) were more likely to report suicidal thoughts.
Clinically, moderate-to-severe AE doubled the odds (OR=2.01), while pruritus, skin pain and high symptom intensity were also strongly linked.
Psychosocial stressors such as skin-related stigma and sleep disorders further contributed, with mixed insomnia associated with particularly high risk (OR=1.78).
Dr Delphine Kerob, one of the lead researchers said the findings revealed a critical insight from the large-scale study, which sought to “uncover the hidden, long-term impact of living with common inflammatory skin conditions such as atopic eczema”.
“The results highlight that the effects of atopic eczema are more than skin deep, with suicidal thoughts representing a serious and frequent concern that is often overlooked by healthcare professionals,” she said.
“By identifying the main risk factors behind suicidal ideation in this population, we hope this study will help healthcare professionals better recognise and address these challenges, supporting patients’ overall well-being more effectively.”
Speaking to Australian dermatologist and head of the EADV’s Communications Committe Professor Dedee Murrell in a recorded interview released by congress organisers, Dr Kerob elaborated on the strong association between suicidal ideation and sleep.
“In our study, we found that high frequency of sleep disorders, particularly as a combination of sleep onset insomnia and sleep maintenance insomnia, in patients exhibiting this suicidal ideation,” she said.
“We know that there is in the literature, correlations between sleep disorders and depression anxiety as well as increased suicidal ideation.
“So we think that there are some factors that can explain the. Sleep disorders, especially pruritus, as well as anxiety and depression, can be associated with pruritus and with atopic dermatitis.
“I think that we need to really understand these factors that can increase the risk of suicidal ideation and manage them, and include in our assessment of the patients, the sleep disturbance, and also assess whether mental health is at risk or not.”
Dr Kerob said these findings were “just one piece of the results of this very large study aiming at better understand the long term visible and invisible scars of life, of common inflammatory skin conditions such as atopic dermatitis”.
“What we think is that suicidal ideation is a frequent issue that is probably overlooked and that all AD clinical signs, symptoms and their impact needed to be assessed by healthcare professionals to minimise their long-term consequence.
“So our objective is definitely to raise awareness and educate both patients, parents and healthcare.”
Atopic eczema affects more than 200 million people worldwide. Beyond the physical symptoms such as recurring episodes of dry, itchy and inflamed skin, its impact on mental health is being increasingly recognised.
Many patients report experiencing anxiety, depression and social stigma, alongside the daily challenges of managing their condition.
“Looking ahead, we are investigating why suicidal ideation occurs at different rates across countries, which may reflect important cultural differences,” said Dr Kerob.
“At the same time, ongoing analyses from the “Scars of Life” study are enhancing our understanding of what happens beneath the surface in patients with atopic eczema.”
The research builds on a paper in the JAAD Reviews, which looked at the suicide risks across a broader cohort of patients with visible skin disease.
This review explored the intersection between dermatology and suicide, highlighting the psychosocial impact of visible skin conditions and the controversies surrounding treatment-related risks, including isotretinoin and biologic exposure.
They looked particularly at acne, psoriasis, atopic dermatitis, psoriasis, alopecia areata and hidradenitis suppurative – finding all contributed to a high burden of psychological distress, including depression, anxiety and suicidal ideation and attempts.
“Skin conditions, which often present visibly and chronically, are commonly associated with psychological distress,” the researchers wrote.
“In a meta-analysis of 113 studies, prevalence of depression and anxiety were 27.2% and 28.8%, respectively, in acne, psoriasis, and atopic dermatitis (AD) patients.
In a systematic review of 31,641 patients <18-years with chronic skin disorders, including acne, AD and psoriasis, the prevalence of suicidal ideation was 0.45% to 67%, with acne patients having the highest suicide attempt rates (21.9%, OR: 1.83, 95% CI: 1.51-2.22; p < .001).
“Suicidal risk remained even after adjusting for patients previously diagnosed with depression.”
The researchers said observing patient behaviours and listening to verbal cues could provide valuable insights into their mental well-being, allowing dermatologists to identify red flags that may indicate psychological distress.
Expressions of hopelessness, such as statements like “I don’t see this getting better” or “I can’t live with this anymore,” may suggest underlying suicidal ideation,” the authors noted.
“Patients who express social withdrawal by mentioning avoidance of social situations or feeling isolated due to their skin condition warrant close monitoring.
“Additionally, poor self-care, evidenced by neglecting hygiene or abandoning treatment plans, may reflect more profound psychological distress.”
The researchers said suicide risk management was an “essential yet often overlooked aspect of dermatologic care”.
“Patients with dermatologic conditions – particularly those with chronic, visible, or stigmatizing diseases – face unique psychological challenges that may increase their risk of depression and suicidal ideation. Dermatologists are uniquely positioned to identify these risks early, using mental health screenings and observing behavioural cues during patient interactions,” the authors concluded.
“By incorporating mental health assessments into routine dermatologic care, dermatologists can help bridge the gap between physical and mental health for at-risk patients. Effective management strategies, including timely referrals to mental health professionals, crisis intervention, and ongoing support, are crucial in supporting patients’ well-being.”
The EADV Congress 2025 is being held in Paris from 17-20 September.
