Eczema

Eczema

by Sadhana Sharanya Jacob -
Number of replies: 3

I am not entirely sure if I have grasped the idea of this task correctly but here is my attempt! 

There are many social aspects to this condition. Firstly as it is predominantly a childhood condition (which can continue into adulthood) there are the social effects on both parents and children. Babies with the condition are tremendously uncomfortable and agitated and this is communicated through crying, which can be intense and continuous. This is obviously incredibly stressful for parents as they have to see their young in such discomfort and as well as the added difficulty of lack of sleep. This can put a great strain on life and relationships at home; including other children and the partnership of the parents. In terms of the parents, their stress may be carried with them to work and in the same fashion children – be they children with eczema or their siblings carry their stress and possible disturbed sleep to school.

 Interactions with others at school and work are another social aspect of eczema. Many children are bullied by their peers and this has in cases continued into adulthood and the workplace. This may cause them to become socially isolated- an aspect of social health that is thought to be a risk factor for ill health.

Another aspect is the stigma associated with many skin conditions, due to a lack of education and understanding of them. 

In reply to Sadhana Sharanya Jacob

Re: Eczema

by Patricia Greenhalgh -

Yes I think you’re on the right track here. It’s certainly the case that eczema has social IMPACTS, which are exactly as you describe. But your account could go further. Instead of taking ‘eczema’ as a given, factual thing that a child either is or isn’t affected by (the ‘personal tragedy’ framing), you could take a sociological perspective on the aetiology and diagnosis of the condition.

 

There are two issues here. One is the ‘social determinants of eczema’. Hywel Willliams did a study back in 1994 which suggested that eczema is a disease of the ADVANTAGED (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2540131/pdf/bmj00438-0028.pdf).  Someone should put the title of this paper into Google Scholar and see what papers subsequently have either confirmed or challenged this finding.

 

The other issue is whether ‘eczema’ is sometimes socially constructed. Or to express that better, it’s about ‘to what extent is there a socially constructed element to eczema?’. When a mum brings a kid to me with a few patches of inflammation on its face and arms and says “is this eczema, doctor?”, I could say “yes this is eczema, you have an allergic child and here’s a prescription for some emollients”, or I could say “these patches are because babies have sensitive skin, so it’s a good idea to buy soft clothes and bath products that are labelled ‘for sensitive skin’”. The former is a very medicalised way of saying the same thing as the latter, but it also MARKS THE CHILD OUT as having a ‘disease’.

 

Comments? Those who are uneasy about the sociology aspects might like to tell stories about how they handle this kind of condition clinically (or what they'd want in their own child)!

In reply to Patricia Greenhalgh

Re: Eczema

by Deleted user -

When i was in the 5th year of my medical school, during my placement in the psychiatry  ward i have seen a case of atopic eczema.. surprisingly she was admitted in the psychiatry ward..doctors were treating her for depression not for eczema.. but the reason behind her depression was dermatities!!! sleepless nights, tiredness, hopelessness, complicated treatments,social isolation due to embarrassements impaired her psychological function and the financial loss was unbearable for the parents..initially she was treated with mood stabilisers and later trasferred to a dermatologist for further treatment with a weekly counselling session for next 6 months!!

In reply to Sadhana Sharanya Jacob

Re: Eczema

by Joseph Daniel Jameson -

Eczema not only has an impact in childhood and can often persist into adulthood.

The impact it has on individuals is increased due to stigma ofteb attached to many dermatological conditions . It not only affects their self esteem but also affects how they are percieved by others. Some huge assumptions of dermatological disease, like that of them being infective can place huge stresses on both primary health care services (as many of us may have experienced on GP placements here at Barts) and mental health services.

Not only does it have psychological impacts but can have a number of impacts on lifestyle. Huge amounts of time have to be spent moisturising, for example. One GP I was with last year was recommending doing this over 5 times a day. This will have impacts on individuals ability to work, their finances and their social life. 

Both the phsycological and physical effects of this disease can cause individuals affected to take on a 'sick role' and it is fair to say that chronic dermatological conditions, such as eczema, and their mental health implications (eg depression) take up huge amounts of primary care resources.