Giving young eczema sufferers a ‘healthier, happier future’

Often beginning before the age of two, eczema can have a profound impact on a child’s quality of life. Frequently, the persistent itching leads to chronic sleep disturbance, which over time can disrupt memory, concentration, and mood. For young people, this often translates into challenges at school, increased anxiety, depression, and social withdrawal.

Professor Carsten Flohr and his team from King’s College London and Evelina London Children’s Hospital are working alongside collaborators from the universities of Surrey, Oxford and Copenhagen. The team are exploring the links between eczema, sleep, and mental health in children and adolescents – research which could pave the way for vital new treatments.

Long-term effects of sleep disturbance

As a clinician at Guy’s and St Thomas’ Hospital, Carsten has supported children of all ages living with eczema.

“In my clinic I’m very often confronted with teenagers who are half-asleep as I’m talking to them,” Carsten explains. “The disrupted sleep and body clock often go back to infancy, with these children never establishing a proper day-night rhythm.”

Not only are the young people affected, but their families and carers are too – who often struggle with the restricted treatment options available for their loved ones. “I sometimes get videos from parents filming their child scratching in their sleep,” he says.

The implications of eczema on sleep have been understood for a long time. Past studies have tracked the impact of night-time scratching using movement monitors, but they haven’t explored what’s happening beneath the surface, including the brain.

Research highlights a striking connection between sleep disturbance and mental health issues. For example, children with eczema who sleep poorly are 40 to 50% more likely to have ADHD than those without eczema.

Exploring what’s going on at a deeper level

While past research has linked eczema to sleep problems, Carsten noticed a significant gap in the research landscape. Previous studies had not yet drilled down into the finer connections that may exist between skin inflammation, sleep disturbance, and possible inflammation elsewhere in the body, such as the brain or the blood.

To help fill this knowledge gap, Carsten has built a diverse team of experts spanning multiple disciplines, including specialists in children’s sleep medicine and circadian rhythms, and researchers from the King’s College London Institute of Psychiatry, Psychology and Neuroscience, who specialise in the links between systemic inflammation and brain inflammation.

With the Foundation award, Carsten has been able to, as he describes it – “bring the modern sleep lab into the home”, using multiple small devices to monitor a range of indicators in children with eczema, allowing them to measure brain activity, heart rate, respiratory rate and movement.

The study focuses on 12- to 18-year-olds. By linking MRI scans with sleep data, the team is uncovering how eczema-related inflammation may be affecting brain function.

A path to new therapies

Carsten is hopeful this research could help lay the groundwork for new therapies for children with eczema. He offers the example of neurofeedback – a therapy that uses real-time monitoring of brain activity to help regulate brain function and improve sleep and wellbeing.

“Sleep disturbance is torture,” says Carsten, “Eczema is a serious disease if you’ve got it severely, and the impact on people’s quality of life must not be underestimated.”

The implications of sleep disturbance in the early years can last well into adulthood, impacting patients’ mental health and workplace performance.

By uncovering how eczema, sleep, and brain inflammation are connected, Carsten’s research could lead to new therapies.

Thanks to you, this vital work is making a real difference – giving young people the chance of a healthier, happier future.