Dr Eva Parker Discusses the Nexus of Climate Change, Atopic Dermatitis, and Mental Health

Mental health is an underrepresented issue in dermatology even though numerous skin diseases are associated with mental health diseases, said Eva R. Parker, MD, associate professor of dermatology at Vanderbilt University Medical Center and president of the Nashville Dermatologic Society.

In addition, climate change is having an important impact on and exacerbating both atopic dermatitis and mental health conditions. In recent research, Parker and her colleagues found climate change is exacerbating the environmental triggers of atopic dermatitis and amplifying comorbid mental health conditions, such as depression, anxiety, and trauma-related disorders.¹

Transcript

You've written about the nexus of climate change, atopic dermatitis, and mental health. Can you explain why it's important to look at all 3 of them together?

I would say just in general, when you look at inflammatory skin diseases, they often have numerous comorbidities: cardiovascular disease, diabetes and metabolic syndrome, mental health issues, liver and kidney disease. That's not unique to atopic dermatitis. We see similar associations with psoriasis and hidradenitis suppurativa. But when we think about how climate change impacts other organ systems, as well as impacting the skin, it really is a double hit.

I chose to focus on mental health because I think it's an issue that is underrepresented in dermatology, numerous skin diseases have associated mental health diseases. And when one flares, the other may flare, and climate change has really important impacts on both atopic dermatitis, as well as exacerbating underlying mental health disease.

What can we attribute to the idea that when the skin condition flares, the mental health condition also flares?

Certainly, it can be the fact that if skin diseases flaring, that's something that is outward and obvious to other people. And so, it can be an issue of self-esteem. People can begin to feel alienated and isolated as a result of their skin disease. But in addition, there are often biochemical reasons as well. The same inflammatory cytokines that flare skin disease have also been implicated in the pathogenesis of certain mental health disorders.

Reference

Kam S, Hwang BJ, Parker ER. The impact of climate change on atopic dermatitis and mental health comorbidities: a review of the literature and examination of intersectionality. Int J Dermatol. Published online January 14, 2023. doi:10.1111/ijd.16557