Q&A: How Lifelong Burdens Are Shaped by Childhood Eczema, With Delphine Kerob, MD

A recent analysis was published in the Journal of Investigative Dermatology, with data suggesting the impacts of childhood atopic dermatitis may continue to be experienced long after visible symptoms resolve, leaving what Delphine Kerob, MD, describes as an “invisible imprint” on patients’ lives.^1,2

Kerob is the La Roche-Posay International Scientific Director and a dermatologist for Saint Louis Hospital in Paris. In a new interview with HCPLive, Kerob highlighted the lasting consequences of childhood atopic dermatitis on patients’ education, employment, and overall quality of life, regardless of whether the disease persists into one’s adult years. Kerob highlighted the cumulative burden of factors such as chronic pruritus, disruption in sleep, anxiety, difficulties related to attention, feelings of stigmatization, and bullying.

Kerob notes clinicians should view pediatric atopic dermatitis as more than a skin condition and pay closer attention to its psychosocial and developmental impacts. The following Q&A interview includes a transcription of Kerob’s HCPLive interview on this topic:

HCPLive: What do you think is the biggest message from this study for doctors treating patients with atopic dermatitis?

Kerob: I think that's what the big [lesson] of this study is: even though atopic dermatitis doesn't lead to visible scars, it can lead to invisible prints. What we saw in our study is that when atopic dermatitis affects children, the impact, whether atopic dermatitis persists or resolves during adulthood…is very important, that it will leave a print in the life of these people all their life for a lot of them. Having that in mind, we should change the way we see atopic dermatitis in kids, and take more care of the burdens of atopic dermatitis.

[We should consider] what the comorbidities are, for example, such as sleep disorders, anxiety, attention disorders. How are these children living with atopic dermatitis, not only at home but also at school? Are they suffering from bullying? Are they stigmatized because of all of this, on top of the disease itself? It will have an impact that can persist long term, so the main [lesson] is that we need to be very, very cautious with atopic dermatitis in kids, even though we know that most of them will resolve when they are adults.

HCPLive: Why do you think patients who develop atopic dermatitis in childhood seem to face more challenges later in school and work?

Kerob: I think there are many drivers. First of all, they have skin lesions, so it's visible sometimes. Especially if they have atopic dermatitis on some uncovered areas, and we know that skin conditions can lead to stigmatization. We have also published this a lot. So this is the first thing. The second thing is that one of the cardinal signs of atopic dermatitis is itch, and itch can lead to difficulties sleeping or awakenings during the night. It can also lead to difficulties in staying concentrated. Because of all of that, it has an impact, either a direct impact or an indirect impact, along with also the environment, which can be at home or at school.

Also, there is this question of whether it resolves; it's a chronic, relapsing skin disease, so you never know when it will stop, and if it will stop at one point, we know that most cases of atopic dermatitis, starting in childhood, will resolve during adulthood. But some of them will persist. Sometimes atopic dermatitis will start in adulthood, but there is this question mark of when it will stop. In the meantime, they need treatment. Sometimes there might also be fear to treat very atopic dermatitis well, which means that you always have this level of inflammation of the skin lesion or burden of disease that is still there. So, I think this might be one of the reasons why it makes this patient feel a little bit different from people without atopic dermatitis.

HCPLive: How can doctors do a better job talking with patients, either children or adults, about the emotional and social effects of atopic dermatitis?

Kerob: I think that one of the easiest ways really to talk, to discuss, to ask direct questions regarding how it goes at home, how it goes at school, and how the kid can concentrate during classes. How are they? Do they have issues with some kids due to the lesions? Do they have some issues when they go to the swimming pool? Are they afraid of some reactions from their peers? [We need to] explain to the kids, because they like to know their disease, but I think the kids also like to understand where it comes from.

This is because they have to explain that to their friends, and I think it's important that, as healthcare professionals. Not only dermatologists, but all the healthcare professionals surrounding patients and parents of patients with atopic dermatitis need to address these questions and talk and listen to the issues they are facing. The value of these epidemiological studies is that we take time to ask questions and ask people what they feel. We [should] go deep into their feelings, which sometimes they would not take the time to do during a consultation to discuss, because they just want to go straight to the point. It might go fast, but I think we need to encourage the patients to speak.

HCPLive: Atopic dermatitis can be a visual disease, with some peers believing a patient’s disease to be contagious. Do you feel that speaking with such patients regarding such concerns is worth a conversation with doctors?

Kerob: I think that's worth a conversation, first with the kids to explain to them to talk about it again to have this discussion and to tell them, ‘Don't worry, it's not contagious.’ You can reassure your kids, but I think it's also a matter of education of the population that skin diseases are not contagious. At least the non-contagious skin diseases aren’t. There are just a few that are contagious, and sometimes the contagious ones are ones one doesn't see. For example, with scabies, you may not see it even if the patient is contagious…

I think we need to educate the population, especially regarding atopic dermatitis, because, as I said, one of the cardinal symptoms of atopic dermatitis is itch. I think that it goes beyond only what you see; people see the itch, which can also raise questions regarding contagious disease. It's very important that first the kid is reassured; of course, the parents need to be reassured as well, but then the kid can reassure the friends at school. We also need to reassure the population, maybe the teachers, the sports teachers, everyone that surrounds these kids. It's so important, because we see that this [impact] is very frequent.

This permanent print of this disease that may have resolved is permanent for a lot of people. They will have a memory of what happened when they were a kid. We know that, with a psychological analysis, a lot of what we are as adults is also the consequence of what we experienced when we were kids. Sometimes what we experience without putting words to it. So this is why I think that talking is one part of the solution; of course, addressing skin inflammation, skin barrier alteration, and each symptom is also key, but we should not forget the other side, the psychological side.

The quotes in this summary were edited for clarity.

Disclosures: Delphine Kerob is a full-time employee of La Roche Posay Laboratoire Dermatologique and has been employed by Laboratoires Vichy, France, and L’Oreal.

References

1. Scars of life: study shows impact of atopic dermatitis on educational and career choices. EurekAlert! May 28, 2026. Accessed June 3, 2026. https://www.eurekalert.org/news-releases/1129244?.

2. Stratigos A, Steinhoff M, Luger T, et al. Impact of atopic dermatitis on education and career choices: the Scars of Life international study. Journal of Investigative Dermatology. May 28, 2026. Accessed June 3, 2026. https://www.jidonline.org/article/S0022-202X(26)01041-9/fulltext.