Adolescent Perspectives on Eczema Treatment

posted 29 Jun 2018, 12:49 by Damian Wood
Kosse and colleagues from Utrecht in the Netherlands have outline young people's views on eczema treatment. They report that Adolescents were in general satisfied with the efficacy of the treatment, however they prefered a faster and more persistent effect. Almost all adolescents developed their own routine in using topical treatment, which often deviated from the proposed medication regimen by the physician. 

In general, they used topical corticosteroids more and longer than prescribed; half of the adolescents used topical corticosteroids every day and did not (always) use emollients or moisturizers on a daily basis. Some of the patients with abundant topical corticosteroids use reported thinner skin as a side effect, however they continued using it. The main reason for everyday use was the (lack of) efficacy when using less. Limited time, forgetting, and indifference were also mentioned as factors for aberrant use. In our study, the adolescents had a lack of knowledge about the treatment and incorrect beliefs about the mechanism of action. Negative experiences with the treatment were stickiness, bad odor, and itchy/burning feeling. The application of topical treatment was not time consuming, ranging from a few to 10 minutes; however, adolescents mentioned that the dermal absorption was slow and did not always fit with their busy schedules, eg, rushing in the morning to get to school.

Most adolescents had little contact with their physician and the advice on how to use topical corticosteroids (in combination with emollients or moisturizers) differed between clinicians; general practitioner, dermatologist, and pharmacist. Some adolescents (with less severe symptoms) visited a physician only once and received repeat prescriptions without a physician visit, whereas others regularly visited their dermatologist or general practitioner. Most adolescents forgot the information they received at the start of treatment; however, at the time of the focus group they did not feel a need for additional information.

Mainly practical issues were mentioned as suggestion to improve treatment: a faster dermal absorption; oral treatment; test samples; a demonstration on how to use topical corticosteroids at the start of treatment; follow-up visits with the physician, in particular at start of treatment; shorter (digital) information leaflet; other packaging (jar or plastic tube); and (online) contact with peers was preferred during early adolescence.