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The positive effects of habit reversal treatment of scratching in children with atopic dermatitis: a randomized controlled study
Author(s) -
Norén P.,
Hagströmer L.,
Alimohammadi M.,
Melin L.
Publication year - 2018
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.16392
Subject(s) - atopic dermatitis , scratching , medicine , dermatology , randomized controlled trial , atopy , habit , allergy , surgery , immunology , psychology , physics , acoustics , psychotherapist
Summary Itching is a main symptom signs of eczema, including the type called atopic dermatitis which is common in children. People often scratch their skin in response to the itching but this only gives temporary relief, and scratching may cause skin damage and infections. Studies of adult patients have shown that reducing scratching can lead to less inflammation and improved healing of the skin, so ways of reducing scratching can be of benefit to eczema patients. Scientists have discovered that the early relief of the itch by scratching serves to reinforce the behaviour, which becomes habitual or compulsive. After a while, scratching behaviour becomes involuntary and automatic. This means that a significant amount of scratching has become a habit, and not necessarily directly in response to itching. One way of reducing this type of habitual scratching in adults is called habit reversal treatment, and this study looked at whether habit reversal, adapted for parents and their children, in combination with a potent steroid cream (which is a normal treatment for eczema), would offer a better outcome in the treatment of scratching and eczema in children compared to the steroid alone. The primary outcome, meaning how they measured the treatment success, was a scoring system called SCORAD that looks at the eczema's severity, the secondary outcome was CDLQI score, which is a questionnaire looking at quality of life (with lower scores indicating less negative impact on quality of life). The treatment of scratching with the HR method in combination with a potent steroid was found to significantly improve both SCORAD and CDLQI after 3 and 11 weeks.