Study reveals international impact of AD on career, academic success

Photo by James Heilman, MD via Wikimedia Commons

New research shows that adults with atopic dermatitis (AD), particularly those with childhood onset, report significantly greater limitations in their educational and professional choices. Investigators found that up to 38% of childhood-onset patients reported career restrictions and more than 36% reporting constrained study choices, compared to individuals whose disease began in adulthood. The authors say their findings, published in the Journal of Investigative Dermatology, provide a scientific basis for more comprehensive, early, and multidimensional care that goes beyond symptom control for patients with AD.

This cross-sectional observational study, conducted between June and Sept. 2024 as part of the international Scars of Life initiative, is the first large-scale, multinational investigation that quantifies how AD shapes educational and career pathways from childhood through adulthood.

Researchers analyzed data from 22,833 participants from 27 countries across five continents with current or past AD. Participants completed validated questionnaires on sociodemographic characteristics, AD severity (POEM scale), and psychosocial burden (ABS-A, PUSH-D).

The most significant findings are:

• 27.9% of current patients with AD reported limited educational choices compared to 25.6% of those with past AD.

• 28.5% of current patients with AD reported career limitations compared to 26.5% of those with past AD.

• 41.3% of current patients with AD avoided public contact compared to 35.8% of those with past AD.

• The impact was markedly greater in childhood-onset patients, with up to 43.5% forced to adapt their living or working environment, compared to 29.8% in adolescent-onset patients.

  
  

“Our findings demonstrate that AD is not merely a skin condition, but a chronic disease with lasting consequences on life trajectories,” said lead investigator Jonathan I. Silverberg, MD, PhD, in a press release. “We were struck by the magnitude of the gap between childhood-onset and adolescent-onset patients across nearly all dimensions studied: educational limitations, career restrictions, social avoidance, and workplace discrimination. We were also intrigued by the finding that workplace discrimination was reported at similar rates between current and past patients with AD, suggesting that even after resolution of the disease, its psychosocial legacy persists.” Dr. Silverberg is an Associate Professor of Dermatology at the George Washington University School of Medicine and Health Sciences in Washington, DC.

The authors identified marked regional disparities in the findings. India showed the highest impact across all outcomes (e.g., 59.2% reporting limited study choices), followed by Southeast Asia-Pacific and the Middle East-North Africa. In comparison, Europe and Australasia reported the lowest rates (21%–23%).

The investigators recommend the following:

• Dermatologists and pediatricians should proactively screen for educational and professional impact during consultations.

• Educational programs, such as eczema schools (which train educators to support students with eczema), could help adolescents make informed choices about their career paths.

• At an institutional level, recognizing the functional limitations caused by AD may justify workplace accommodations or compensatory measures.

• Finally, these data support the development of occupational health policies specifically tailored to patients with AD.