New research suggests that skin disorder-based stigmatization is perhaps unsurprisingly associated with a diminished quality of life and poorer mental health. 

Researchers conducted a cross-sectional, single-visit study that included 1,671 children (57.9% female) across 32 pediatric centers in the U.S. and Canada. Patients were between 8 and 17 years of age with chronic skin disease and one parent. The research team used the Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) Stigma-Skin measurement tool to assess the extent of stigma with child-, caregiver-, and physician-assessed disease visibility, which was also the primary study endpoint. For secondary outcomes, they evaluated severity and reduced quality of life as assessed by Skindex-Teen, depression, anxiety, and poor peer relationships.

According to the results, 56.4% of the study participants reported high disease visibility and 50.5% reported moderate disease severity. In children with chronic skin disorders (primarily acne, atopic dermatitis, alopecia areata, and vitiligo), just 27% had little to no stigma, and 43.8% reported at least moderate stigma compared with children with other chronic diseases. Higher stigma scores correlated with lower quality of life, more depression, more anxiety, and poorer peer relationships. Nearly one-third of parents reported bully of their child. 

"The findings of this study suggest that physician assessment of disease severity and visibility is insufficient to evaluate the disease impact in the patient/caregiver," the study authors wrote. "Identifying stigmatization, including bullying, and tracking improvement through medical and psychosocial interventions may be a key role for practitioners."

Source: Paller A, et al. JAMA Dermatology. 2024. Doi:10.1001/jamadermatol.2024.0594