Eczema is a chronic, inflammatory skin condition. Some research suggests that there may be an association between eczema and certain behavioral issues, such as difficulty completing tasks and controlling the temper.

The most common type of eczema is atopic dermatitis (AD), which affects more than 9.6 million children in the United States. The condition can cause discomfort and make it hard to sleep, potentially increasing a child’s risk of behavioral challenges.

Researchers involved with the Fragile Families and Child Wellbeing Study (FFCWS) recently published data that suggest a link between childhood eczema and challenges at school. The same researchers also traced a link between eczema and delinquent behaviors. However, other factors, including sleep disturbances, likely play a role in the connection between eczema and behavior.

Read on to learn more about the findings of this study and how people can address these factors.

The FFCWS is a long-term research project that has followed 4,898 children in urban cities in the U.S. who were born between 1998 and 2000. The FFCWS researchers interviewed parents of the children shortly after birth and conducted follow-up questionnaires at the approximate ages of 1, 3, 5, 9, 15, and 22 years.

In 2021, researchers who analyzed the data reported a link between childhood eczema and challenges at school.

The study showed that 9-year-old children who had had AD in the past year were more likely than average to have difficulties with the following activities:

  • completing tasks, including keeping things orderly
  • controlling their temper in conflict with peers
  • playing

In addition, 15-year-old adolescents who had had AD in the past year were more likely than average to have:

  • trouble getting along with teachers
  • low school connectedness
  • impulsivity, causing them to say or do things before thinking through the consequences

Children and adolescents with low school connectedness do not feel:

  • happy at school
  • safe at school
  • close to others at school
  • as though they belong at school

In 2022, the same researchers reported in the Archives of Dermatological Research that eczema was linked to “delinquent behaviors” in children and adolescents.

On average, children aged 5 years who had had AD in the past year had high delinquent scores at the age of 9 years. Similarly, those who had had eczema or a skin allergy in the past year at the age of 9 tended to have high delinquent scores aged 15.

The following behaviors and outcomes were more common in children and adolescents with a history of eczema:

  • damaging property
  • cheating on a test
  • fistfight involvement
  • school suspension

Children and adolescents who had persistent eczema throughout childhood had a higher risk of delinquent behaviors than those who had eczema for a shorter period.

More research is necessary to understand why children and adolescents with eczema may have an increased risk of behavioral challenges.

The FFCWS findings suggest that sleep disturbances may play a role. Children and adolescents with eczema who had trouble sleeping had the highest rates of poor behaviors at school.

The authors of a 2018 review report that other studies have also linked sleep disturbances to behavioral challenges in children with eczema. Eczema-related itching and other symptoms can make it hard for children to sleep at night. Insufficient sleep can negatively affect their mood, attention, and energy level.

According to the National Eczema Association, nearly 30% of children with eczema experience disrupted sleep 5 nights or more per week.

Children with eczema also have an increased risk of:

  • bullying and social isolation
  • depression and anxiety
  • attention deficit hyperactivity disorder (ADHD)

These experiences and conditions may affect their behavior at home and school.

To help limit behavioral challenges in children and adolescents with eczema, the FFCWS researchers have called for behavioral interventions in schools.

In a letter to the Editor, they write: “Education of school teachers, nurses, and administrators about AD may enhance psychosocial support for and reduce conflict with students who have AD. Additional research is necessary to confirm these associations and determine optimal mitigation strategies.”

The National Eczema Association encourages parents and caregivers to speak with their child’s teacher about their eczema, including:

  • their treatment needs
  • how eczema-related symptoms and sleep disturbances affect them
  • which activities they may need to limit to manage eczema symptoms
  • which activities they can participate in instead
  • the risk of eczema-related bullying

This information may help prepare the teacher to support the child throughout the school year. Open communication can also help parents or caregivers and teachers work together to address any social or emotional issues that might arise.

In some cases, it may be beneficial to have a formal plan in place to accommodate the child’s needs. In the U.S., this is a 504 plan. Tips for beginning the 504 process are available here.

Treating eczema might help limit behavioral challenges in affected children and adolescents by reducing the symptoms of the condition and improving sleep. To treat childhood eczema, a doctor may prescribe one or more of the following:

  • regular bathing with gentle cleansers
  • regular application of moisturizer
  • bleach baths
  • wet wrap therapy
  • topical medication, such as medicated creams or ointments
  • oral or injectable medication
  • light therapy

If a child is having trouble sleeping due to eczema symptoms, a parent or caregiver should let a doctor know. They should also speak with a doctor if they suspect that the child might have anxiety, depression, or another mental health condition. The doctor may recommend changes to the child’s treatment plan or refer them to a specialist for care.

Childhood eczema can cause uncomfortable symptoms, which may make it hard to sleep. Sleep disturbances can negatively affect a child’s mood, memory, and attention.

Eczema can also increase the likelihood of bullying, social isolation, or mental health symptoms. These factors may contribute to an increased risk of behavioral challenges among children and adolescents with eczema.

Anyone with concerns about a child’s eczema, sleep quality, or behavior should speak with a doctor. The doctor can help identify the underlying cause and recommend treatments or management strategies.

It can also be helpful to seek out a mental health professional who can help address challenges such as sleep issues and managing a pediatric chronic illness. Taking a holistic approach can help break the cycle.