College joins call for national eczema strategy

The ‘poor cousin’ of other allergic and immune system diseases is one of the 10 most common health conditions in Australia.

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The Australasian College of Dermatology has thrown its support behind a push for the development of a national eczema strategy.

The strategy calls for a number of changes, including measures to address the national dermatology workforce shortage and lack of training for GPs, and the establishment of an eczema registry.

College president Dr Adriene Lee penned the foreword in a new 36-page report providing evidence for the strategy, saying she welcomed the opportunity to “shine a spotlight on this common and often under-recognised condition”.

“For many years, eczema has been the ‘poor cousin’ of other allergic and immune system diseases when it comes to recognising and addressing its impact,” she wrote.

“While many living with the condition hide it and suffer in silence, it presents a heavy burden both on patients and Australia’s health system. This report seeks to bring eczema out of the shadows and to show that Australia can, and must, do better.”

Eczema Support Australia joined forces with an expert advisory group representing nurses, psychologists, and GPs, and supported by the ACD to produce the report, titled The Burden of Eczema – Evidence for a National Strategy.

It found eczema affected up to three million Australians, including one in three children aged six years or less. This makes it one of the 10 most common health conditions in Australia.

Dr Lee said the report highlighted the “profound impact” of the disease on everyday life.

“As dermatologists who support thousands of Australians with this condition, we can attest to the distress and pain caused by severe eczema and the domino effect this can have on other aspects of life,” she wrote.

“We also endorse the report’s finding that there is a nationwide shortage of dermatologists, with just over 600 dermatologists to meet the skin health needs of 26 million Australians, and limited levels of dermatology education in medical schools and in general practice, where the majority of people with the condition are managed.”

The report revealed eczema costs the Australian economy some $4 billion every year.

Adults with eczema are three times more likely to suffer depression than those without the condition, and more than one-in-five adults with eczema consider suicide, yet only 3% of impacted adults reported receiving information about psychological help from their GP.

Each year, Australians incur up to $336 million out-of-pocket costs for medical visits, plus a further $1.2 billion for medications, emollients, special food and clothing to manage eczema, the report revealed.

The report makes a raft of recommendations for the delivery of a dedicated national eczema strategy. This is the wish list:

• Standardise care to end treatment maze.
• Address steroid phobia which leads to eczema flare-ups.
• Prevent hospitalisation and manage comorbidities.
• Ensure equitable access to treatment.
• Increase health literacy through patient education.
• End isolation via government funding to Eczema Support Australia.
• Bolster dermatology training for GPs, nurses, and Aboriginal health workers.
• Improve transitions from paediatric, adolescent to adult care.
• Address dermatologist shortage (only 2.3 specialists per 100,000 Australians).
• Establish an eczema registry.

Eczema Support Australia managing director Melanie Funk said that the report “should act as an SOS call to government to establish a national eczema strategy to urgently address the suboptimal treatment of eczema”.

“As a mum with twin boys diagnosed with eczema 14 years ago, it was shocking to me how little support and patient education there was, made all the worse because eczema never sleeps – so neither does anyone dealing with eczema,” she said.

“Fast forward 14 years and nothing has changed. We hear the same cry for help repeatedly from those contacting us, who are driven to desperation by pain and exhaustion. Many do not have timely access to specialists, and many suffer from a huge variation in care across Australia.

“For a condition that is so common and requires such a high level of self-management, it is truly shocking there isn’t more support and education, and so many are lost in a treatment maze.”

Eczema Support Australia has written to the Federal Health Minister and Department of Health and Aged Care to share the report’s findings and to seek their support for establishing a national eczema strategy.

The organisation has also formalised its call via a petition to the House of Representatives. The e-petition closes tonight (6 September). More than 1300 people have already signed the petition.

Dr Lee said a coordinated response would go a long way to ensuring all Australians with eczema have optimal and equitable access to treatment and care, “which is why the college has no hesitation in supporting this report – and the evidence for a national eczema strategy”.

“The widespread underuse of topical corticosteroids due to ‘steroid phobia’ has long been a concern of the College but without a coordinated effort to change these perceptions using evidence-based information, Australians will continue to experience avoidable and unnecessary severe disease flares,” she said.

“As well as education and awareness raising for general practice and pharmacy, it is also critical to ensure access to specialist care by addressing the dermatology workforce shortage through federal and state investment in dermatology services and training.”

To sign the e-petition calling for a national eczema strategy, see here.