Scars of life: study shows impact of atopic dermatitis on educational and career choices

Atopic dermatitis (AD), the most common form of eczema, impacts patients’ life trajectories beyond the physical scars. A novel study shows that adults with AD, particularly those with childhood onset, report significantly greater limitations in their educational and professional choices, with up to 38% of childhood-onset patients reporting career restrictions and more than 36% reporting constrained study choices, compared to individuals whose disease began in adulthood. The findings of the new study in the Journal of Investigative Dermatology (JID), published by Elsevier, provide a scientific basis for more comprehensive, early, and multidimensional care that goes beyond symptom control for patients with AD.

AD’s physical symptoms are widely recognized, but its long-term impact on life choices—particularly educational and career decisions—remains underexplored. Growing clinical and patient-reported evidence shows that AD beginning in childhood or adolescence leaves lasting marks beyond what appears on the skin itself.

Prior to this study, previous research was primarily limited to single countries, small groups, or focused only on absenteeism. This cross-sectional observational study, conducted between June and September 2024 as part of the international Scars of Life initiative, is the first large-scale, multinational investigation that quantifies how AD shapes educational and career pathways from childhood through adulthood.

“Data from this global study highlight the multidimensional, long-term burden of AD. In particular, the greater burden for those with earlier onset of the disease and recent availability of more targeted therapy for young children create an imperative for treating early and aggressively for optimal control,” observes JID Section Editor Amy Paller, MS, MD, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.

Researchers analyzed data from 22,833 participants from 27 countries across five continents with current or past AD. Participants completed validated questionnaires on sociodemographic characteristics, AD severity (POEM scale), and psychosocial burden (ABS-A, PUSH-D).

The most significant findings are:

• 27.9% of current patients with AD reported limited educational choices compared to 25.6% of those with past AD.
• 28.5% of current patients with AD reported career limitations compared to 26.5% of those with past AD.
• 41.3% of current patients with AD avoided public contact compared to 35.8% of those with past AD.
• The impact was markedly amplified in childhood-onset patients, where up to 43.5% were forced to adapt their living or working environment, compared to 29.8% in adolescent-onset patients.

“Our findings demonstrate that AD is not merely a skin condition, but a chronic disease with lasting consequences on life trajectories,” explains lead investigator Jonathan I. Silverberg, MD, PhD, MPH, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. “We were struck by the magnitude of the gap between childhood-onset and adolescent-onset patients across nearly all dimensions studied: educational limitations, career restrictions, social avoidance, and workplace discrimination. We were also intrigued by the finding that workplace discrimination was reported at similar rates between current and past patients with AD, suggesting that even after resolution of the disease, its psychosocial legacy persists.”

Marked regional disparities were identified in the findings. India showed the highest impact across all outcomes (e.g., 59.2% reporting limited study choices), followed by Southeast Asia-Pacific and the Middle East-North Africa, while Europe and Australasia reported the lowest rates (21%–23%). “These differences likely reflect variation in disease awareness, healthcare access, and socioeconomic conditions,” notes co-lead investigator Laurent Misery, MD, PhD, Department. of Dermatology, Venereology, and Allergology, University Hospital of Brest, and Laboratoire Interactions Épithéliums Neurone (LIEN), University of Brest, Brest, France.

At a time when chronic disease management increasingly incorporates quality-of-life and life-course perspectives, these findings provide a scientific basis for integrated psychological, academic, and professional support. The investigators recommend the following:

• Dermatologists and pediatricians should proactively screen for educational and professional impact during consultations.
• Educational programs, such as eczema schools (programs to train educators to support students with eczema) could help adolescents make informed choices about their career paths.
• At an institutional level, recognizing the functional limitations caused by AD may justify workplace accommodations or compensatory measures.
• Finally, these data support the development of occupational health policies specifically tailored to patients with AD.

“AD leaves invisible scars. Beyond the itch and the sleepless nights, our data show that this disease silently redirects life choices—from the classroom to the boardroom. We must stop treating AD as merely a skin condition and start recognizing it as a chronic disease with lifelong socio-professional consequences," urges co-lead investigator Charles Taieb, MD, PhD, European Market Maintenance Assessment (EMMA), Patients Priority Départment, and Société Française des Sciences Humaines pour la Peau (SFSHP), Maison de la dermatologie, Paris, France.

"These results confirm what patients have long told us: that the true burden of AD extends far beyond the skin. This international initiative gives us the scale to make that burden undeniable," adds Delphine Kerob, MD, dermatologist in Saint Louis hospital in Paris and Scientific Director at La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France.

Reference:

Stratigos A, Steinhoff M, Luger T ... Impact of atopic dermatitis on education and career choices: the Scars of Life international study Journal of Investigative Dermatology, 2026; DOI: 10.1016/j.jid.2026.03.037